高压氧治疗时的禁忌症及副作用.ppt

CONTRAINDICATIONS to Hyperbaric Oxygen TherapyTe-Chun HsiaHyperbaric Oxygen Therapy CenterChina Medical College Hospital Absolute contraindications§Untreated pneumothorax lthe volume changes that take place in the pleural space, the air doubling or tripling in volume as normal atmospheric pressure is approachedlbe relieved surgically before pression or chest tube is made readyAbsolute contraindications§itant administration of doxorubicin or cisplatin as chemotherapeutic agents for cancer. lHBO and doxorubicin given together has caused death in rats (probably from cardiac toxicity), and cisplatin with HBO weakens the tensile strength of healing wounds in contraindications§Disulfiram lblocks the production of superoxide dismutase(a protective antioxidant)Premature infants§Retrolental fibroplasia§Full-term babies may be safely treated with HBO§Babies may require papoose restraints, and young children may need mild sedation. Premature infants§HBO treatment of pregnant women might stimulate premature closure of the patent ductus in the fetus have been mitigated by research in the Soviet Union in which women in all stages of pregnancy, when treated with HBO, produced normal children§Overriding need to treat a pregnant patient; eg, in carbon monoxide poisoning (where the fetus suffers much more than the mother) or gas gangreneRelative contraindications§History of spontaneous pneumothorax §Previous thoracic surgery §Severe emphysema with CO2 intoxication, removal of the hypoxic drive may cause respiratory arrest. § Upper respiratory infections may make it difficult for the patient to equalize pressure in the ears and sinuses; decongestants are indicatedRelative contraindications§History of middle ear surgery for otosclerosis, a wire or plastic strut might be displaced if patient cannot equalize pressure in the ears; tympanostomy tubes needed. §Seizure disorders may increase susceptibility to O2 seizures, and additional premedication (eg, with diazepam) may be