Volume 70 (2020): Issue 1 (March 2020)

This two-part article reviews the current legal situation of professional personnel implementing hyperbaric procedures other than those used for diving. Numerous inconsistencies between the existing legal acts and the lack of legal regulations concerning procedures not financed from the State budget are shown.

The first significant problem was the lack of mutual correlation of various regulations of the Minister of Health concerning hyperbaric diseases, as well as incoherence with medical and nursing specialisation programs in force in Poland.

The second problem is the lack of requirements in the documents of the Ministry of Health for medical staff other than doctors and nurses, including technical staff, necessary for the implementation of a safe oxybarotherapy procedure.

The situation is clearer with respect to technical personnel than in relation to medical personnel. There are provisions which strictly define the qualifications of such staff for a very narrow group of technical personnel. Although they deal with issues related to the use of hyperbaric chambers in diving, to date no other separate regulations have been developed for medical applications of hyperbaric therapy. Unfortunately, both in centres financed by the National Health Fund and in private centres, no-one observes these regulations because there is no such formal requirement.

The same applies to occupational research (occupational medicine) for all groups of personnel involved in hyperbaric oxygen therapy treatments.

It was also found that medical hyperbaric centres not seeking funding from the budget (the National Health Fund) do not have even minimum qualification requirements for the medical staff working there. Furthermore, there is no knowledge of the requirements set out in other legal acts other than those concerning medicine.

Maintaining a stable oxygen content in the breathing loop of the diving apparatus with a semi-closed respiratory circuit is essential for the safety of underwater mine clearance operations. This article discusses the influence of modified methods of flushing the breathing apparatus on the quality of the breathing loop ventilation process. The problem of flushing an apparatus is presented in light of the Polish Naval Academy’s change from statistical to deterministic decompression schedules, based on the model of apparatus ventilation, oxygen toxicity hazard and decompression. The examination and determination utilising the required accuracy of the method used for flushing the breathing loop of the device allowed to assess the stable oxygen content during the decompression phase. The assumptions were verified based on a system for measuring oxygen content in the breathing loop.

The aim of the study was to determine the effect of the application of hyperbaric oxygen therapy on the course of an infection with group A type T-3 hemolytic β streptococcus. Experiments were carried out on Porton white mice and in vitro blood plates. General and local infections with streptococci were induced in animals. The infected animals were treated with hyperbaric oxygenation. The lethal effect of infection was significantly inhibited using hyperbaric oxygenation on the first and second day following the infection.

Objective: Paraoxonase1 (PON1) and Arylesterase (ARE) levels are associated with reduced risk of atherosclerosis. The functional status of high density lipoprotein (HDL) is closely related to the PON1/ARE enzyme activity. Functional changes in treatment of sudden sensorineural hearing loss (SSNHL) may be achieved by post-translational modification of lipid metabolism induced by hyperbaric oxygen therapy (HBOT).

Methods: Men patients with SSNHL who met the research criteria were included in the study. HBOT was performed on average 30 sessions. Laboratory measurements were made at the beginning and end of HBOT for the same patients. Serum levels of PON1/ARE and routine lipid laboratory parameters were measured to determine possible changes in SSNHL after HBOT.

Results: In this study, a reducing effect on PON1 enzyme amount of long-term HBOT was detected. The serum PON1 amount of patients with SSNHL was 19.7 ± 2.7 ng / mL (mean ± SD) before HBOT, and the serum PON1 decreased to 17.0 ± 2.1 ng / mL (mean ± SD) after 30 sessions of HBOT. This decrease in PON1 levels was statistically significant (p =0.035). There was also a statistically significant decrease in the enzyme activity of ARE in the SSNHL patients (p=0.024).

Conclusion: This preliminary study showed a significant decrease in serum PON1/ARE enzyme content in SSNLH patients with HBOT. In fact, it can be assumed that HBOT has no adverse effect on HDL functionality. However, the decrease in PON1 level by HBOT with 30 or more sessions may be important for the antioxidant function of HDL.It may possibly cause post-translational changes in antioxidant defense mechanisms due to increased oxidative stress with HBOT. In conclusion, larger clinical studies are needed to determine the possible effects of HBOT on HDL-related PON1/ARE functionality in SSNHL.

The paper presents a continuation of studies on the influence of increased ambient pressure on the eye-muscle reflex. Using the same methods, the research was carried out in real conditions, i.e. during dives in water. Dives were performed in classical equipment with air as a breathing mix at depths of 10, 20, 30, 40, 50 and 60 m. It was found that statistically significant differences in the time of eye-muscle reflexes occur during the transition from 0 to 10, from 40 to 50 and 50 to 60 meters of overpressure. In the conclusions, it was found that the prolongation of reflex time is much greater than in hyperbaric chamber studies. As in previous studies, toxic effects of components of the breathing mixture, especially nitrogen, were considered the main cause.