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Authors
Abstract(s)
A oxigenoterapia hiperbárica (OTHB) é uma modalidade de tratamento que envolve
a inalação de oxigénio puro (O2 a 100%) a uma pressão ambiente superior à pressão
atmosférica medida ao nível do mar, promovendo a hiperóxia do plasma e dos tecidos.
Os tratamentos são realizados com os doentes a inalar oxigénio puro, alojados no
interior de câmaras hermeticamente fechadas, pressurizadas com ar (câmaras multi-lugar),
ou com oxigénio (câmaras monolugar), a uma pressão superior a uma atmosfera.
Historicamente, a OTHB tem sido utilizada numa ampla variedade de patologias
médicas, incluindo o tratamento da doença de descompressão, embolia gasosa vascular,
intoxicação pelo monóxido de carbono e intoxicação cianídrica, gangrena gasosa por
Clostridioides, infeções necrotizantes dos tecidos moles, osteomielite crónica, feridas
crónicas, lesões induzidas pela exposição prévia a radiações ionizantes, lesões por
esmagamento, síndromes compartimentais, viabilização de enxertos e retalhos músculocutâneos, edema, sépsis, queimaduras agudas, anemia severa aguda, entre outras.
Na gastrenterologia, o uso da OTHB está a emergir como um tratamento
complementar promissor para doenças inflamatórias intestinais e isquemia
gastrointestinal. Esta dissertação explora a eficácia da OTHB na cicatrização de tecidos e
redução da inflamação em distúrbios gastrointestinais e avalia o potencial da terapia para
melhorar os resultados clínicos em pacientes com doença de Crohn, colite ulcerosa e
perfurações gastrointestinais.
Através de uma revisão integrativa da literatura, identificamos estudos que abordam
não só a aplicação da OTHB em contextos gastrointestinais, mas também seu uso bemsucedido noutras áreas médicas. Os mecanismos de ação da OTHB, tais como a promoção
da angiogénese e a modulação da resposta imune, são discutidos no contexto de várias
doenças. Além disso, abordamos as preocupações de segurança, os desafios na
padronização dos protocolos de tratamento e a necessidade de diretrizes clínicas baseadas
em evidências para otimizar o uso da OTHB. Com base nos achados, a dissertação propõe
uma abordagem multidisciplinar para o uso da OTHB em gastroenterologia e destaca áreas
para pesquisa futura que poderão expandir o entendimento e a aplicação desta terapia
promissora.
Hyperbaric oxygen therapy (HBOT) is a treatment modality involving the inhalation of pure oxygen (100% O2) at an ambient pressure higher than the atmospheric pressure measured at sea level, promoting hyperoxia in plasma and tissues. Treatments are conducted with patients inhaling pure oxygen, housed inside hermetically sealed chambers, pressurized with air (multiplace chambers), or with oxygen (monoplace chambers), at a pressure exceeding one atmosphere. Historically, HBOT has been used in a wide variety of medical pathologies, including treatment for decompression sickness, vascular gas embolism, carbon monoxide poisoning, cyanide poisoning, clostridial gas gangrene, necrotizing soft tissue infections, chronic osteomyelitis, chronic wounds, injuries induced by previous exposure to ionizing radiation, crush injuries, compartment syndromes, viability of muscle-cutaneous grafts and flaps, edema, sepsis, acute burns, extreme acute anemia, and many others. In gastroenterology, the use of HBOT is emerging as a promising adjunctive treatment for inflammatory bowel diseases and gastrointestinal ischemia. This thesis explores the efficacy of HBOT in tissue healing and reducing inflammation in gastrointestinal disorders and assesses the therapy's potential to improve clinical outcomes in patients with Crohn's disease, ulcerative colitis, and gastrointestinal perforations. Through an integrative review of the literature, we identify studies addressing not only the application of HBOT in gastrointestinal contexts but also its successful use in other medical areas. The mechanisms of action of HBOT, such as promoting angiogenesis and modulating the immune response, are discussed in the context of various diseases. Additionally, we address safety concerns, challenges in standardizing treatment protocols, and the need for evidence-based clinical guidelines to optimize the use of HBOT. Based on the findings, the thesis proposes a multidisciplinary approach to the use of HBOT in gastroenterology and highlights areas for future research that could expand understanding and application of this promising therapy.
Hyperbaric oxygen therapy (HBOT) is a treatment modality involving the inhalation of pure oxygen (100% O2) at an ambient pressure higher than the atmospheric pressure measured at sea level, promoting hyperoxia in plasma and tissues. Treatments are conducted with patients inhaling pure oxygen, housed inside hermetically sealed chambers, pressurized with air (multiplace chambers), or with oxygen (monoplace chambers), at a pressure exceeding one atmosphere. Historically, HBOT has been used in a wide variety of medical pathologies, including treatment for decompression sickness, vascular gas embolism, carbon monoxide poisoning, cyanide poisoning, clostridial gas gangrene, necrotizing soft tissue infections, chronic osteomyelitis, chronic wounds, injuries induced by previous exposure to ionizing radiation, crush injuries, compartment syndromes, viability of muscle-cutaneous grafts and flaps, edema, sepsis, acute burns, extreme acute anemia, and many others. In gastroenterology, the use of HBOT is emerging as a promising adjunctive treatment for inflammatory bowel diseases and gastrointestinal ischemia. This thesis explores the efficacy of HBOT in tissue healing and reducing inflammation in gastrointestinal disorders and assesses the therapy's potential to improve clinical outcomes in patients with Crohn's disease, ulcerative colitis, and gastrointestinal perforations. Through an integrative review of the literature, we identify studies addressing not only the application of HBOT in gastrointestinal contexts but also its successful use in other medical areas. The mechanisms of action of HBOT, such as promoting angiogenesis and modulating the immune response, are discussed in the context of various diseases. Additionally, we address safety concerns, challenges in standardizing treatment protocols, and the need for evidence-based clinical guidelines to optimize the use of HBOT. Based on the findings, the thesis proposes a multidisciplinary approach to the use of HBOT in gastroenterology and highlights areas for future research that could expand understanding and application of this promising therapy.
Description
Keywords
Aplicações Gastrenterologia Oxigenoterapia Hiperbárica Terapêutica