Hyperbaric oxygen therapy is a treatment method that involves inhalation of 100% oxygen, and under higher pressure than the atmospheric. Blood has the ability to deliver more oxygen authorities. Treatment takes place in facilities called the hyperbaric chamber. During treatment, patients must adhere to certain principles that are given by the doctors and nurses working in these workplaces.The main objectives of this thesis were to map the influence of preparation on the course of treatment in a hyperbaric chamber and to determine how the patients are instructed by nurses during treatment in the hyperbaric chamber. Three research questions were set up to clarify how the preparation affects the patient during treatment in a hyperbaric chamber, as the patient is educated before treatment and what output the patient receives after leaving the hyperbaric chamber. In order to fulfill the objectives qualitative research methods were done, using a semi structured interview. The survey was conducted in two selected hospitals, in the České Budejovice Hospital, and at the University Hospital Plzeň - Lochotin. An individual, semi-structured interview was used as data collection technique, which was initially recorded on a cell phone and then transcribed into written form. At the beginning of the research interviews were conducted with nurses, who gave a comprehensive view of their job description. These conversations only complement the research. We included the brochure with basic information in our research and that was supplemented by information obtained from these interviews. The sample included patients treated in a hyperbaric chamber. They were subsequently divided into three subgroups. The first subgroup consisted of chronic patients, the second subgroup of patients undergoing hyperbaric oxygen therapy for the first time and who got the booklet with background information before their first exposure and in the third were also new patients but who were given a booklet after their first exposure. The survey was conducted in January and February 2015. Analyzed data formed four categories. Careful preparation of the patient is an essential part of treatment in a hyperbaric chamber, largely because of the specificity of this treatment, which consists mainly of placing the patient in an enclosed space, the need for a breathing mask and the inability to quickly leave the hyperbaric chamber without health risks. Therapy in a hyperbaric chamber alone is, in compliance with the indication, contraindication and dosing schedules and well-executed preparation, relatively safe and simple. From the above mentioned reasons it is necessary that the nurses in the area are sufficiently educated and that the patient who enters the hyperbaric chamber is properly prepared. Nurses educate each patient just before their first exposure, but also before every following one. There is very much information given to patients during preparation for entry into a hyperbaric chamber. The research showed that almost all the respondents had difficulty to remember all the details. Nurses tell them about hyperbaroxy essence, indications, contraindications, the exposure pattern, they select a breathing mask with them, and teach the patients to equalize the pressure in their ears, check their clothes and what they have with them. The nurses also check whether they are greased with creams, makeup and other cosmetics, and in the case of wounds if they are treated using a moist treatment instead of greasy. Before each exposure, the patient is asked about their health (a cold is a contraindication), their blood pressure is measured and the necessary nasal drops are applied. Precisely because of the considerable amount of information that patients get at their first exposure, we decided to include the booklet, which contains basic information for patients who are treated in a hyperbaric chamber for the first time, in our research.

Title: Hyperbaric environment and it's impact on physical performance Objectives: To investigate possible impact of of hyperbaric environment on individual's performance compared to normobaric environment with constant physical load. To outline the hyperbaric environment from physical side of view. To determine the usability of these effects for Training and regeneration purposes for athletes. Methods: The five respondents completed two sessions of Kinderman-Schnabell test. There was a seven days gap between hyperbaric and normobaric sessions to exclude the influence of fatique. Each session consisted of 40 seconds of sub-maximal load and a maximal load after 40 minutes rest. The squats were used as anaerobic type of load. The responders were taken a blood samples from finger and earlobe to state the level of lactate. Other measured indicators were blood pressure, heart and respirátory rate. The respondents also stated the subjective level of fatique using visual scale Results: The hyperbaric environment of 3 ATA had a significant effect on heart rate reduction. The sub-max load average was 86 bpm (resp. 99 bpm at normobaric environment) and the max-load average was 101 bpm (resp. 120 bpm normobaric). No significant effect was measured on blood pressure level averages. The sub-max load indicated...

Os nervos periféricos são extensões do sistema nervoso central e responsável pela interação das atividades entre as extremidades, em suas funções sensitivas e motoras. São vulneráveis aos mesmos tipos de traumas que afetam outros tecidos: contusão, compressão, esmagamento, estiramento, avulsão e laceração. As lesões de nervos periféricos situam-se entre as mais incapacitantes que acometem indivíduos em idade produtiva, em face dos múltiplos aspectos concernentes às sequelas deste tipo de afecção. Desta forma, a interrupção de continuidade da estrutura do nervo, como no caso da neurotmese, por algum tipo de trauma, resulta na interrupção de transmissão dos impulsos nervosos e na desorganização de suas atividades funcionais. Por meio da utilização da microcirurgia foi possível desenvolver técnicas reparadoras que vão desde simples neurorrafia término-terminal até sofisticados procedimentos cirúrgicos com a utilização de enxertos de nervos, veias e artérias invertidas, tubos sintéticos de materiais variados, tais como silicone e polietileno. Outro aspecto que intriga pesquisadores de todo mundo é a utilização de fatores neurogênicos capazes de acelerar ou melhorar a regeneração de nervos periféricos. A gordura autóloga tem sido continuamente referenciada pela sua abundante oferta, no próprio sitio cirúrgico, apresentando resultados promissores, visto que a adventícia dos vasos é constituída por tecido conjuntivo frouxo, rico em adipócitos. Assim, em um trauma, os neuritos oriundos do coto proximal do nervo lesado, ficam diretamente em contato com esses adipócitos. Seguindo este raciocínio, e com base em trabalhos anteriores onde foi usada veia preenchida com músculo esquelético a fresco como enxerto, decidiu-se testar a possibilidade de crescimento axonal por meio de enxerto com tubo de polietileno preenchido por tecido adiposo autólogo associado a protocolo de imersão em câmara hiperbárica, por meio de um estudo Randomizado Controlado. Para tanto utilizou-se um tubo com 12 mm de comprimento por 0,25 mm de diâmetro, com poros de 80 μm de diâmetro, preenchido com tecido adiposo in natura retirado das adjacências do referido nervo, na tentativa de se recuperar o nervo isquiático. Os resultados morfométricos demonstraram que, os grupos experimentais com e sem preenchimento de gordura tiveram resultados, do ponto de vista morfométrico e funcional sem diferenças estatisticamente significantes, contudo, quando estes foram confrontados ao grupo controle final, apresentaram diferenças estatisticamente significantes. Já relevando a avaliação funcional, por meio do Catwalk, constatou-se que não houve diferença estatisticamente significante entre os grupos experimentais, mas teve diferença ao comparar com o grupo controle final, Diante das evidências encontradas e apoiados na literatura pode-se concluir que a câmara hiperbárica trouxe resultados positivos verificados pela aproximação dos resultados dos grupos experimentais tanto morfométrica como funcionalmente. / The peripheral nerves are extensions of the central nervous system and are responsible for the sensory and motor functions of the limbs. These nerves are vulnerable to the same types of traumas that affect other tissues: contusion, compression, crushing, stretching, avulsion, and laceration. Amongst the most disabling kinds of injuries that affect working-age individuals are those of the peripheral nerves; due to the multifaceted characteristics of the aftereffects of the injury. The break in continuity of the nerve structure due to trauma, as in the case of neurotmesis, results in the disruption of the transmission of nerve impulses and the disorganization of their functions. Through the use of microsurgery, it was possible to develop reconstructive techniques that range from a simple end-to-end neurorrhaphy to sophisticated surgical procedures that utilize nerve grafts, inverted veins and arteries, and synthetic rods of varied materials such as silicone or porous polyethylene. Another aspect that intrigues researchers around the world is the utilization of neurogenic factors capable of accelerating or improving the regeneration of peripheral nerves. Autologous fat has been a constant reference in this field of surgery due to its abundant supply at the surgical site itself. The results are promising, as the adventitia of vessels consists of loose connective tissue rich in adipocytes. Thus in a trauma, the neurites derived from the proximal stump of the damaged nerve are in direct contact with these adipocytes. Following this reasoning, and based on previous studies where veins grafted with fresh skeletal muscle were used, we decided to conduct a randomized controlled study to test the possibility of axonal growth by means of grating with a polyethylene rod filled with autologous adipocytes associated with immersion in a hyperbaric chamber. In an attempt to recover the sciatic nerve, a rod 12 mm in length, with a diameter of 0.25 mm, and with pores of 80 μm in diameter, filled with adipose tissue in natura removed from the surroundings of said nerve, was used. The morphometric results showed that the experimental groups with and without fat fillings had results that, from the morphometric and functional point of view, were of no statistically significant difference. However, when these results were compared with the final control group, statistically significant differences were noted. Highlighting the functional evaluation through the use of Catwalk, it was found that there were no statistically significant differences between the experimental groups, but there was indeed a difference in comparison to the final control group. In light of the evidence found and supported by literature, one can conclude that the use of the hyperbaric chamber brought positive results verified by the proximity of both the morphometric and functional results of the experimental groups.

Os nervos periféricos são extensões do sistema nervoso central e responsável pela interação das atividades entre as extremidades, em suas funções sensitivas e motoras. São vulneráveis aos mesmos tipos de traumas que afetam outros tecidos: contusão, compressão, esmagamento, estiramento, avulsão e laceração. As lesões de nervos periféricos situam-se entre as mais incapacitantes que acometem indivíduos em idade produtiva, em face dos múltiplos aspectos concernentes às sequelas deste tipo de afecção. Desta forma, a interrupção de continuidade da estrutura do nervo, como no caso da neurotmese, por algum tipo de trauma, resulta na interrupção de transmissão dos impulsos nervosos e na desorganização de suas atividades funcionais. Por meio da utilização da microcirurgia foi possível desenvolver técnicas reparadoras que vão desde simples neurorrafia término-terminal até sofisticados procedimentos cirúrgicos com a utilização de enxertos de nervos, veias e artérias invertidas, tubos sintéticos de materiais variados, tais como silicone e polietileno. Outro aspecto que intriga pesquisadores de todo mundo é a utilização de fatores neurogênicos capazes de acelerar ou melhorar a regeneração de nervos periféricos. A gordura autóloga tem sido continuamente referenciada pela sua abundante oferta, no próprio sitio cirúrgico, apresentando resultados promissores, visto que a adventícia dos vasos é constituída por tecido conjuntivo frouxo, rico em adipócitos. Assim, em um trauma, os neuritos oriundos do coto proximal do nervo lesado, ficam diretamente em contato com esses adipócitos. Seguindo este raciocínio, e com base em trabalhos anteriores onde foi usada veia preenchida com músculo esquelético a fresco como enxerto, decidiu-se testar a possibilidade de crescimento axonal por meio de enxerto com tubo de polietileno preenchido por tecido adiposo autólogo associado a protocolo de imersão em câmara hiperbárica, por meio de um estudo Randomizado Controlado. Para tanto utilizou-se um tubo com 12 mm de comprimento por 0,25 mm de diâmetro, com poros de 80 μm de diâmetro, preenchido com tecido adiposo in natura retirado das adjacências do referido nervo, na tentativa de se recuperar o nervo isquiático. Os resultados morfométricos demonstraram que, os grupos experimentais com e sem preenchimento de gordura tiveram resultados, do ponto de vista morfométrico e funcional sem diferenças estatisticamente significantes, contudo, quando estes foram confrontados ao grupo controle final, apresentaram diferenças estatisticamente significantes. Já relevando a avaliação funcional, por meio do Catwalk, constatou-se que não houve diferença estatisticamente significante entre os grupos experimentais, mas teve diferença ao comparar com o grupo controle final, Diante das evidências encontradas e apoiados na literatura pode-se concluir que a câmara hiperbárica trouxe resultados positivos verificados pela aproximação dos resultados dos grupos experimentais tanto morfométrica como funcionalmente. / The peripheral nerves are extensions of the central nervous system and are responsible for the sensory and motor functions of the limbs. These nerves are vulnerable to the same types of traumas that affect other tissues: contusion, compression, crushing, stretching, avulsion, and laceration. Amongst the most disabling kinds of injuries that affect working-age individuals are those of the peripheral nerves; due to the multifaceted characteristics of the aftereffects of the injury. The break in continuity of the nerve structure due to trauma, as in the case of neurotmesis, results in the disruption of the transmission of nerve impulses and the disorganization of their functions. Through the use of microsurgery, it was possible to develop reconstructive techniques that range from a simple end-to-end neurorrhaphy to sophisticated surgical procedures that utilize nerve grafts, inverted veins and arteries, and synthetic rods of varied materials such as silicone or porous polyethylene. Another aspect that intrigues researchers around the world is the utilization of neurogenic factors capable of accelerating or improving the regeneration of peripheral nerves. Autologous fat has been a constant reference in this field of surgery due to its abundant supply at the surgical site itself. The results are promising, as the adventitia of vessels consists of loose connective tissue rich in adipocytes. Thus in a trauma, the neurites derived from the proximal stump of the damaged nerve are in direct contact with these adipocytes. Following this reasoning, and based on previous studies where veins grafted with fresh skeletal muscle were used, we decided to conduct a randomized controlled study to test the possibility of axonal growth by means of grating with a polyethylene rod filled with autologous adipocytes associated with immersion in a hyperbaric chamber. In an attempt to recover the sciatic nerve, a rod 12 mm in length, with a diameter of 0.25 mm, and with pores of 80 μm in diameter, filled with adipose tissue in natura removed from the surroundings of said nerve, was used. The morphometric results showed that the experimental groups with and without fat fillings had results that, from the morphometric and functional point of view, were of no statistically significant difference. However, when these results were compared with the final control group, statistically significant differences were noted. Highlighting the functional evaluation through the use of Catwalk, it was found that there were no statistically significant differences between the experimental groups, but there was indeed a difference in comparison to the final control group. In light of the evidence found and supported by literature, one can conclude that the use of the hyperbaric chamber brought positive results verified by the proximity of both the morphometric and functional results of the experimental groups.