History of carboxytherapy in general medicine
In certain areas of the world, natural carbon dioxide gas rises from the ground with 99% purity. Such gas can mix with deep water resources of space origin along with rare elements. The pure gas that arises as a result of the temperature below 100 degrees is called Moffite [7]. Sometimes the rising of gas and water creates an interesting natural phenomenon, bubbling muddy lakes colored by minerals (such as sulfur and iron) and protected as a unique natural heritage. In certain areas, natural mineral springs have formed naturally throughout history (Royat Mineral Spring in France, a large center with a local gas release of 99.5% carbon dioxide, and a similar site in Japan).
Perhaps the best-documented historical type is the mineral springs of Royat in France, where the first Roman mineral springs containing iron-rich water were discovered in 20 BC during the reign of Augustus. Later, the Celts honored this place because of the miracle, although after the attack of the barbarians in the fifth century, this place was forgotten. In the late Middle Ages, a Benedictine church was established in this place and although it was soon destroyed by wars, it was later rediscovered[8]. In the 20th century, and the arrival of the new age, scientific research was replaced by traditions. In 1932, Barrieu was the first person to treat his patients with carbon dioxide emitted from this site [9].In the same year, this method was followed in Argentina [3] and very soon in 1934 this technique entered the field of Spanish medicine. In 1946 in France, the Deravit Research Institute was opened, followed by the publication of 400 books on carboxytherapy in the second half of the century[8]. In 1953, Romeuf [10] published his 20 years of experience on this method.
Therefore, basic research on carboxytherapy can be found in Royat’s studies. Ambrosi et al published their articles [11] that after subcutaneous injection of carbon dioxide gas (150-300 ml) into the ankle, the pulse curve increased with a peak 15 minutes after the injection. In addition, the increase of the smaller pulse curve also appeared on the other hand (probably by the reflex mechanism).
] also showed the improvement of tcPCO2 (bilateral skin oxygen pressure) in patients with intermittent laxity who spent the treatment period in Royat spring (3 weeks of subcutaneous injection of carbon dioxide). After the treatment period, the tcPO2 curve before, during, and after the walking test was increased and its recovery was faster. Evaluation of tcPO2 in the medical profession is a more valid indicator of local anemia before surgery and the result of revascularization after surgery than blood circulation[13].
In another work, Ambrosi and Lafaye [14] proved by thermometry that after 18 days of continuous temperature treatment of carbon dioxide injection (500-800 ml), 23 out of 32 patients had more than 20% overheating and 2 The patient showed less warming and 7 cases did not show warming, which indicated slow cooling. In the article of Avril et al[15], 143 ulcers were studied (80 with arterial origin, 13 with venous origin, 9 with capillary origin, and 31 with mixed condition) and all of them did not respond to the usual treatment. After treating wounds with local gas bath (dry bath), 22.2% of wounds were cured, 57.3% improved, 16.1% did not change, and only 1.4% worsened.
In 1989 and 1990, the agreement about the effects of carbon dioxide was discussed at the Freiburg International Conference [16,17]:
- Local increase of blood support and opening of functionally closed capillaries
- Dilation of precapillary segments
- Improving oxygen delivery by increasing the release of oxygen during the Bohr effect (in lower pH and higher carbon dioxide pressure, the binding ability of hemoglobin to oxygen decreases)
- Improving the deformability of red blood cells
- Threshold optimization of temperature receptors
- The effect of disinfection
Recently, research has become more detailed. Toriyama et al. [18] 83 patients with acute anemia, of which 68 patients had peripheral arterial disease, by bathing in carbon dioxide water (1000 PPM at 37 degrees Celsius) twice for 10 minutes. faced in the day for more than 2 months. 13 out of 16 members (81.2%) could be saved. 27 out of 28 members (96.4%) had scars and gangrene on one toe at the beginning of the treatment, 13 out of 16 members (81.2%) had wounds and gangrene in several toes, and 29 out of 39 people (74.4%) or and gangrene were present in all fingers. Those researchers concluded that the effect of carbon dioxide-rich water on subcutaneous microcirculation may be caused by vasodilatation, characterized by increased parasympathetic activity and decreased sympathetic activity.
The most comprehensive research can be found in the article of Irie et al [19], who investigated the effects of carbon dioxide bath in rats with acute anemia. They showed that water rich in carbon dioxide (1-1.2 grams of carbon dioxide per liter of water at pH=5) increases the induction of VEGF synthesis along with the activation of the NO-cGMP pathway and fluidization of endothelial progenitor cells, which It leads to the formation of new capillaries dependent on nitric oxide (NO), which subsequently leads to an increase in the adjacent blood flow. Therefore, the treatment method with a water bath rich in carbon dioxide can be used in angiogenic treatments related to neovascularization.
Carboxytherapy in general: different types of treatment
In places other than the mineral spring where there is no carbon dioxide gas or natural spring water, we use cheap medical grade CO2 gas that is commercially available. In mineral springs, depending on the natural conditions, local natural gases and waters are still widely used.
- Bathing in water with free carbon dioxide gas in concentrations of at least 1 gram per liter of water (whole body in the bath/bathing body parts/persons or usual walking in the corridor of water with carbon dioxide
- Dry external bath – bath in carbon dioxide gas located in the bath tube (because the gas is heavier than air) or in a bag (the whole body/more than half of the body/organ exposed)
- Various forms of the above- jet motion such as carbon dioxide water, carbon dioxide water vapor applied topically to target organs or parts of organs, warm mud prepared from local soil and carbon dioxide water Carbon is used locally
- Injectable Carboxytherapy – Carboxytherapy on a more precise scale that targets the problem in question because this method is only used on or around the problem area. This type of treatment is usually used in cosmetic medicine. The injected carbon dioxide expands in the tissue immediately and quickly diffuses into the blood (the transfer of carbon dioxide was described earlier. Most of the gases are removed by the lungs, and a small part is converted into carbonic acid and excreted through the kidneys [3 ].
General benefits
Carboxytherapy can be used in the treatment of any disease when we need to improve vascular support and improve local pain. Traditionally, there are good results in the treatment of vascular injuries, acute anemia diseases including diabetes syndrome, Buerger’s syndrome, Raynaud’s syndrome, acute venous and lymphatic failure. The new finding is the treatment of reversible defects with microangiopsy.In dermatology, this method is very useful in the treatment of wounds, including leg ulcers, in the treatment of hair disorders, and sometimes in the treatment of psoriasis, scroderma, angiotectic rosacea (although during carboxytherapy treatment, there is vasodilatation, in repetitions it tends to be normal. There is vascular circulation (vascular blood circulation) so sometimes during facial rejuvenation we see the reduction of small vessels in the eyelids or on the cheeks. Some doctors have successfully experienced the treatment of nail disorders, vitiligo, or erysipelas, but these experiences It can also depend on the individual condition of the patient and it is not always repeatable.
General Contraindications
The general defects of croboxy therapy include severe respiratory defects, severe kidney defects, severe heart defects, patients treated with carbonic anhydrase blockers experience severe amnesia, acute liver failure with a decrease in plasma protein levels, and gaseous gangrene. However, in treating patients with poor general conditions, for example, leg ulcers or gangrene, the physician must make individual decisions. As carboxytherapy is not a medical treatment method and the next alternative can only be amputation, that is why this technique is valuable and should be tried, although this bad condition occurs less in healthy patients. In cosmetic medicine, most of the prohibitions are related to pregnancy and breastfeeding.