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Jan B. Wade · #1 (**permalink**) 07-14-2004, 01:50 PM

Does Medicare reimburse for HBO treatment for Blood Loss? - Jan

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Facilitation of Recovery From Acute Blood Loss with Hyperbaric Oxygen
BACKGROUND: Hyperbaric oxygen (HBO) has been used for more than 25 years as therapy for extreme blood loss in cases where transfusion therapy has been unavailable. The use of HBO for lesser amounts of blood loss to avoid the transfusion of blood products has not been investigated.

HYPOTHESIS: Hyperbaric oxygen up-regulates hemoglobin synthesis after acute blood loss in an animal model of moderate (30%) blood loss.

DESIGN: Twenty-four New Zealand white rabbits were bled to a calculated loss of 30% of the circulating blood volume. The rabbits received Ringer lactate infusions to correct hypovolemia and were divided into 2 groups: a control group and a treatment group receiving HBO.

INTERVENTION: One group of 12 animals received no treatment other than Ringer lactate resuscitation, whereas the other group of 12 received 5 HBO treatments in the 4 days immediately following blood loss. Hemoglobin levels and reticulocyte counts were monitored for 14 days after the bleeding episode.

RESULTS: The control group was more affected by the blood withdrawal than the HBO group, reaching a low of 37 % hemoglobin loss compared with 29 % hemoglobin loss at 48 hours (P<.001). The HBO group recovered faster, reaching the baseline level of hemoglobin in 11 days as opposed to 14 days for the control group (P<.001). Reticulocyte counts were not significantly altered by HBO treatments.

CONCLUSION: Treatment with HBO favorably affected recovery from moderate (30%) acute blood loss, resulting in lessened effects at 48 hours and hastening recovery to baseline hemoglobin levels. Our results support the data gained from clinical experience treating extreme blood loss with HBO.

Wright JK, Ehler W, McGlassen DL. Thompson W. Facilitation of recovery from acute blood loss with hyperbaric oxygen. Arch. Surgery, 2002;137:850-3.