{"id":2337,"date":"2024-12-24T16:35:43","date_gmt":"2024-12-24T16:35:43","guid":{"rendered":"https:\/\/medreasons.com\/?page_id=2337"},"modified":"2025-01-31T04:15:21","modified_gmt":"2025-01-31T04:15:21","slug":"hyperbaric-oxygen-therapy","status":"publish","type":"page","link":"https:\/\/medreasons.com\/index.php\/posts\/surgery\/hyperbaric-oxygen-therapy\/","title":{"rendered":"Hyperbaric Oxygen Therapy"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2337\" class=\"elementor elementor-2337\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-832c25a e-con-full e-flex e-con e-parent\" data-id=\"832c25a\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-ae3c3aa e-con-full e-flex e-con e-child\" data-id=\"ae3c3aa\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ccdab0e elementor-widget elementor-widget-text-editor\" data-id=\"ccdab0e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1>Hyperbaric Oxygen Therapy in Wound Healing\u00a0<\/h1>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aacc219 elementor-widget elementor-widget-text-editor\" data-id=\"aacc219\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><em>Joseph Priestley discovered Oxygen in 1775. Little did he knew that a gas considered toxic due to its effect on CNS and Lungs would be used therapeutically in near future!<\/em><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2eab269 elementor-widget elementor-widget-text-editor\" data-id=\"2eab269\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tHyperbaric Oxygen Therapy refers to the treatment modality where a patient breathes 100% O<sub>2<\/sub> inside a closed chamber containing high atmospheric pressure. The patient may be subjected to this pressure directly through the pressurized closed chamber or through a facemask, hood or an endotracheal tube.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ad38829 elementor-widget elementor-widget-text-editor\" data-id=\"ad38829\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Hyperbaric Oxygen Therapy has been used in management of air and gas emboli, decompression sickness, Carbon monoxide poisoning, wound management and may other medical conditions. We will discuss the mechanisms through which it works in the management of above cases while specifically discussing about its mechanisms in wound healing.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7ebec16 elementor-widget-divider--separator-type-pattern elementor-widget-divider--no-spacing elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"7ebec16\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\" style=\"--divider-pattern-url: url(&quot;data:image\/svg+xml,%3Csvg xmlns=&#039;http:\/\/www.w3.org\/2000\/svg&#039; preserveAspectRatio=&#039;xMidYMid meet&#039; overflow=&#039;visible&#039; height=&#039;100%&#039; viewBox=&#039;0 0 126 26&#039; fill=&#039;black&#039; stroke=&#039;none&#039;%3E%3Cpath d=&#039;M10.7,6l2.5,2.6l-4,4.3l4,5.4l-2.5,1.9l-4.5-5.2l-3.9,4.2L0.7,17L4,13.1L0,8.6l2.3-1.3l3.9,3.9L10.7,6z M23.9,6.6l4.2,4.5L32,7.2l2.3,1.3l-4,4.5l3.2,3.9L32,19.1l-3.9-3.3l-4.5,4.3l-2.5-1.9l4.4-5.1l-4.2-3.9L23.9,6.6zM73.5,6L76,8.6l-4,4.3l4,5.4l-2.5,1.9l-4.5-5.2l-3.9,4.2L63.5,17l4.1-4.7L63.5,8l2.3-1.3l4.1,3.6L73.5,6z M94,6l2.5,2.6l-4,4.3l4,5.4L94,20.1l-3.9-5l-3.9,4.2L84,17l3.2-3.9L84,8.6l2.3-1.3l3.2,3.9L94,6z M106.9,6l4.5,5.1l3.9-3.9l2.3,1.3l-4,4.5l3.2,3.9l-1.6,2.1l-3.9-4.2l-4.5,5.2l-2.5-1.9l4-5.4l-4-4.3L106.9,6z M53.1,6l2.5,2.6l-4,4.3l4,4.6l-2.5,1.9l-4.5-4.5l-3.5,4.5L43.1,17l3.2-3.9l-4-4.5l2.3-1.3l3.9,3.9L53.1,6z&#039;\/%3E%3C\/svg%3E&quot;);\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f0efa5c elementor-widget elementor-widget-text-editor\" data-id=\"f0efa5c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><strong>Hyperbaric Oxygen Therapy &#8211; General Mechanisms\u00a0<\/strong><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e328452 elementor-widget elementor-widget-text-editor\" data-id=\"e328452\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong><em>So, whenever we think about how Hyperbaric oxygen might work, it immediately clicks in our mind that hyperbaric Oxygen is just Oxygen gas at high pressures, and it will mechanically compress the gases which are present in our bloodstream and probably this might be its mechanism of action.<\/em><\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f83d767 elementor-widget elementor-widget-text-editor\" data-id=\"f83d767\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>However it is not as simple as it looks !<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-11fb0c6 elementor-widget elementor-widget-image\" data-id=\"11fb0c6\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"768\" height=\"223\" src=\"https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Untitled-768x223.png\" class=\"attachment-medium_large size-medium_large wp-image-2520\" alt=\"hyperbaric pressure therapy\" srcset=\"https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Untitled-768x223.png 768w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Untitled-300x87.png 300w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Untitled-1024x297.png 1024w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Untitled.png 1406w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-156f5c6 elementor-widget elementor-widget-text-editor\" data-id=\"156f5c6\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The two aspects of Hyperbaric Oxygen contribute to its therapeutic action &#8211;<span style=\"font-size: 16px;\">\u00a0<\/span><\/p><ol><li><span style=\"font-size: 16px;\">The elevated partial pressure of inspired O2, and\u00a0<\/span><\/li><li>Increased Hydrostatic pressure throughout the body present in the HBOT chamber.<\/li><\/ol><p>Let&#8217;s discuss them one by one &#8211;\u00a0\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7d597f2 elementor-widget elementor-widget-text-editor\" data-id=\"7d597f2\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3>1. The elevated partial pressure of Inspired O2<\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-48e3551 elementor-widget elementor-widget-text-editor\" data-id=\"48e3551\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>When the subject breathes 100% O<sub>2<\/sub> at elevated pressures (usually 3 atm), more amount of O<sub>2<\/sub> diffuses into the blood owing to a large pressure difference along the alveoli. It has been estimated that there is a net increase of dissolved O<sub>2<\/sub> by 22.7%. This creates a state of excess O<sub>2<\/sub> in the blood known as Hyperoxia. This O<sub>2<\/sub> now goes to mitochondria to serve as the final electron acceptor in the electron transport chain. During this process a lot of free radicals are generated. In this way hyperoxia increases the production of reactive O2 species (ROS) and Reactive nitrogen species (RNS).<\/p><p>But wait! This doesn&#8217;t seem to be going in the right path. One might wonder that the ROS &amp; RNS generated due to hyperoxia would cause more damage than good.<\/p><p>So here comes the interesting part. HBOT is not given continuously, rather a typical HBOT session varies from 1.5 to 2 h and is usually performed from one to three times daily, being given among 20 to 60 therapeutical doses depending on the medical condition. Thus, HBOT generates hyperoxia intermittently and this intermittent hyperoxia causes a transient rise of ROS &amp; RNS, and to our surprise, this transient rise causes many beneficial effects including the synthesis of different growth factors finally improving neovascularization and immunomodulatory properties. This property is called <a href=\"https:\/\/medreasons.com\/index.php\/posts\/physiology\/general-physiology\/hormesis\/\">Hormesis<\/a>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8abb306 elementor-widget elementor-widget-text-editor\" data-id=\"8abb306\" data-element_type=\"widget\" id=\"increased hydrostatic pressure throughout the body\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3>2. Increased Hydrostatic pressure throughout the body<\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9e94f28 elementor-widget elementor-widget-text-editor\" data-id=\"9e94f28\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Now let&#8217;s revisit one of the laws we&#8217;ve read in our +2s &#8211; &#8216;<strong>The Henry&#8217;s Law<\/strong>&#8216;. It states that the amount of gas that is dissolved in a liquid is directly proportional to the partial pressure of that gas above the liquid when the temperature is kept constant.\u00a0<\/p><p>For administration of the therapy the patient is taken to a specially designed chamber and the pressure inside the chamber is set to almost 1.5-3 times the normal air pressure. At this moment the patient is inside the chamber and every tissue including blood inside his\/her body is experiencing increased pressure.<\/p><p>Our blood contains gases which are circulating in a dissolved form. So, this increased pressure contributes to a compression of all gas-filled spaces in the body (Henry&#8217;s Law) and is relevant to treat conditions where gas bubbles are present in the body and cause the disease (e.g. intravascular embolism; decompression sickness with intravascular or intra-tissue bubbles).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ce193a9 elementor-widget elementor-widget-text-editor\" data-id=\"ce193a9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tHowever, the majority of patients treated with hyperbaric oxygen do not suffer from bubble-induced injuries but derive clinical improvements from the elevated O<sub>2<\/sub> partial pressures.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82710fe elementor-widget elementor-widget-image\" data-id=\"82710fe\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"https:\/\/post.healthline.com\/wp-content\/uploads\/2022\/09\/patient-receiving-hyberbaric-oxygen-therapy-1296x728-Header.jpg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-81d3800 elementor-widget-divider--separator-type-pattern elementor-widget-divider--no-spacing elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"81d3800\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\" style=\"--divider-pattern-url: url(&quot;data:image\/svg+xml,%3Csvg xmlns=&#039;http:\/\/www.w3.org\/2000\/svg&#039; preserveAspectRatio=&#039;xMidYMid meet&#039; overflow=&#039;visible&#039; height=&#039;100%&#039; viewBox=&#039;0 0 126 26&#039; fill=&#039;black&#039; stroke=&#039;none&#039;%3E%3Cpath d=&#039;M10.7,6l2.5,2.6l-4,4.3l4,5.4l-2.5,1.9l-4.5-5.2l-3.9,4.2L0.7,17L4,13.1L0,8.6l2.3-1.3l3.9,3.9L10.7,6z M23.9,6.6l4.2,4.5L32,7.2l2.3,1.3l-4,4.5l3.2,3.9L32,19.1l-3.9-3.3l-4.5,4.3l-2.5-1.9l4.4-5.1l-4.2-3.9L23.9,6.6zM73.5,6L76,8.6l-4,4.3l4,5.4l-2.5,1.9l-4.5-5.2l-3.9,4.2L63.5,17l4.1-4.7L63.5,8l2.3-1.3l4.1,3.6L73.5,6z M94,6l2.5,2.6l-4,4.3l4,5.4L94,20.1l-3.9-5l-3.9,4.2L84,17l3.2-3.9L84,8.6l2.3-1.3l3.2,3.9L94,6z M106.9,6l4.5,5.1l3.9-3.9l2.3,1.3l-4,4.5l3.2,3.9l-1.6,2.1l-3.9-4.2l-4.5,5.2l-2.5-1.9l4-5.4l-4-4.3L106.9,6z M53.1,6l2.5,2.6l-4,4.3l4,4.6l-2.5,1.9l-4.5-4.5l-3.5,4.5L43.1,17l3.2-3.9l-4-4.5l2.3-1.3l3.9,3.9L53.1,6z&#039;\/%3E%3C\/svg%3E&quot;);\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-07f3c5d elementor-widget elementor-widget-text-editor\" data-id=\"07f3c5d\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h2><strong>Hyperbaric Oxygen Therapy &#8211; Specific Mechanisms\u00a0<\/strong><\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-be70796 elementor-widget elementor-widget-text-editor\" data-id=\"be70796\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Hyperbaric Oxygen Therapy in Wound healing<\/strong><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5944408 elementor-widget elementor-widget-text-editor\" data-id=\"5944408\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>HBOT plays a major role in wound healing and is nowadays indicated for microbial-infected wounds (e.g., Clostridial myonecrosis and Fournier\u2019s gangrene), traumatic wounds, thermal burns, skin grafts, radiation-induced wounds &amp; diabetic and vascular insufficiency ulcers.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-655d5ff elementor-widget elementor-widget-image\" data-id=\"655d5ff\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"768\" height=\"228\" src=\"https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Screenshot-2025-01-12-092501-768x228.png\" class=\"attachment-medium_large size-medium_large wp-image-2618\" alt=\"hyperbaric oxygen therapy\" srcset=\"https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Screenshot-2025-01-12-092501-768x228.png 768w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Screenshot-2025-01-12-092501-300x89.png 300w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Screenshot-2025-01-12-092501-1024x305.png 1024w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Screenshot-2025-01-12-092501.png 1321w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-af6d7d7 elementor-widget elementor-widget-spacer\" data-id=\"af6d7d7\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae627c0 elementor-widget elementor-widget-text-editor\" data-id=\"ae627c0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Role of Oxygen<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-39e5830 elementor-widget elementor-widget-text-editor\" data-id=\"39e5830\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Oxygen is required for healing in multiple ways &#8211;\u00a0<\/p><ol><li style=\"list-style-type: none;\"><ol><li>Oxygen is required for adenosine tri-phosphate synthesis within the mitochondria (through complex V of Electron transport chain) for oxidative metabolism.<\/li><li>essential for collagen and protein synthesis.<ul><li>Oxygen acts as cofactor for enzymes which synthesize collagen &amp; protein. For eg &#8211; Mature collagen synthesis requires <em>prolyl-hydroxylase and lysyl-hydroxylase<\/em>, which are enzymes dependent on oxygen for function.<\/li><\/ul><\/li><li><p>Oxygen is a substrate for all NOX enzymes(NADPH oxidases), which are a major source of ROS. The production of ROS during wound healing is critical for cell signaling, angiogenesis, and wound disinfection.\u00a0<\/p><figure><\/figure><\/li><li>NO is produced by the nitric oxide synthase (NOS) family of enzymes, which require molecular oxygen as a co-substrate for the oxidation of the amino acid L-arginine to NO and citrulline. NO plays a critical role in the regulation of vascular tone and angiogenesis in the wound bed.<\/li><\/ol><\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b86dd49 elementor-widget elementor-widget-text-editor\" data-id=\"b86dd49\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Increase in NRF2\u00a0<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0c50ad0 elementor-widget elementor-widget-text-editor\" data-id=\"0c50ad0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>NRF2 stands for <b>Nuclear factor erythroid 2-related factor 2,\u00a0<\/b>it is a transcription factor which regulates the expression of antioxidant proteins that protects the cell against oxidative damage triggered by injury and inflammation.<\/p><p>Wounded tissues normally produce large amounts of ROS to combat invading pathogens, to attract immune cells, and to regulate different cell signaling events and this process is aided by high partial pressures of O<sub>2.<\/sub> ROS and other electrophilic compounds induce the activity of NRF2 by stabilizing it and regulating its degradation. NRF2 regulates the transcription of cytoprotective genes, including genes encoding various ROS-detoxifying enzymes, antioxidant proteins, and drug transporters by binding to antioxidant response elements (AREs) in the promoter regions of genes encoding cytoprotective proteins<span style=\"font-style: inherit; font-weight: inherit; color: var( --e-global-color-text ); background-color: var(--ast-global-color-5);\">.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2bfa0ed elementor-widget elementor-widget-text-editor\" data-id=\"2bfa0ed\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Epithelialization and Neovascularization<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-48ac877 elementor-widget elementor-widget-text-editor\" data-id=\"48ac877\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Hyperbaric Oxygen promotes epithelization and neovascularization through up-regulation of host factors like tumor necrosis factor-\u03b1 (TNF-\u03b1), matrix metallopeptidase 9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1).\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9bb7d66 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"9bb7d66\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ae2056 elementor-widget elementor-widget-text-editor\" data-id=\"9ae2056\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Hyperbaric Oxygen Therapy in Infections<\/strong><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-50122c9 elementor-widget elementor-widget-text-editor\" data-id=\"50122c9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"text-decoration: underline;\"><strong>THE HYPOXIA-HYPEROXIA PARADOX <\/strong><\/span><\/p><p>The actions of Hyperbaric oxygen therapy i.e. exposure of cells to intermittent hyperoxic environment, induces mediators and cellular adaptive mechanisms which are similar to those induced by hypoxia.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-81c45cd elementor-widget elementor-widget-text-editor\" data-id=\"81c45cd\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ol><li style=\"list-style-type: none;\"><ol><li>HBOT upregulates HIF that induces the expression of Nitric Oxide Synthases (NOS) and virus killing peptides (defensins and cathelicidins such as cathelin-related antimicrobial peptide) with consequent neutrophil and monocyte phagocytosis of the microbes.<ol><li>Cathelicidin peptides are dual-natured molecules called\u00a0amphiphiles: one end of the molecule is attracted to water and repelled by fats and proteins, and the other end is attracted to fat and proteins and repelled by water. Members of this family react to pathogens by disintegrating, damaging, or puncturing cell membranes.<\/li><\/ol><\/li><li>Anaerobic bacteria are killed by a much higher amount of pressurized O<sub>2 <\/sub>\u00a0(bacteriostasis)<\/li><li>Anti inflammatory potential &#8211; prevents rolling and activation of WBCs &#8211;prevents reperfusion injuries.<\/li><li>Intracranial abscess (ICA)<ol><li>Inflammatory response may damage the surrounding brain parenchyma causing morbidity and mortality. Infection proper and the use of antibiotics leads to a localized acidotic and hypoxic environment. HBOT impairs the acidotic and hypoxic environment in ICAs due to the proper infection and the use of antibiotics.HBOT being a non-invasive and safely tolerated method, is accepted as an adjunctive therapy in patients suffering from ICA.\u00a0<\/li><\/ol><\/li><li>\u00a0osteomyelitis<ol><li style=\"list-style-type: none;\"><ol><li>Osteomyelitis becomes a challenging condition to treat, as many antimicrobials do not penetrate in the bone properly. HBOT acts as a synergist to antibiotic activity, while enhancing angiogenesis, leukocyte oxidative killing and osteogenetic process.<\/li><\/ol><\/li><\/ol><\/li><\/ol><\/li><\/ol><ol><li style=\"list-style-type: none;\">\u00a0<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e3d8d7e elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"e3d8d7e\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f0eb65b elementor-widget elementor-widget-text-editor\" data-id=\"f0eb65b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3><strong>Hyperbaric Oxygen Therapy in Medical Emergencies<\/strong><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-001c283 elementor-widget elementor-widget-text-editor\" data-id=\"001c283\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Decompression Sickness &amp; Air embolism<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-944c290 elementor-widget elementor-widget-text-editor\" data-id=\"944c290\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p style=\"text-align: center;\"><a href=\"#increased hydrostatic pressure throughout the body\">discussed above.<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-831ecea elementor-widget elementor-widget-text-editor\" data-id=\"831ecea\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Central retinal artery occlusion (CRAO)<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cb325ec elementor-widget elementor-widget-text-editor\" data-id=\"cb325ec\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>CRAO is an ophthalmological complication caused by a permanent occlusion of the central retinal artery, mostly due to an embolus at its narrowest part that is typically associated with a sudden, massive loss of vision in the affected eye. It should be noted that retinal tissue has the highest Oxygen consumption rate in the body, which makes it nontolerant to hypoxia.<\/p><p>Hyperbaric oxygen therapy helps in providing more oxygen to the tissues and thus minimizes the ischemic damage to the retina.\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-857910d elementor-widget elementor-widget-text-editor\" data-id=\"857910d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Trauma &amp; Crush injuries<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d144b80 elementor-widget elementor-widget-text-editor\" data-id=\"d144b80\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The affected tissue suffer from hypoxia, edema and ischemia &amp; HBOT improves neovascularisation and promotes healing.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-80ac822 elementor-widget elementor-widget-text-editor\" data-id=\"80ac822\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Carbon monoxide poisoning<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61973f4 elementor-widget elementor-widget-text-editor\" data-id=\"61973f4\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>CO is readily absorbed through the lungs and binds to the hemoglobin molecule in red blood cells with an affinity 240 times that of oxygen. The COHb thus formed, impairs the delivery of the remaining oxygen bound to the hemoglobin molecule. This results in decreased oxygen delivery to the tissues and relative tissue hypoxia.<\/p><p>Not only this, almost 10% to 15% of the CO binds to myoglobin, cytochromes, and NADPH reductase, thus impairing oxidative phosphorylation in the mitochondria of the cells. This is especially toxic to the heart muscle and the brain, as they have high oxygen demands. This results in the classic symptoms of headache, dizziness, nausea, vomiting, flu-like symptoms, fatigue, shortness of breath, impaired judgment, and cognitive dysfunction, chest pain, agitation, abdominal pain, drowsiness, loss of consciousness, visual changes, and seizures.<\/p><p>CO is itself toxic and damages the endothelial cells of the vessels in the brain. Neutrophils adhere to these damaged endothelial cells. Activated neutrophils release an enzyme called as Xanthine oxidase which generates Oxygen Free radicals and is thus responsible for the cytotoxic property of neutrophils. <br \/>Lipid peroxidation by toxic oxygen species generated by xanthine oxidase in the brain cause neurological sequelae such as depression, memory problems, ataxia, behavior problems, and impaired cognitive function.<\/p><p>Hyperbaric Oxygen competitively binds with haemoglobin &amp; rapidly displaces CO from Hb and generates normal oxyhemoglobin in the red blood cell. Hyperbaric oxygen therapy reduces the adherence of neutrophils on the damaged endothelium of the blood vessels in the brain, which reduces tissue edema and reduces lipid peroxidation. The extra oxygen that is delivered to the tissue also helps to reduce the CO bound to the cytochrome proteins in the mitochondria of the cells and contributes to restoring oxidative phosphorylation, which neurons are especially dependent upon for normal function and survival from the ischemic insult. It also decreases the risk for brain injury and nerve damage(delayed neuropsychiatric syndrome) through its anti-inflammatory properties.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d9569e5 elementor-widget elementor-widget-text-editor\" data-id=\"d9569e5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Anaemia\u00a0<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-736f90f elementor-widget elementor-widget-text-editor\" data-id=\"736f90f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>As Hb levels drops to a critical level, O<sub>2<\/sub> delivery to the tissues gets impaired. In this line, the use of 100%, hyperbaric O<sub>2<\/sub> solves the problem by increasing the amount of oxygen dissolved in the plasma by virtue of the Henry&#8217;s Law.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3dbc170 elementor-widget elementor-widget-text-editor\" data-id=\"3dbc170\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Sensorineural Hearing Loss (SNHL)<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f72a577 elementor-widget elementor-widget-text-editor\" data-id=\"f72a577\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of at least 30 decibels occurring over at least three consecutive audiometric frequencies and lasting for at least 3 days.<\/p><p>Hearing function in the inner ear is maintained by the cochlea which has a high oxygen demand. Cochlear hypoxia is associated with progressive ossification, fibrosis, loss of neurons, endolymphatic hydrops, and hearing loss. Direct blood supply to the organ of Corti is minimal, so oxygen must diffuse through the perilymph and cortilymph.<\/p><p>The labyrinthine artery (internal auditory artery) is a long, slender branch of the anterior inferior cerebellar artery or the basilar artery. It accompanies the vestibulocochlear nerve through the internal acoustic meatus into the inner ear. Labyrinthine artery occlusion has shown to cause progressive degenerative changes, fibrosis, new bone formation, and hearing loss. Any pathology that results in vascular occlusion of this artery can result in hearing loss.<\/p><p>HBOT not only prevents Cochlear hypoxia by increasing the amount of Oxygen delivery but also helps in resolving vascular occlusion in the labyrinthine artery if any. Also, HBOT protects the hair cell stereocilia, through hormetic mechanisms. Hormesis is a biological phenomenon where a low dose of a potentially harmful stressor, such as a toxin or environmental factor, stimulates a beneficial adaptive response in an organism. In other words, small doses of stressors that would be damaging in larger amounts can actually enhance resilience, stimulate growth, or improve health at lower levels.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c6160ad elementor-widget elementor-widget-text-editor\" data-id=\"c6160ad\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h4><strong>Femoral head necrosis<\/strong><\/h4>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9ccda55 elementor-widget elementor-widget-image\" data-id=\"9ccda55\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Avascular-necrosis-Pathogenesis-1024x576.jpg\" class=\"attachment-large size-large wp-image-2747\" alt=\"Avascular necrosis Pathogenesis\" srcset=\"https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Avascular-necrosis-Pathogenesis-1024x576.jpg 1024w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Avascular-necrosis-Pathogenesis-300x169.jpg 300w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Avascular-necrosis-Pathogenesis-768x432.jpg 768w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Avascular-necrosis-Pathogenesis-1536x864.jpg 1536w, https:\/\/medreasons.com\/wp-content\/uploads\/2025\/01\/Avascular-necrosis-Pathogenesis.jpg 1920w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2038577 elementor-widget elementor-widget-text-editor\" data-id=\"2038577\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Femoral Head necrosis also called as Avascular necrosis of the femoral head, is mainly caused by a compromised blood supply to the bone ultimately leading to apoptosis of bone marrow cells and osteocytes.\u00a0<\/p><p>Hyperbaric Oxygen therapy works by promoting neo angiogenesis and neovascularization, by increasing extracellular oxygen concentration, by reducing cellular ischemia and edema by causing vasoconstriction, and by\u00a0 reducing bone marrow pressure and improves oxygen delivery to ischemic cells, thus preventing further necrosis.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d293c29 e-flex e-con-boxed e-con e-parent\" data-id=\"d293c29\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-32743b1 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"32743b1\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-345475a elementor-post-navigation-borders-yes elementor-widget elementor-widget-post-navigation\" data-id=\"345475a\" data-element_type=\"widget\" data-widget_type=\"post-navigation.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-post-navigation\">\n\t\t\t<div class=\"elementor-post-navigation__prev elementor-post-navigation__link\">\n\t\t\t\t<a href=\"https:\/\/medreasons.com\/index.php\/medical-disclaimer\/\" rel=\"prev\"><span class=\"post-navigation__arrow-wrapper post-navigation__arrow-prev\"><i class=\"fa fa-chevron-circle-left\" aria-hidden=\"true\"><\/i><span class=\"elementor-screen-only\">Prev<\/span><\/span><span class=\"elementor-post-navigation__link__prev\"><span class=\"post-navigation__prev--label\">Previous<\/span><span class=\"post-navigation__prev--title\">Medical Disclaimer<\/span><\/span><\/a>\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-post-navigation__separator-wrapper\">\n\t\t\t\t\t<div class=\"elementor-post-navigation__separator\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"elementor-post-navigation__next elementor-post-navigation__link\">\n\t\t\t\t<a href=\"https:\/\/medreasons.com\/index.php\/posts\/pathology\/patterns-of-necrosis-in-hepatic-zones\/\" rel=\"next\"><span class=\"elementor-post-navigation__link__next\"><span class=\"post-navigation__next--label\">Next<\/span><span class=\"post-navigation__next--title\">Patterns of Necrosis to liver zones<\/span><\/span><span class=\"post-navigation__arrow-wrapper post-navigation__arrow-next\"><i class=\"fa fa-chevron-circle-right\" aria-hidden=\"true\"><\/i><span class=\"elementor-screen-only\">Next<\/span><\/span><\/a>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Hyperbaric Oxygen Therapy in Wound Healing\u00a0 Joseph Priestley discovered Oxygen in 1775. Little did he knew that a gas considered toxic due to its effect on CNS and Lungs would be used therapeutically in near future! Hyperbaric Oxygen Therapy refers to the treatment modality where a patient breathes 100% O2 inside a closed chamber containing [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":126,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-2337","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/pages\/2337","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/comments?post=2337"}],"version-history":[{"count":323,"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/pages\/2337\/revisions"}],"predecessor-version":[{"id":2771,"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/pages\/2337\/revisions\/2771"}],"up":[{"embeddable":true,"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/pages\/126"}],"wp:attachment":[{"href":"https:\/\/medreasons.com\/index.php\/wp-json\/wp\/v2\/media?parent=2337"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}