From the Guidelines
Hyperbaric Oxygen (HBO) therapy is not a recommended treatment for Purpura Fulminans based on the provided evidence. The 2018 guidelines for management of venous thromboembolism from the American Society of Hematology, published in Blood Advances 1, do not mention HBO therapy as a treatment option for Purpura Fulminans. Instead, the guidelines discuss anticoagulation, protein C replacement, and liver transplant as potential treatments for congenital Purpura Fulminans.
Key points to consider in the management of Purpura Fulminans include:
- Anticoagulation therapy
- Protein C replacement in the form of protein C concentrate or fresh-frozen plasma for management of acute exacerbations
- Liver transplant for homozygous protein C deficiency
- Long-term maintenance therapy, as well as therapy required for acute exacerbations
It is essential to note that the provided evidence does not support the use of HBO therapy in the treatment of Purpura Fulminans, and therefore, it should not be considered as a treatment option. The decision to use any treatment should be made in consultation with specialists in critical care, infectious disease, and other relevant fields as part of a comprehensive treatment approach.
From the Research
Relationship Between Hyperbaric Oxygen Therapy and Purpura Fulminans
The relationship between Hyperbaric Oxygen (HBO) therapy and Purpura Fulminans is supported by several studies, which suggest that HBO therapy can be a useful adjunct in the treatment of Purpura Fulminans.
- HBO therapy has been shown to reduce ischemic tissue and demarcation of blackened tissue in patients with Purpura Fulminans 2.
- A review of 19 cases of Purpura Fulminans treated with HBO therapy found that it was believed to be of value in most cases, with improvement associated with timeliness and aggressiveness of initiating HBO therapy 2.
- Other studies have also reported successful use of HBO therapy in the treatment of Purpura Fulminans, including a case of a 4-month-old child with Haemophilus influenzae type b purpura fulminans 3 and an extremely low birth weight preterm infant with protein S deficiency and MTHFR and Factor V Leiden mutations 4.
Comparison with Other Treatments
In comparison to other treatments, such as activated protein C and recombinant protein C activator, HBO therapy has been shown to be a useful adjunct in the treatment of Purpura Fulminans.
- Activated protein C has been used successfully in the treatment of sepsis-associated purpura fulminans, but its efficacy and safety need to be evaluated further 5.
- Recombinant protein C activator has also been used in the treatment of meningococcal purpura fulminans, but it can be associated with significant adverse effects, such as intracranial hemorrhages 6.
Key Findings
Key findings from the studies include:
- HBO therapy can reduce ischemic tissue and demarcation of blackened tissue in patients with Purpura Fulminans 2, 3, 4.
- Timeliness and aggressiveness of initiating HBO therapy are important factors in its effectiveness 2.
- HBO therapy can be a useful adjunct in the treatment of Purpura Fulminans, particularly in cases where other treatments have failed or are not effective 2, 3, 4.