Ozone Therapy: Experiences in Critically ill Patients
therapy is presented like an alternative therapy in
critically ill patients. After ozone therapy, an improvement
in the hemo-dynamic parameters with an increase in tissue
oxygenation were demonstrated. No modifications in the
cardiac output were reported. A modulating effect of ozone
therapy in certain biochemical parameters was observed.
Also, microbiologic cultures were negative and leukocyte
figure became normal. An ozone therapy preventive effect in
the appearance of generalized sepsis was observed. With all
these results we conclude that ozone therapy can be
considered as a prophylactic therapy in critically ill
ill patients that are submitted to the Intensive Care Unit
(ICU), represent a challenge for the multidisciplinary
teamwork. Because of the wide variety of physiological
elements that are involved, a great number of deaths per
year are present in the whole world.
United States for example, sepsis develops in more than
750,000 critically patients each year with only 50 to 70 %
survival rate. Unfortunately, because of the high mortality
rate associated with sepsis, there are in excess of 600
patients per day dying of sepsis-related complications in
the United States alone (1).
long history of efforts to produce efficacious therapeutic
interventions just like intensive medical care, antibiotic
treatments and surgery when indicated, the condition remains
a major cause of hospital-based mortality and morbidity
(2-4). Several therapeutic strategies have been used in
order to minimize this problem with variable results.
therapy is presented like an alternative therapy due to its
different biological effects. Specifically: improvement in
the oxygen metabolism, modulation in the biological
oxidative stress and in the immunologic system (Figure 1)
All the effects above mentioned are closely linked with the recovery and prognosis of critical patients. Taking into account all these aspects and also preliminary experiences (10,11), the results, using ozone therapy in a group of patients hospitalized in the ICU, are presented.
Materials and Methods
Patients and Treatment
A multi-center study in 20 patients hospitalized in the ICU was performed. Patients presented the following inclusion criteria: less than 65 years old, cranial and/or thoracic trauma, submitted to surgery or not, with mechanical ventilation or not, without humoral, radiologic or microbiologic evidence of clinical infection, without criteria of brain death.
Prophylactic ozone was administered, daily, by major autohemotherapy (200 ml of blood with anticoagulant mixture with 200 ml of ozone/oxygen, at a concentration of 45 mg/l) during 5 sessions. Prophylactic antibiotic therapy was not indicated.
Clinical laboratory test and radiologic studies were performed, daily, in each patient, during the first 5 days of evolution. To 13 patients that needed mechanical ventilation, hemodynamic determinations were performed using thermodilution with Swan Ganz catheter, before ozone therapy and after each hour up to 4 hours. This was repeated every day during the 5 days of ozone therapy.
From the 13 patients that needed ventilator support, 10 were weaning from the machine. The other 3 patients died, due to the magnitude of the cranial trauma (Table I).
After ozone therapy, an improvement in the hemodynamic parameters with an increase in tissue oxygenation were demonstrated. A shift of the HbO2/Hb balance to the right, towards deoxygenated hemoglobin, improving peripheral oxygen supply was observed. Also, an increase in hemoglobin saturation with high oxygen partial pressure figures and normalization of the difference alveolus-capillary oxygen (DA-a02) were found. No modifications in the cardiac output (CO) were reported (Figures 2, 3, 4 and 5).
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