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2018, Number 3-4

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Rev Sanid Milit Mex 2018; 72 (3-4)

Safety and experience of the use of hyperbaric oxygen in the patient with acute myocardial infarction with ST elevation

Martín-Hernández P, Gutiérrez-Leonard H, Montes-Bautista CV, Valdéz-Becerril G, Aguirre-Alvarado A, Hernández JL

Language: Spanish
References: 26
Page: 231-239
PDF size: 226.37 Kb.


ABSTRACT

Hyperbaric oxygen (HBO2) is a useful treatment for ischemic diseases; however, as an adjuvant treatment in myocardial infarction (MI), there is very little experience worldwide. It has been used in some research work as a single treatment in a single exposure in the context of an ST-segment elevation myocardial infarction (STEMI) and in addition to thrombolysis. Our study describes the feasibility and safety of continuous doses of HBO2 after a heart attack by improving left ventricular function. Objective: The objective of this study is to describe the experience and safety of HBO2 doses in the patient with STEMI taken to primary angioplasty to improve left ventricular function. Material and methods: 24 randomized patients were collected and divided into two groups: 13 in the case group and 11 control patients. Both groups were taken to primary angioplasty and conventional treatment. Left ventricular function was assessed with SPECT CT; the case group received 15 repeated 90-minute sessions of isopressure at 2.0 ATA. Results: The two groups were similar in characteristics; they were admitted to the hospital with an STEMI, taken to primary angioplasty, randomized into two groups. The group of cases was taken to the hyperbaric chamber to receive daily doses of HBO2 for 15 days at 2 ATA for 90 minutes of isopressure. There were no cardiovascular complications during the treatment with hyperbaric oxygen: reinfarction, bleeding, hypertensive disorder, arrhythmias or heart failure data. Complications typical of the hyperbaric chamber: only one patient presented significant claustrophobia. In addition to the benefits of the conventional treatment of STEMI, the left-ventricular ejection fraction (LVEF) in anteroseptal MI was significantly improved in the group of cases. Conclusions: Continuous-dose hyperbaric oxygen is safe and feasible as an additional treatment for patients with STEMI taken to primary angioplasty, in addition to improving left ventricular function in extensive heart attacks.


REFERENCES

  1. Instituto Nacional de Estadística, Geografía e Informática. Epidemiología de la defunción poblacional. México: INEGI; 2015. Disponible en: www.inegi.gob.mx

  2. Crea F, Liuzzo G. Pathogenesis of acute coronary syndromes. J Am Coll Cardiol. 2013; 61 (1): 1-11.

  3. Sánchez GB, Covarrubias HÁ, Rodríguez GP, Uribe EA, Ramírez- Arias E, Peralta MR et al. Impact of the implementation of the Infarction Code strategy in patients with acute myocardial infarction diagnosis in the Hospital de Cardiología of the Centro Médico Nacional Siglo XXI. Gac Med Mex. 2017; 153 (Supl. 2): S13-S17.

  4. Szummer K, Wallentin L, Lindhagen L, Alfredsson J, Erlinge D, Held C et al. Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995-2014. Eur Heart J. 2017; 38 (41): 3056-3065.

  5. Khan JN, Razvi N, Nazir SA, Singh A, Masca NG, Gershlick AH et al. Prevalence and extent of infarct and microvascular obstruction following diff erent reperfusion therapies in STelevation myocardial infarction. J Cardiovasc Magn Reson. 2014; 16: 38.

  6. De Waha S, Desch S, Eitel I, Fuernau G, Zachrau J, Leuschner A et al. Impact of early vs. late microvascular obstruction assessed by magnetic resonance imaging on long-term outcome after ST-elevation myocardial infarction: a comparison with traditional prognostic markers. Eur Heart J. 2010; 31 (21): 2660-2668.

  7. Abdel-Aty H, Cocker M, Meek C, Tyberg JV, Friedrich MG. Edema as a very early marker for acute myocardial ischemia: a cardiovascular magnetic resonance study. J Am Coll Cardiol. 2009; 53 (14): 1194-1201.

  8. Fernández-Jiménez R, Barreiro-Pérez M, Martin-García A, Sánchez-González J, Agüero J, Galán-Arriola C et al. Dynamic edematous response of the human heart to myocardial infarction: implications for assessing myocardial area at risk and salvage. Circulation. 2017; 136 (14): 1288-1300.

  9. Fröhlich GM, Meier P, White SK, Yellon DM, Hausenloy DJ. Myocardial reperfusion injury: looking beyond primary PCI. Eur Heart J. 2013; 34 (23): 1714-1722.

  10. Feldmeir J. Hyperbaric oxygen therapy: a committee report. Kensington, Maryland: Undersea and Hyperbaric Medical Society, Inc.; 2003.

  11. Smith G, Lawson DA. Experimental coronary arterial occlusion: eff ects of the administration of oxygen under pressure. Scott Med J. 1958; 3 (8): 346-350.

  12. Kuhn LA, Kline HJ, Wang M, Yamaki T, Jacobson JH 2nd. Hemodynamic eff ects of hyperbaric oxygenation in experimental acute myocardial infarction. Circ Res. 1965; 16: 499-509.

  13. Dotsenko EA, Nikulina NV, Salivonchik DP, Lappo OG, Gritsuk AI, Bastron AS. Low doses of hyperbaric oxygenation eff ectively decrease the size of necrotic zone in rats with experimental myocardial infarction. Bull Exp Biol Med. 2015; 158 (6): 732-734.

  14. Shandling AH, Ellestad MH, Hart GB, Crump R, Marlow D, Van Natta B et al. Hyperbaric oxygen and thrombolysis in myocardial infarction: the “HOT MI” pilot study. Am Heart J. 1997; 134 (3): 544-550.

  15. Dekleva M, Neskovic A, Vlahovic A, Putnikovic B, Beleslin B, Ostojic M. Adjunctive eff ect of hyperbaric oxygen treatment after thrombolysis on left ventricular function in patients with acute myocardial infarction. Am Heart J. 2004; 148 (4): E14.

  16. Sheffield PJ. Measuring tissue oxygen tension: a review. Undersea Hyperb Med. 1998; 25 (3): 179-188.

  17. Leach RM, Rees PJ, Wilmshurst P. Hyperbaric oxygen therapy. BMJ. 1998; 317 (7166): 1140-1143.

  18. Bennett MH, Lehm JP, Jepson N. Hyperbaric oxygen therapy for acute coronary syndrome. Cochrane Database Syst Rev. 2015; (7): CD004818.

  19. Marabotti C, Belardinelli A, L’Abbate A, Scalzini A, Chiesa F, Cialoni D et al. Cardiac function during breath-hold diving in humans: an echocardiographic study. Undersea Hyperb Med. 2008; 35 (2): 83-90.

  20. Weaver LK, Howe S, Snow GL, Deru K. Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen. J Appl Physiol (1985). 2009; 107 (1): 336-345.

  21. Weaver LK, Churchill S. Pulmonary edema associated with hyperbaric oxygen therapy. Chest. 2001; 120 (4): 1407-1409.

  22. Acuña-Valerio J, Abundes-Velasco A. Estado del arte de la trombólisis intracoronaria. Rev Mex Cardiol. 2016; 27 (s1): s41-s46.

  23. http://www.cenetec-difusion.com/CMGPC/IMSS-357-13/ER.pdf

  24. Zamboni WA, Roth AC, Russell RC, Graham B, Suchy H, Kucan JO. Morphologic analysis of the microcirculation during reperfusion of ischemic skeletal muscle and the effect of hyperbaric oxygen. Plast Reconstr Surg. 1993; 91 (6): 1110- 1123.

  25. Stone GW, Selker HP, Thiele H, Patel MR, Udelson JE, Ohman EM et al. Relationship between infarct size and outcomes following primary PCI: patient-level analysis from 10 randomized trials. J Am Coll Cardiol. 2016; 67 (14): 1674-1683.

  26. Swift PC, Turner JH, Oxer HF, O’Shea JP, Lane GK, Woollard KV. Myocardial hibernation identifi ed by hyperbaric oxygen treatment and echocardiography in postinfarction patients: comparison with exercise thallium scintigraphy. Am Heart J. 1992; 124 (5): 1151-1158.




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