1/4. Hyperbaric oxygen treatment in deep frostbite of both hands in a boy.An 11-year-old boy in good general health conditions suffered deep frostbite on six fingers while he was working without gloves as a beater during a hunt in poland at an outdoor temperature of -32 degrees C over a 4 h-period. Three days later he was first seen by a physician who planned to amputate the affected fingers. The patient was transferred by his family to our University Hospital in Aachen, germany. We found third degree frostbite on four fingers of the right and on two fingers of the left hand. Because of the late beginning of the therapy, the patient was treated by HBO(2) according to the Marx-schema for problem wounds (2,4 bar, total time at depth: 90 min, alternations of 100% O(2) and air breathing). HBO(2)-treatment was repeated daily for 14 days. No adverse events were recorded during the course of therapy. A total recovery of the severe frostbite was observed after 14 days of HBO(2)-treatment. Twenty-eight months after the injury the patient reports fully regained sensibility and no pain. The plain X-ray after this period showed no premature closure of the epiphyses or sclerosis of the metaphyses. Conclusions: Because of the low risk associated with HBO(2), and its potential therapeutic efficiency, HBO(2) should be recommended as adjunct therapy in the treatment of deep frostbite.- - - - - - - - - - ranking = 1keywords = oxygen (Clic here for more details about this article) |
2/4. Delayed treatment of frostbite injury with hyperbaric oxygen therapy: a case report.The effects of hyperbaric oxygen therapy on skin microcirculation were evaluated by laser-doppler flowmetry and vital capillary microscopy in a frostbite victim 2 wk after the injury. Laser-Doppler skin blood flow, measured in intact skin on the dorsum of the foot, decreased from 52 to 31 perfusion units during hyperbaric oxygen therapy. The number of visible nutritive capillaries in frostbitten areas on the toes increased from 2 to 12 per mm2, as measured immediately after the hyperbaric oxygen therapy. We conclude that hyperbaric oxygen therapy is capable of improving nutritive skin blood flow in frostbitten areas more than 2 wk after the injury.- - - - - - - - - - ranking = 2keywords = oxygen (Clic here for more details about this article) |
3/4. One night in a snowbank: a case report of severe hypothermia and cardiac arrest.hypothermia < 28 degrees C is rarely compatible with life, with only a few cases described surviving such low temperatures. We present a case of a man who survived with a core body temperature below 21.0 degrees C after spending a night in a snowbank with an ambient temperatures as low as -20.0 degrees C. Prolonged CPR and early initiation of extracorporeal membrane oxygenation enabled survival without neurological deficit at hospital discharge. frostbite was limited to both hands and all toes only; although the entire upper and lower extremity appeared to be deeply frozen on admission, amputation of both hands was inevitable and resulted in permanent disability.- - - - - - - - - - ranking = 0.25keywords = oxygen (Clic here for more details about this article) |
4/4. Clinical and morphological aspects of death due to liquid nitrogen.A 24-year-old student died while filling flasks with liquid nitrogen. The arms, legs and back were frozen and the face, ears and neck showed a dark red and livid colour with horizontal lines of demarcation. In the electrocardiogram, the heart showed asystolia followed by wide ventricular complexes. The patient was intubated orally as the situs of the larynx and pharynx showed no pathology findings. cardiopulmonary resuscitation was carried out and terminated after 90 min. Unfortunately, the body temperature was not measured. The gas analysis of venous blood showed metabolic acidosis and oxygen deficiency. The student had worked alone with nitrogen, without opening the windows and without a working ventilation system. While filling the third flask he lost consciousness. As nitrogen does not cause characteristic prodromal signs he laid on the floor and was unable to help himself. The liquid nitrogen which was still escaping spread over the floor and vaporized. The student died from asphyxia due to oxygen deficiency in an atmosphere of nitrogen.- - - - - - - - - - ranking = 0.5keywords = oxygen (Clic here for more details about this article) |