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  1. Incidence of middle ear barotrauma in staged versus linear chamber compression during hyperbaric oxygen therapy: a double blinded, randomized controlled trial
    Ng AWA, Muller R, Orton J
    Undersea Hyperb Med, 2017 8 5;44(2):101-107.
    PMID: 28777900
    CONTEXT: Middle ear barotrauma (MEB) is common during chamber compression in hyperbaric oxygen therapy. However, little evidence exists on an optimal compression protocol to minimize the incidence and severity of MEB.

    OBJECTIVE: To compare the incidence of MEB during hyperbaric oxygen therapy using two different chamber compression protocols.

    DESIGN: Double-blinded, randomized controlled trial.

    SETTING: Hyperbaric Medicine Unit, The Townsville Hospital, Queensland, Australia, September 2012 to December 2014.

    PATIENTS: 100 participants undergoing their first hyperbaric oxygen therapy session.

    INTERVENTION: Random assignment to a staged (n=50) or a linear (n=50) compression protocols. Photographs of tympanic membranes were taken pre- and post-treatment and then graded. Middle ear barotrauma was defined as an increase of at least one grade on a modified TEED scale.

    RESULTS: The observed MEB incidence under the staged protocol was 48% compared to 62% using the linear protocol (P=0.12, exact one-sided binomial test), and thus the staged protocol did not show a significant improvement in MEB. However, the staged protocol resulted in significantly less severe deteriorations in MEB grades when compared to the linear protocol (P=0.028, exact one-sided Mann-Whitney type test).

    CONCLUSION: The use of the assessed staged compression protocol for the first hyperbaric oxygen treatment showed no significant effect on the overall incidence of MEB when compared to the gold standard linear protocol but resulted in a significant improvement in the severity of the experienced MEBs. Further studies are needed to elucidate an optimal compression protocol to minimize middle ear barotrauma.

    Matched MeSH terms: Barotrauma/etiology*; Barotrauma/epidemiology*
  2. Fulltext Oral bag-valve-mask insufflation technique to remove unilateral friable nasal foreign body in emergency department
    Cheah PK, Ahmed R, Ho CV, Lim CC
    Malays Fam Physician, 2009;4(2-3):91-3.
    PMID: 25606171 MyJurnal
    Nasal foreign body in children is not an uncommon presentation to the Emergency Department. Removal is essential. Many methods of removal exist. Nasal wash technique is advocated mainly in friable foreign bodies. We report the successful use of the oral bag-valve-mask insufflation technique to remove friable facial tissue in the left nose of a 2 year-old girl. We used a pediatric bag-valve-mask with a pop-off pressure relief valve to avoid barotrauma. Pop-off pressure relief valve limits the pressure beyond 30mmHg. Conscious sedation was not required. There were no complications.
    Matched MeSH terms: Barotrauma
  3. Effect of normabaric hyperoxia treatment on neuronal damage following fluid percussion injury in the striatum of mice: a morphological approach
    Muthuraju S, Pati S, Rafiqul M, Abdullah JM, Jaafar H
    J Biosci, 2013 Mar;38(1):93-103.
    PMID: 23385817
    Traumatic brain injury (TBI) causes significant mortality in most developing countries worldwide. At present, it is imperative to identify a treatment to address the devastating post-TBI consequences. Therefore, the present study has been performed to assess the specific effect of immediate exposure to normabaric hyperoxia (NBO) after fluid percussion injury (FPI) in the striatum of mice. To execute FPI, mice were anesthetised and sorted into (i) a TBI group, (ii) a sham group without injury and (iii) a TBI group treated with immediate exposure to NBO for 3 h. Afterwards, brains were harvested for morphological assessment. The results revealed no changes in morphological and neuronal damage in the sham group as compared to the TBI group. Conversely, the TBI group showed severe morphological changes as well as neuronal damage as compared to the TBI group exposed to NBO for 3 h. Interestingly, our findings also suggested that NBO treatment could diminish the neuronal damage in the striatum of mice after FPI. Neuronal damage was evaluated at different points of injury and the neighbouring areas using morphology, neuronal apoptotic cell death and pan-neuronal markers to determine the complete neuronal structure. In conclusion, immediate exposure to NBO following FPI could be a potential therapeutic approach to reduce neuronal damage in the TBI model.
    Matched MeSH terms: Barotrauma
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