OT medical question

My brother(age 57) has gone through three very scary days after a staph infection went ballistic and entered his blood stream, which put him into emergency surgery, kidneys shutting down, heart function diminishing, 50/50 chance of death. Glad to report he is improving now, still too soon to say he is out of the woods, but getting better. From talking to my nephew, he was saying that the doctors had put him in a hyperbaric chamber, and that had greatly improved his survival chances question is this: What does a hyperbaric chamber do? I know it has to do with enclosing the patient in a pressurized 100% oxygen chamber, but how does that help the body heal itself?

Dale Nelson

This might be part of it:

".... greatly aids the treatment of infection by enhancing white blood cell action and potentiating [I think that means getting the most from] germ-killing antibiotics."

From: http://drcranton.com/hbo.htm

You might find more to read here:
http://www.google.com/search?hl=en&q=hyperbaric+chamber&btnG=Google+Search

Good luck to you and your brother.
Roger

Many types of bacteria are anaerobic - meaning they thrive in an environment lacking oxygen. So by placing the patient in a hyperbaric chamber, which "forces" oxygen into the blood stream and deep into other tissues (because the oxygen is at 2-1/2 to 3 times normal 14.7 lbs/sqin) the oxygen enriched environment kills off the anaerobic bugs.

Stan

Access DB is correct. By forcing pure oxygen into the tissue and other vital organs, the anaerobic bacteria are not as likely to thrive. The chamber also lets the rest of the body kinda recuperate by giving the heart a chance to not work as hard yet achieve optimun oxygen saturation (o2 sat.*side note-- I'm sure you noticed the little thing that is over the end of one of his fingers and has a red light under it. This is constantly measuring his o2 saturation. --)
This happens because pure 02 is forced to bind with the hemoglobin (all part of the RBC's composition) which carries the fresh 02 to all the vital organs. So, you see, there is a double benefit. But, the primary reason has to do with anaerobic bacteria not being able to live in a o2-rich environment.
Which staph bug did he acquire? MRSA? This is one of the "superbugs" we have created due to our over use of antibiotics!! Unfortunately many of the bugs we once thought were eradicated are now coming back with a vengeance and more dangerous than ever before.
I hope your brother makes a full recovery. Hospitals are very good at treating these conditions as they are becoming all too familiar.
BTW, I am in the medical field which is why I felt I could help a little.

With a hyperbaric chamber they have to monitor the oxygen levels very carefully. They don't just pressurize you to 2 or 3 atmospheres with 100% oxygen. That would kill you. 100% oxygen can be fatal over 2 atmospheres and certainly over three.

I just saw a report the other day about the staph and other superbugs. They are present in just about every hospital now. But the good thing is that the staff at the hospitals are more aware and catch the symptoms earlier which increases your chances of surviving the infection.

Dale, sorry to hear about your brother. I'm pulling for a 100% recovery for him.

Les

First staph is a facultative anaerobe. It will survive in the presence or absence of oxygen. Our blood is one of the most "oxygen rich" environments in out bodies. Aerobic/Anaerobic bacterial infection and sepsis secondary to it is a much more complex problem than simply provide oxygen. Most patients are sick enough to require assisted ventilation, an if you want to increase oxygen saturation in the blood, this is the more common way it is done. In fact, Oxygen is quite toxic to our systems in high dose, hence our drive to keep the inspired percent oxygen delivered less than 50% (we will use 100% in for small durations, or when the patient requires it, however if required, esp in setting of sepsis this is very bad.) The high oxygen concentration is given not to "kill bacteria" but to provide end organ perfusion/oxygen. Interestingly once sepsis sets in one of the common findings is a decrease in oxygen extraction. The oxygen is provided but the tissues wont use it. Sepsis, and the bodies response to it is not so much the bacteria, rather the toxins produced by the bacteria, both while alive, or after the bacteria has been "killed." Meaning, the endo/exo toxins are liberated (also bacteria variations) also upon the killing of the bacteria. This causes a huge inflammatory response, the body ..for lack of a better term..almost overreacts to the toxin. If hyperbaric oxygen does help it wont be because of the blood concentration of oxygen as we control that now, rather it may improve end organ delivery of oxygen. It may also improve some antibiotic delivery (depends on the antibiotic.) Also be careful what you read. Most information regarding the use of hyperbaric oxygen are not from double blind, prospective trials, rather case reports and retrospective reviews. Sadly one of the major contraindications to hyperbaric oxygen is acidosis. Unfortunately acidosis is quite common in sepsis secondary to the perfusion issues mentioned above. I'm glad your brother is on the mend. Would hyperbaric oxygen helped? If a facility was available that the unit monitors/pumps/ventilator and he had the required support services available (needing most likely and open chamber, for RN/MD/resp therapy, etc to still be able to function.) And he did not meet any of the exclusion criteria, and the risk of complications, as mentioned in the link provided, from small amounts of barotrauma to seizure/embolism.=death were considered, it could be used. As to would it have helped, at this point we don’t know if it would help or hurt.
A better review of hyperbaric oxygen can be seen here.
http://www.emedicine.com/plastic/topic526.htm
scott

All I can say is that my dad went through all that stuff about 10 years ago now, it started with Pancreatitis with severe bleeding, took to the ER. They ended up operating, then sent him to UPMC hospital because this one couldn't handle it. Then he got infections, those ones that are resistant to antibiotics. Then it turned into a mess, they said about 10% survival as bad and as many problems as he has. He was about 53 when it happened. Heart rate was 150+ BPM for weeks, on a ventilator for weeks at a time. 90% of his pancreas was gone, took out much of his intestines due to severe damage, probably had 20 surgeries over that 2 years.
But, he is just fine now, Not even diabetic like they basically guaranteed that he would be, and said he would have to take pills to digest his food, and have all kinds of problems.
But now he is just fine, goes to work every day, doesn't take one pill except some Beano sometimes, and is just fine. You would never know anything happened except for the crater left in his stomach from all the surgeries.
But he was in one of those oxygen chambers, so they must help, something sure did. Those resistant strains can be tough.

I am glad to see that he is doing better though. It sounds like he is getting out of it, there can still be ups and downs, but improvement is always a good sign.

If your brother got the Staph infection before he was hospitalized, and he wasn't living or working in a nursing home, he is considerably less likely to have a multiple-antibiotic resistant organism. Hopefully he has a garden-variety Staph that is sensitive to the Methicillin category of antibiotics.

BluegrassMD

I appreciate all the well-wishings and the distilled-down explanations of hyperbaric chambers. I knew if I googled it, I would find more info than I could read in a week , and I knew there were medical professionals who frequent this site who would have all I needed to know. I remember the first time I heard of hyperbarics, it had to do with Michael Jackson, figured they were some weird thing he would use But whether they really work or not, I will leave to researchers and thank the lord that it seems to have worked for my brother.

My brother had spinal fusion surgery back in June, we have been speculating if a staph infection could sit and fester for that long before it attacks?

Dale Nelson

Wow, June- that's a long time, but I suppose it's a possibility. Your infectious disease specialist might be able to tell you more. I've heard tales of these things lying "dormant" for years on end, but it's pretty rare. You would almost always see an infection at the surgical site, too. Maybe plastikosMD can offer input? I am not directly connected to infectious disease, so it's a little out of my arena. BGMD

It is a very good question and yes it is possible, staph (there are a couple of species) do enjoy sitting on hardware, heart valves, etc. Chicken and egg, secondary infection of the hardware is also possible with his bacteriema (bacterial in the blood.) Most likely tho the hardware is fine. Close monitoring, repeat negative blood cultures, lack of reaction at hardware site are all encouraging signs. Also regarding community aquired staph infections, in the past the exposure to a "hospital setting" was a risk for MRSA exposure (and still is) however we are seeing a HUGE increase in community aquired MRSA. Weekly I admit patients with soft tissue infections, boils, abcesses etc...with community aquired MRSA, (much to the dismay of the ID service) all without exposure to "hospitals." We treat all staph infections as MRSA until proven otherwise.
scott

A previous post is correct. The pressure is raised slowly, lowered even slower to avoid decompression sickness (the bends) and other problems.

Many, if not most, technicians operating these chambers are former Navy Master Divers, often from the Hospital Corpsman rate.

Another use for these chambers is to help kids suffering from the effects of sickly cell anemia. It is heart rendering to see a young child in deep pain undergo a little oxygen pressure. You can see the pain just melt away and usually the child falls almost instantly asleep being weary from fighting the pain.

My brother had spinal fusion surgery back in June, we have been speculating if a staph infection could sit and fester for that long before it attacks?

Click to expand...

Apparently so, A guy at work has been fighting one on and off that occurred at the time of a knee replacement some years back.

The doctors say it has been sitting hidden in the area of the replacement and flaring up from time to time. Apparently whatever antibiotics ARE effective cannot reach it where it hides.

He needs the replacement replaced, but they are afraid to do it in case the infection gets out of hand as a result.

It's a mess.

One question.... Are these bugs heat sensitive? before antibiotics, it was not uncommon to use heat to fight infections, because so many of the "bugs" are adapted to work only very close to body temperature....

I believe the Mayo brothers (Mayo clinic founders) did that a long time ago, and it was done even for some STDs, with varying results.

Hyperbearic chambers... now, that's gotta be Goldilocks worst nightmare!

(Sorry, I couldn't resist)...

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Good that he's getting better... and I hope things keep improving.

Something else that they used to do way back when, is colloidal silver. My understanding of it is that it's highly toxic to bacteria (and viruses, too - but to what extent, I don't know), but that it was largely discontinued in favor of penicillin (which is much easier to handle, and at least initially more effective - colloidal silver doesn't like to stay that way, and tends to react to ionic silver, which I understand is much less reactive to bacteria). IIRC, silver nitrate solution is still used as eye drops...

Hammerheads comments about silver medical products brings to mind Silvadene® (the generic equivalent is silver sulfadiazine). This is used for serious burns to reduce the chance of infection. Somewhat expensive but well worth it.