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June 6, 1993
HYPERBAR.ASC
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This file shared with KeelyNet courtesy of Mike Hughes.
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Date : Thu, 3 Jun 93 15:51:40 -0700
Subject: FATIGUE RELATED TO HIV/AIDS
From : Jeffry Skidmore <wombat@u.washington.edu>
ABSTRACT
HIV-Related Fatigue and Hyperbaric Oxygen Therapy
Reillo, M, R.N., B.S.N.,
Myers, R., M.D.,
HBO Staff, MIEMSS,
Baltimore, Maryland, USA
Objectives: Hyperbaric Oxygen Therapy (HBO) is being evaluated to
determine the effectiveness in relieving HIV-related
fatigue and determine the clinical and immunological
effects on HIV-infected individuals.
Methods: Twenty-five patients have been enrolled over a two-
year period. Admission criteria include chief
complaint of fatigue, seropositivity as confirmed by
ELISA and Western Blot for HIV infection, 500 CD4
cells or less, and absence of active opportunistic
infections which might compromise pulmonary or
neurologic function.
Twenty patients received 2 ATA, for 90 minutes, three
times per week.
Five patients voluntarily received surface air at the
same parameters to control for a placebo effect, and
then received 100% oxygen; all patients were treated
simultaneously in the HBO chamber. Withdrawal of HBO
therapy for one month was completed for 21 patients,
secondary to chamber construction.
Laboratory, clinical assessment, and Karnofsky Performance Scores
were completed monthly on all patients.
Results: All patients indicated relief of debilitating fatigue
within two weeks. Karnofsky Scores improved 10% to
30% within one month. Weights for all patients
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remained stable or increased; CD4, Hemoglobin, and
Hematocrit counts remained stable and/or increased.
Tumor Necrosis Factor decreased in 13 patients. P-24
antigens remained nonreactive or decreased if
reactive. Withdrawal of therapy for one month
secondary to new chamber construction for all but four
patients correlated with return of baseline fatigue
levels.
Additionally, two patients developed PCP and were treated outpatient
with dapsone and HBO via monoplace chamber.
One patient developed herpes zoster and was treated with zovirax and
HBO via monoplace chamber. After resuming HBO therapy, all
remaining patients returned to their six month Karnofsky Score,
which indicated significant improvement in their fatigue levels.
Twenty-three of the twenty-five patients have shown no clinical
disease progression; 80% of patients enrolled in the study have 50
CD4 cells or less.
Further, HBO appeared to relieve pain associated with peripheral
neuropathy in two patients and was a beneficial adjunct to the
treatment of mild PCP; the investigators have established protocols
to further investigate these findings.
Conclusion: The study is ongoing. HBO appears to be effective in
relieving HIV-related fatigue and improving the
quality of life of individuals with HIV/AIDS.
Preliminary research indicates a probable correlation with an
increase in length of employment capability, delayed disability
requirement, and reduction in number and length of hospitalizations
by incorporating HBO as a component in the medical management of HIV
disease.
The investigators believe HBO may relieve fatigue by inhibiting the
activity of certain cytokines, enhancing red blood cell production,
and enhancing the ability of HIV-impaired monocytes to absorb and
utilize oxygen.
The Center for Advancement of Hyperbaric Medicine is a Washington
corporation and has filed for IRS non-profit status as a 501(c)(3)
organization. CAHM's goals are:
1. To promote the acceptance and broadest appropriate application
of hyperbaric oxygen therapy in the professional medical
community.
2. To research and promote the research of promising applications
of hyperbaric oxygen therapy in a manner that will insure its
highest professional recognition and acceptance.
3. To collect, organize and disseminate all available information
about hyperbaric oxygen therapy so as to insure its most
knowledgeable application and implementation.
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4. To discover, research, develop and introduce new medical
applications for hyperbaric oxygen therapy.
5. To distinguish inappropriate, ineffective or fraudulent
application of hyperbaric oxygen therapy and to discourage
their practice.
Hyperbaric oxygen therapy consists of sitting in a closed chamber in
which the pressure is elevated to twice that at sea level (14.7 PSI
X 2 = 29.4 PSI 'pounds per square inch'), and then breathing pure
oxygen (while in the chamber).
The typical course of treatment is about 90 minutes two to three
times per week. This therapy is an established therapy for 13
recognized conditions and experimental in may more. It is practiced
in hospitals throughout the United States and the world.
The Center for Advancement of Hyperbaric Medicine can provide
treatment on your physicians prescription. This is *NOT A COMMERCIAL
VENTURE* the application to AIDS/HIV is experimental and
investigatory in nature.
CAHM can be reached at 1720 130th Ave. NE.,
Suite 103,
Bellevue, WA 98005,
Phone (206) 883-7819
FAX (206) 881-1795
or rapid pass along on INTERNET at wombat@u.washington.edu
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