{"id":957,"date":"2016-07-15T14:20:10","date_gmt":"2016-07-15T14:20:10","guid":{"rendered":"http:\/\/test.kriesi.at\/enfold-medical\/?page_id=957"},"modified":"2021-04-13T14:05:50","modified_gmt":"2021-04-13T12:05:50","slug":"hyperbaric-oxygen-therapy","status":"publish","type":"page","link":"https:\/\/www.medicinaiperbarica.it\/english\/hyperbaric-oxygen-therapy\/","title":{"rendered":"Hyperbaric Oxygen Therapy"},"content":{"rendered":"<div id='full_slider_1'  class='avia-fullwidth-slider main_color avia-shadow   avia-builder-el-0  el_before_av_heading  avia-builder-el-first   container_wrap sidebar_right' style=' '  ><div   data-size='featured'  data-lightbox_size='large'  data-animation='slide'  data-conditional_play=''  data-ids='1334'  data-video_counter='0'  data-autoplay='false'  data-bg_slider='false'  data-slide_height=''  data-handle='av_slideshow_full'  data-interval='5'  data-class=' '  data-el_id=''  data-css_id=''  data-scroll_down=''  data-control_layout='av-control-default'  data-custom_markup=''  data-perma_caption=''  data-autoplay_stopper=''  data-image_attachment=''  data-min_height='0px'  data-src=''  data-position='top left'  data-repeat='no-repeat'  data-attach='scroll'  data-stretch=''  data-default-height='28.666666666667'  class='avia-slideshow avia-slideshow-1  av-control-default av-default-height-applied avia-slideshow-featured av_slideshow_full   avia-slide-slider '  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><ul class='avia-slideshow-inner ' style='padding-bottom: 28.666666666667%;' ><li  class=' av-single-slide slide-1 ' ><div data-rel='slideshow-1' class='avia-slide-wrap '   ><img src='https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/01\/00025OFFSHORE-scaled-e1615972690498-1500x430.jpeg' width='1500' height='430' title='00025OFFSHORE' alt=''  itemprop=\"thumbnailUrl\"   \/><\/div><\/li><\/ul><\/div><\/div><div id='after_full_slider_1'  class='main_color av_default_container_wrap container_wrap sidebar_right' style=' '  ><div class='container' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-957'><div class='entry-content-wrapper clearfix'>\n<div  style='padding-bottom:25px; color:#0a0a0a;font-size:34px;' class='av-special-heading av-special-heading-h3 custom-color-heading blockquote modern-quote  avia-builder-el-1  el_after_av_slideshow_full  el_before_av_textblock  avia-builder-el-first  av-inherit-size '><div class ='av-subheading av-subheading_above av_custom_color ' style='font-size:15px;'><p>Hyperbaric chamber<\/p>\n<\/div><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >What is it<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' style='border-color:#0a0a0a'><\/div><\/div><\/div>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  av_inherit_color '  style='color:#0a0a0a; '  itemprop=\"text\" ><p><span style=\"font-weight: 400;\">The Hyperbaric Chamber is an environment that can be pressurized with air and\/or a mixture such as to increase the internal pressure in a verifiable way, of such thickness as to withstand pressures higher than those of exercise and used to house people, it can be fixed and mobile, single-seater and multi-seater.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The Hyperbaric Chamber complies with the definition of type II B devices and is framed in the EEC directive of 14.06.1993 relating to medical devices.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Hyperbaric chambers can be classified, based on their use, in:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hyperbaric Health Chambers: located in all public and private health facilities;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Working Hyperbaric Chambers: located in workplaces and used only in emergencies and urgencies such as underwater construction sites both onshore and offshore, or in construction sites such as tunnel constructions (motorways, subways, marine underground tunnels, etc.) using tunnel-digging machines that work in a hyperbaric regime (at pressures higher than the environmental pressure).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The Hyperbaric Chamber must be of a size that allows the stay of a patient on a stretcher with the possibility of assistance by suitable health personnel and must be equipped with a reserved area for rapid access by staff.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">During the treatment inside the room, once the predetermined altitude for the specific therapy is reached, the patient will breathe pure oxygen (or a hyperoxygenated gaseous mixture) in a closed circuit, using a device customized to the specific case (orofacial mask, helmet, mount or mechanical ventilation).<\/span><\/p>\n<\/div><\/section>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_1'  class='avia-section main_color avia-section-small avia-no-border-styling  avia-bg-style-scroll  avia-builder-el-3  el_after_av_textblock  el_before_av_layout_row   container_wrap sidebar_right' style=' '  ><div class='container' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-957'><div class='entry-content-wrapper clearfix'>\n<div class=\"flex_column av_one_half  av-animated-generic bottom-to-top  flex_column_div av-zero-column-padding first  avia-builder-el-4  el_before_av_one_half  avia-builder-el-first  \" style='border-radius:0px; '><p><div  style='padding-bottom:20px; font-size:34px;' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-5  el_before_av_textblock  avia-builder-el-first  av-inherit-size '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >When?<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\"><strong>HYPERBARIC OXYGEN<\/strong>:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The use of <strong>OTI<\/strong> is for the indications recognized by the Guidelines* and by <strong>Evidence-Based Medicine<\/strong> (the <strong>EBM<\/strong> of the <strong>AA<\/strong>.) and has to be carried out only in full compliance with the safety regulations in force for pressure vessels, as in fact it is the hyperbaric chamber.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When delivered safely and for recognized indications, and provided that a careful assessment of the risk\/benefit ratio of this procedure is made during the access visit\/suitability for treatment, <strong>OTI<\/strong> is usually well tolerated and free of complications, even in critically ill patients.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The hyperbaric doctor will evaluate the feasibility of treatment with <strong>OTI<\/strong> on the basis of the relationship between the &#8220;number of sessions to be performed&#8221; and the &#8220;relative risk&#8221; of the individual case.<\/span><\/p>\n<\/div><\/section><br \/>\n<div  style='padding-bottom:20px; font-size:34px;' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-7  el_after_av_textblock  el_before_av_textblock  av-inherit-size '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >RATIONALE OF HYPERBARIC OXYGEN<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">The effectiveness of hyperbaric treatment essentially depends on two factors:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increase in barometric pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increase in partial pressure of O2<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Dissolved oxygen is used in three circumstances:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">In the original circulatory defect (transport), replacing the oxygen transport by means of hemoglobin, when it is deficient due to lack (anemia) or functional incapacity (carbon monoxide poisoning)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Circulatory defect of &#8220;ischemic&#8221; origin by restoring the diffusion of oxygen from the capillaries to the cells when blood perfusion is obstructed or decreased (ischemia)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Circulatory deficit of &#8220;edematous&#8221; origin due to thickening of the means of transit (edema of any nature, pyogenic, cerebral, medullary and tissue membranes edema)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">This mechanism defines the increase of the partial pressure of oxygen (PO<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\">) which is expressed in different ways:<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span> <span style=\"font-weight: 400;\">1. Brings greater availability of oxygen to the periphery<\/span><\/p>\n<p>2. It nourishes the areas lacking in oxygen (hypoxia) and determines the\u00a0resumption of functions dependent on precise therapeutic &#8220;ranges&#8221;.<\/p>\n<p><span style=\"font-weight: 400;\">In particular, the pharmacological action of oxygen determines:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Activities on reparative processes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Osteogenic stimulation action<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Bactericidal and\/or bacteriostatic activity<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Action on the arterial and venous circulation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Restoration of the previously insufficient biochemical substrate<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tissue resuscitation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Toxicity<\/span><\/li>\n<\/ul>\n<\/div><\/section><\/p><\/div><div class=\"flex_column av_one_half  av-animated-generic bottom-to-top  flex_column_div av-zero-column-padding   avia-builder-el-9  el_after_av_one_half  el_before_av_toggle_container  \" style='border-radius:0px; '><p><div  style='padding-bottom:20px; font-size:34px;' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-10  el_before_av_textblock  avia-builder-el-first  av-inherit-size '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >PHYSIOLOGY OF OXYGEN<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">The mechanism of action of hyperbaric oxygen derives from the application of physical gas laws (Boille-Mariotte, Henry, Dalton) which regulate tissue absorption and diffusion, and from principles of oxygen physiology up to its application in the field of pharmacology.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The administration of oxygen, in fact, is based on the principle of the solubility of a gas dissolved in a fluid; in our case the gas is represented by O2 and the fluid is the blood.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Henry&#8217;s law states that the amount of a gas that dissolves in a liquid is directly proportional to the pressure the gas exerts on the surface of the liquid and to its solubility coefficient.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A subject, to the current ambient pressure (760 mmHg or 1 ATA) breathes air formed by O<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> at 21% and N<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> at 79%.<\/span><\/p>\n<p><i><span style=\"font-weight: 400;\">TRANSPORT OF OXYGEN IN BLOOD AT ATMOSPHERIC PRESSURE AND IN HYPERBARISM (100% BREATHING OF AIR AND OXYGEN &#8211; SEE TAB.)<\/span><\/i><\/p>\n<p><img loading=\"lazy\" class=\"size-large wp-image-1648 aligncenter\" src=\"https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/04\/Schermata-2021-04-13-alle-14.02.40-1030x701.png\" alt=\"\" width=\"1030\" height=\"701\" srcset=\"https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/04\/Schermata-2021-04-13-alle-14.02.40-1030x701.png 1030w, https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/04\/Schermata-2021-04-13-alle-14.02.40-300x204.png 300w, https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/04\/Schermata-2021-04-13-alle-14.02.40-768x523.png 768w, https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/04\/Schermata-2021-04-13-alle-14.02.40-705x480.png 705w, https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/04\/Schermata-2021-04-13-alle-14.02.40.png 1116w\" sizes=\"(max-width: 1030px) 100vw, 1030px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">In normal conditions and at normobaric pressure, oxygen is transported by red blood cells bound to hemoglobin (Hb) for 97%. It is known from physiology that one gram of Hb carries 1.34 ml of O<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> per 100 cc of blood and that the amount of Hb transported in 100 cc of blood is 15 grams. It can be said, therefore, that the quantity of O<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> transported by the red blood cells is 19.7 ml per 100 cc of blood, while the quantity of O<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> physically dissolved in the plasma is 0.32 ml. per 100 cc of blood (See Table).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In normobaric conditions, breathing of oxygen at 100% (FiO<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> = 1) determines minimal changes in the oxygen linked to hemoglobin which passes from values \u200b\u200bof 19.7 to 20.1 ml per 100 cc of blood, while the amount of O2 dissolved in the plasma passes from 0.32 to 2.09 ml per 100 cc of blood (Tab. 1).<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In hyperbaric conditions, at a pressure of 2.0-2.8 ATA, breathing of oxygen at 100% (FiO<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> = 1) causes an increase in oxygen partial pressures up to values \u200b\u200bof 1560-2280 mmHg.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The O<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> bound to hemoglobin in hyperbaric conditions, according to Henry&#8217;s law, does not experience variations, while the free share in the plasma has a significant increase from 0.32 ml. for 100 cc. of blood to 6ml. for 100 cc of blood (See Tab.)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This amount of oxygen is sufficient to meet cellular metabolic demands, resulting in a &#8220;tissue resuscitation&#8221; regardless of the oxygen content linked to hemoglobin. This is the main mechanism on which hyperbaric oxygen acts. Tissue oxygenation is therefore maintained even in conditions of modified transport of O<\/span><span style=\"font-weight: 400;\">2<\/span><span style=\"font-weight: 400;\"> linked to hemoglobin.<\/span><\/p>\n<\/div><\/section><\/p><\/div><div  class=\"togglecontainer  av-minimal-toggle toggle_close_all  avia-builder-el-12  el_after_av_one_half  avia-builder-el-last \" >\n<section class=\"av_toggle_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\"  >    <div role=\"tablist\" class=\"single_toggle\" data-tags=\"{Tutto} \"  >        <p data-fake-id=\"#toggle-id-1\" class=\"toggler  av-inherit-border-color \"  itemprop=\"headline\"  style='border-color: #238dd3; '  role=\"tab\" tabindex=\"0\" aria-controls=\"toggle-id-1-container\">ACCESS REQUIREMENTS TO HYPERBARIC THERAPY<span class=\"toggle_icon\" >        <span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p>        <div id=\"toggle-id-1-container\" class=\"toggle_wrap \"  >            <div class=\"toggle_content invers-color  av-inherit-border-color \"  itemprop=\"text\"  style='border-color: #238dd3; ' ><p><strong>Chest X-ray in two projections<br \/>\nSpirometry<br \/>\nE.C.G. baseline<br \/>\nAudio-Impedance measurement<br \/>\nFurther investigations to be defined based on the pathology<\/strong><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">* Israeli studies, still in progress, have highlighted indications for <strong>OTI<\/strong> in Fibromyalgia.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In Italy, some Hyperbaric Centers have taken steps to carry out the therapy in Fibromyalgia to verify its effectiveness. The therapy is currently considered Off Label and the results obtained<\/span> <span style=\"font-weight: 400;\">encourage us to treat patients with fibromyalgia with <strong>OTI<\/strong>.<\/span><\/p>\n            <\/div>        <\/div>    <\/div><\/section>\n<\/div>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av-layout-grid-1'  class='av-layout-grid-container entry-content-wrapper main_color av-flex-cells     avia-builder-el-13  el_after_av_section  el_before_av_layout_row  submenu-not-first container_wrap sidebar_right' style=' '  >\n<div class=\"flex_cell no_margin av_one_half  avia-builder-el-14  el_before_av_cell_one_half  avia-builder-el-first   avia-full-stretch av-zero-padding \"  style='height:500px; min-height:500px;background:url(https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2021\/01\/00002OFFSHORE-1030x769.jpg) center center no-repeat scroll #22689e; vertical-align:middle; padding:0px; background-color:#22689e; ' ><div class='flex_cell_inner' ><\/div><\/div><div class=\"flex_cell no_margin av_one_half  avia-builder-el-15  el_after_av_cell_one_half  avia-builder-el-last   \"  style='height:500px; min-height:500px;background: #22689e; vertical-align:middle; padding:80px; background-color:#22689e; ' ><div class='flex_cell_inner' ><p><div  style='padding-bottom:25px; color:#ffffff;font-size:34px;' class='av-special-heading av-special-heading-h3 custom-color-heading blockquote modern-quote  avia-builder-el-16  el_before_av_toggle_container  avia-builder-el-first  av-inherit-size '><div class ='av-subheading av-subheading_above av_custom_color ' style='font-size:15px;'><p>in-depth analysis and details<\/p>\n<\/div><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >INDICATIONS FOR HYPERBARIC OXYGEN THERAPY<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' style='border-color:#ffffff'><\/div><\/div><\/div><br \/>\n<div  class=\"togglecontainer   toggle_close_all  avia-builder-el-17  el_after_av_heading  avia-builder-el-last \" >\n<section class=\"av_toggle_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\"  >    <div role=\"tablist\" class=\"single_toggle\" data-tags=\"{Tutto} \"  >        <p data-fake-id=\"#toggle-id-2\" class=\"toggler \"  itemprop=\"headline\"    role=\"tab\" tabindex=\"0\" aria-controls=\"toggle-id-2-container\">INDICATION OF CONSOLIDATED CLINICAL EVIDENCE OR BECAME A PRACTICAL USE<span class=\"toggle_icon\" >        <span class=\"vert_icon\"><\/span><span class=\"hor_icon\"><\/span><\/span><\/p>        <div id=\"toggle-id-2-container\" class=\"toggle_wrap \"  >            <div class=\"toggle_content invers-color \"  itemprop=\"text\"   ><p><span style=\"font-weight: 400;\">The clinical indications for hyperbaric oxygen therapy are based on the analysis of the scientific literature and in particular on what emerged from the documents of SIAARTI (Italian Society of Anesthesia, Analgesia, Intensive Care and Intensive Care), and SIMSI (Society of Underwater and Hyperbaric Medicine).<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">Document of the UHMS (Undersea and Hyperbaric Medical Society) Committee Report Documents of the Consensus Conference of the ECHM (European Committee for Hyperbaric Medicine).<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\"><br \/>\n<\/span><span style=\"font-weight: 400;\">The European Committee for Hyperbaric Therapy is committed, together with the national scientific societies, to improving knowledge, qualities and cultural exchanges; moreover, to promote ideas and research programs and to harmonize indications and operational protocols.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The use of OTI is to be addressed for the recognized indications and to be carried out only in full compliance with the safety standards in force for pressure vessels, in particular for hyperbaric chambers.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The access visit\/suitability for treatment requires a careful assessment of the risk\/benefit ratio of this procedure. The hyperbaric doctor will evaluate the feasibility of treatment with OTI on the basis of the relationship between the &#8220;number of sessions to be performed&#8221; and the &#8220;relative risk&#8221; of the individual case.<\/span><\/p>\n            <\/div>        <\/div>    <\/div><\/section>\n<\/div><\/p>\n<\/div><\/div>\n<\/div><\/p>\n<div id='av-layout-grid-2'  class='av-layout-grid-container entry-content-wrapper main_color av-flex-cells     avia-builder-el-18  el_after_av_layout_row  el_before_av_layout_row  submenu-not-first container_wrap sidebar_right' style=' '  >\n<div class=\"flex_cell no_margin av_one_half  avia-builder-el-19  el_before_av_cell_one_half  avia-builder-el-first   \"  style='height:500px; min-height:500px;background: #22689e; vertical-align:middle; padding:80px; background-color:#22689e; ' ><div class='flex_cell_inner' ><p><div  style='padding-bottom:25px; color:#ffffff;font-size:34px;' class='av-special-heading av-special-heading-h3 custom-color-heading blockquote modern-quote  avia-builder-el-20  el_before_av_textblock  avia-builder-el-first  av-inherit-size '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >ACUTE PATHOLOGIES<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' style='border-color:#ffffff'><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  av_inherit_color '  style='color:#ffffff; '  itemprop=\"text\" ><ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Decompression Pathology (EGA, MDD)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Progressive Necrotizing Infections (Anaerobic myositis, necrotizing fasciitis, necrotizing dermo-epidermal infections, diabetic gangrene)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Carbon monoxide poisoning<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Crushing\/traumatic injuries and fractures at risk<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Skin grafts and flaps at risk<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sudden hearing loss<\/span><\/li>\n<\/ol>\n<\/div><\/section><\/p>\n<\/div><\/div><div class=\"flex_cell no_margin av_one_half  avia-builder-el-22  el_after_av_cell_one_half  avia-builder-el-last   avia-full-stretch \"  style='height:500px; min-height:500px;background: #ffffff; vertical-align:middle; padding:80px; background-color:#ffffff; ' ><div class='flex_cell_inner' ><p><div  style='padding-bottom:25px; font-size:34px;' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-23  el_before_av_textblock  avia-builder-el-first  av-inherit-size '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >CHRONIC PATHOLOGIES<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><h3><\/h3>\n<ol>\n<li style=\"list-style-type: none;\">\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chronic refractory osteomyelitis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Chronic skin ulcers<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Post-actinic tissue lesions<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diabetic foot<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Aseptic osteonecrosis<\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/div><\/section><\/p>\n<\/div><\/div>\n<\/div>\n<div id='av-layout-grid-3'  class='av-layout-grid-container entry-content-wrapper main_color av-flex-cells     avia-builder-el-25  el_after_av_layout_row  avia-builder-el-last  submenu-not-first container_wrap sidebar_right' style=' '  >\n<div class=\"flex_cell no_margin av_one_half  avia-builder-el-26  el_before_av_cell_one_half  avia-builder-el-first   \"  style='height:500px; min-height:500px;vertical-align:middle; padding:80px; ' ><div class='flex_cell_inner' ><p><div  style='padding-bottom:25px; font-size:34px;' class='av-special-heading av-special-heading-h3  blockquote modern-quote  avia-builder-el-27  el_before_av_textblock  avia-builder-el-first  av-inherit-size '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Other Indications<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock  '   itemprop=\"text\" ><p><span style=\"font-weight: 400;\">OTHER INDICATIONS TO OTI WITH MORE EVIDENCE TO BE DEFINED<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Periodontal disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Algodystrophy syndrome<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Retinitis Pigmentosa &#8211; Central artery ischemia of the retina<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0M\u00e9ni\u00e8re&#8217;s disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Osteonecrosis of the mandible due to bisphosphonates<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Fibromyalgia * (Currently not included in the SIMSI guidelines)<\/span><\/li>\n<\/ol>\n<\/div><\/section><\/p>\n<\/div><\/div><div class=\"flex_cell no_margin av_one_half  avia-builder-el-29  el_after_av_cell_one_half  avia-builder-el-last   avia-full-stretch av-zero-padding \"  style='height:500px; min-height:500px;background:url(https:\/\/www.medicinaiperbarica.it\/english\/wp-content\/uploads\/2020\/12\/00010Tunnelling-773x1030.jpeg) center center no-repeat scroll #22689e; vertical-align:middle; padding:0px; background-color:#22689e; ' ><div class='flex_cell_inner' ><\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/pages\/957"}],"collection":[{"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/comments?post=957"}],"version-history":[{"count":51,"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/pages\/957\/revisions"}],"predecessor-version":[{"id":1650,"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/pages\/957\/revisions\/1650"}],"wp:attachment":[{"href":"https:\/\/www.medicinaiperbarica.it\/english\/wp-json\/wp\/v2\/media?parent=957"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}