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Hyperbaric Chamber Overview

Hyperbaric Chamber Overview. Michael J. Natoli Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, NC 27710. Hyperbaric Surgery & Research at Duke, 1963-67. F.G. Hall Laboratory, 1968. Seven Multiplace Chambers. Main Deck. Second Deck. Golf.

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Hyperbaric Chamber Overview

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  1. Hyperbaric Chamber Overview Michael J. Natoli Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, NC 27710

  2. Hyperbaric Surgery & Research at Duke, 1963-67

  3. F.G. Hall Laboratory, 1968

  4. Seven Multiplace Chambers Main Deck Second Deck Golf Golf Foxtrot Delta Echo Charlie Bravo Alpha

  5. Pipe Color Coding - US Navy Oxygen Nitrogen Helium Air Exhaust Vacuum Potable Water Fire system

  6. Alpha Chamber

  7. Compressors

  8. Air Storage Banks

  9. Control Console Don Bordeaux, 2005

  10. Internal Environmental Control Pneumatic valves Muffler Cold water Heating / Cooling Coils Hot water Lubrication level Blower Electric motor Air flow Shaft seal Temperature indicator Thermistor

  11. External Environmental Control Blower Thermistor Temperature controller Need Picture Cold water CO2 absorbent Hot water

  12. Breathing Gas Systems BIBS Panel

  13. Liquid Oxygen and Nitrogen

  14. Oxygen Delivery • Head tent • Face mask • Scott Duo-seal • Single hose • Overboard dump • Plastic disposable • Mouthpiece • “T” piece • Ambu-bag • Ventilator

  15. Oxygen Delivery - Recirculating Head Tent Eduction Oxygen Purge Venturi Eduction Line 30 20 40 Purge 10 50 Sample Line 0 60 Venturi Sample Line Bubbler Sodasorb Canister Ice Bucket Latex Ice Water Condensate Neckseal Drain Drain

  16. Headtents

  17. Oxygen Delivery - Single Pass Head Tent Overboard Dump Line Oxygen Patient Sample Line Oxygen Supply Regulator Oxygen Dump Regulator Latex Neckseal

  18. Oxygen Administration by Overboard Dump Mask

  19. Ventilator

  20. Eduction Manifold Description Outside Building Foxtrot 50 ft Delta Air Amplifier Charlie 1” pipe Bravo 3” pipe Alpha 4 ft2 Chamber Exhaust Duct Manifold Inlet

  21. OFF Fire Suppression System Relief valve 200 psig reg. check valve 450 psig air Muffler Fire Suppression Tank Pneumatic valve Air mask Overhead sprinklers Manual Pump ON Hand-held hose Level indicators Drain

  22. Nitrogen Purge

  23. Plantronics Headset

  24. Telex TR-200 Wireless Intercom

  25. Two-way Mic/Speaker Box

  26. Sound-powered Phone

  27. Breathing Gas Analysis • Chamber Atmosphere O2 (20.5% - 23.5%) CO2 (< 1.0% SEV) • Patients O2 (> 98.0%) CO2 ( < 1.0% SEV)

  28. Breathing Gas Analysis

  29. Patient Monitoring

  30. Monitoring Connections Inside the Chamber

  31. Defibrillator

  32. Transcutaneous Oxygen Monitors

  33. Suction

  34. Medical Lock

  35. Hyperbaric Oxygen Therapy Program • Each year, 300 patients breathe 100% oxygen at about 2 times atmospheric pressure • 13 UHMS approved conditions including air embolism, decompression sickness, CO poisoning, gas gangrene, problem wounds

  36. Education Program • Graduate students • Intern & resident training • 12 month Diving & Hyperbaric Medicine Fellowship (2 per year) • Semester course in the “Physiology & Medicine of Extreme Environments”

  37. Research Program • Supporting agencies • National Heart, Lung, Blood Institute • National Aviation & Space Agency • Navy, Army, Air Force • National Oceanographic & Atmospheric Administration • Divers Alert Network • Commercial diving companies

  38. Saturation Diving to 2,250 Feet (1970s-80s)

  39. Right Heart Bubbles LV RV LA RA

  40. Flying After Diving Recreational Diving High Altitude Parachuting (Divers Alert Network) (Army Special Forces)

  41. ‘Combat Edge’ Positive Pressure Suit

  42. NASA Extravehicular Activity (EVA)

  43. O2 Breath-Hold Diving

  44. Differential Gene Expression • Affymetrix U133A chip measures 14,000 genes per sample • Response to decompression stress (ONR) • Genetic predisposition to IPE (NAVSEA)

  45. Immersion Pulmonary Edema • Sudden dyspnea, hemoptysis during swim/dive. Can be fatal • Divers, triathletes, Navy trainees (NEDU, BUD/S) • Pathophysiology may be exaggerated increase in pulmonary vascular pressures during immersed exercise in cold water

  46. Biochemical Modification of Susceptibility to Mountain Sickness (DARPA) • Can adaptation to altitude be accelerated by a combination of several drugs? • Can exercise performance be improved? • Increase systemic blood flow without increasing pulmonary blood flow? • Initial tests in mice, then humans

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