with water-filtered infrared-A radiation

Dr. Michael W. Trogisch and Dr. Alexander von Ardenne

The Three Steps of Whole-Body Hyperthermia

Why Water-Filtered Infrared-A Radiation ?

Absorption of Infrared-A Radiation by Different Skin- and Tissue Layers for Superficial Irradiation

[acc. to Borchert and Jubitz 1958]

Temperature - Depth Profiles before and after 30 Minutes Infrared Irradiation with and without Water Filtering

mean values out of 6 profile measurements each with exper. animals [acc. to Hellige et.al. 1995]

Relative Variation of Perfusion of Tissue after 30 Minutes Infrared Irradiation with and without Water Filtering

mean values out of 5 profile measure-ments each based on colourmicrospherical technique with exp. Animals [acc. to Hellige et. al. 1995]

Water-Filtered Infrared-A Radiation versus Fango-Paraffin-Pack

mean values from measurements with 11 test persons / Regio Lumbalis [acc. to Vaupel, Stofft 1995]

Effect of Exsiccation

muscular tissue of neat, equal irradiation power [acc. to Rzeznik, 1995]

Whole Body Hyperthermia Equipment „IRATHERM



1000“

with water-filtered infrared-A radiation

Advantages of Whole-Body Hyperthermia with Water-Filtered Infrared-A Heat Radiation with IRATHERM ®

skin-tolerable heat radiation by water filtering (realization of a

deep-heat

in the skin by eliminating the

conductance-heat

ranges of the spectrum) patient-taylored heat flow with regard to locus and intensity (six radiators) short body-core temperature heating-up phase (39 °C in approx. 45 min) no claustrophobic stress for the patient due to open design permanent free access to the patient possible no risk of cataract (patient does not look into the light, because lamps are positioned underneath the patient) patient does not lie in his own sweat, as he is placed onto a network high compliance

Effects of the Moderate Hyperthermia

acceleration of metabolism increase of perfusion in organs and tissues

 supplying of cells with O 2 und nutrients  elimination of end-products of metabolism (detoxification)

stimulation of hormonic system stimulation of immunological system chronical Inflammations will be acute reduction of muscle tone acceleration of velocity of nerve conduction

acc. to K.L. Schmidt: Hyperthermie und Fieber und M. Heckel: Ganzkörper-Hyperthermie und Fiebertherapie a.o.

02/01

Possible Indications of Moderate Hyperthermia

arterial hypertension overstraining of musculature, especially deep-lying muscles of lumbar region (adjuvant to massage treatment) chronic back pain (after detailed establishing a diagnose) fibromyalgia syndrome therapy-resistant neuralgias migraine sub-acute and masked chronic inflammations rheumatic illnesses (degenerative and sub-acute inflammatory) Morbus Bechterev systemic sclerosis allergic nasitis bronchial asthma neurodermitis pain and immune therapy in oncology saisonal affective disorder / SAD regeneration or rehabilitation in sports medicine acc. to K.L. Schmidt: Hyperthermie und Fieber, M. Heckel: Ganzkörper-Hyperthermie und Fiebertherapie a.o.

Reduction of High Blood Pressure by Whole-Body Hyperthermia by the help of Water-Filtered Infrared-A Radiation

[M. Mischke 1991, H. Meffert et.al. 1989/1991/1993] Prospective controlled study 40 patients: single treatment, serial treatment, control group

Patients

arterial hypertension, WHO-stage I and II (  13 male patients (39  13 years) RR 160/97), hypertonia  3.9 years known,

Therapy Effect

serial mild infrared-A hyperthermia, 2 x / week, over 6 weeks, period of 30 min each with increase of T rectal by 1.0 ... 1.3 °C reduction of peripheral vascular resistance by distending the peripheral vessels; vascular training

Result

• • reduction in blood pressure: sytolic by  22 mmHg serial treatment diastolic by  12 mmHg 2 x / week over 4 weeks enough!

sustained reduction in blood pressure possible, by „freshening“ corresponding to development of blood pressure, e.g. 1 x / month • potential therapeutic failures, not responding to thermal blood pressure reduction, are selectable by a single mild infrared-A hyperthermia • reduction of resting heart frequency, RR and arterial mean pressure is more intensive than Sauna • increasing of radiation time for 60 min does‘nt lead to a stronger decreasing of the blood pressure • no side effects of clinical relevance

Effect of a Serial Whole-Body Hyperthermia with Water-Filtered Infrared-A Radiation on Fibromyalgia Pain

[ H.G. Schleenbecker, K.L. Schmidt 1998 ] Pilot Study Patients Therapy Result 11 female patients (53 ± 5 years) fibromyalgia (established acc. to Wolfe 1990, Müller 1990, Yunns 1981), known for several month to 12 years serial mild infrared-A-hyperthermia, 3 x / week, over 3 weeks, period of 30 min each with increase of T tymp by 1.3 °C • measurement of tenderness threshold on 24 tenderpoints with dolorimeter • measurement of subjective pain intensity with pain score for 11 sections of the body • measurement of subjective pain intensity with visual pain analog scala Treatment  Before 1. After 1. Before Last Significance tenderness threshold pain score pain analog scala

2.0

± 0.3

2.5

± 0.9

68

± 7 2.3 1.3 31 ± 0.5

± 0.6

± 5

2.2

1.7

37

± 0.4

± 0.5

± 16 n.S.

S.

S.

A mild whole-body hyperthermia with water-filtered infrared A radiation „has a significant analgesic effect in fibromyalgia, especially under repeated application“.

Improvement of Systemic Scleroderma by Whole-Body Hyperthermia with Water-Filtered Infrared-A Radiation

[H. Meffert et.al. 1990/1993] Patients 15 female patients systemic scleroderma Typ II (acc. to Holzmann), heavy Raynaud-symptoms existing for 8 – 35 years and involvement of inner organs Therapy serial mild Infrared-A-hyperthermia, 2 x / week, over 7.5 weeks, period of 30 min each with increase of T rectal by 1.0 ... 1.3 °C Result for one to two days after treatment all patients told about a comfortable feeling of warmth in the follow-up period of two years for about 50% of the female patients the frequency and severity of Raynaud attacks were sustained and strongly reduced.

(demonstration by Fourier analysis of the pulse curve and acral skin rewarming) The mild whole-body hyperthermia with water-filtered infrared-A radiation proves in respect to systemic scleroderma to be „a method with longlasting therapeutical effect, which possibly may have an impact on the basis defect of the disease“.

Effects of Preoperative Warming on the Incidence of Wound Infection after Clean Surgery

[A.C. Melling et.al., The Lancet 2001] Randomised Controlled Trial Patients 421 patients with clean breast, varicose vein, or hernia surgery 3 groups: Control group, local warming, systemic warming Method 1/3 of pat.: standard preparation before surgery 1/3 of pat.: single local warming of surgery spot for minimum 30 minutes before surgery 1/3 of pat.: single systemic warming for minimum 30 minutes before surgery follow up: 2 and 6 weeks after surgery Result control group warming groups patients wound infections „wound score“ postop. Antibiotics 139

14 %

significant more p=0,002 277

5 %

significant lower p=0,001 significant lower p=0,007 The preoperative warming before clean surgery seems to aid the prevention of postoperative wound infection. It is unessential, if local or systemic warming is realised.

Prophylactic Treatment of Seasonal Affective Disorder (SAD Syndrome) by Using „Bright White Light“ (> 400 nm) and „Infrared Light ” (> 720 nm)

Y. Meesters et.al. 1999] Patients bright white light n = 14 2 (41 ± 13), 12 (40 ± 9) infrared light n = 15 5 (35 ± 7), 10 (37 ± 5) no light (control group) n = 9 4 (48 ± 7), 5 (39 ± 8) free of drugs, SAD acc. to criteria of Rosenthal 1984, seasonal pattern acc. to APA 1987 Therapy daily 30 min light treatment (except Sa+So) between 6:00 ... 9:00 a.m. from October until March Result depression appears in: BDI SIGH –SAD–SR 36 % 43 % 7 % 33 % 78 % 67 % For prophylactic treatment of SAD –syndrome infrared light seems to be at least as good as bright white light.

BDI: Beck depression inventory (21 item version, 1961/1979) SIGH-SAD-SR: Williams score (29 item version, 1992)

Improvement of Regeneration after Physical Exertion by Local Hyperthermia with Water-Filtered Infrared-A Radiation

[G. Hoffmann 2002]

Irradiance on the Level of the Patient IRATHERM



1000 hydrosun



50 0 1.500

1.200

900 600 300 0 y / m x / m

distance: patient - radiator 50 cm 25 cm

Contra-Indications of moderate Hyperthermia

cardiac insufficiency (hyperthermia possible after checking the mechanical fitness and by monitoring the heart rate) disordered action of the heart (hyperthermia possible with monitoring by ECG) arteriosclerotic-cerebral state of confusions hyperthyreosis diabetes type I active cavitary pulmonary tuberculosis, acute kinds of hepatits, progressive chronical hepatitis, late stages of cirrhosis of the liver advanced chronical nephritis and nephrosclerosis acute thermal lesions of the skin (e.g. sunburn ) acute severe inflammations acute infections disposition to convulsion during fever pregnancy application of photosensitizers lack of thermosensitivity and cooperation of the patient acc. to M. Heckel: Ganzkörper-Hyperthermie und Fiebertherapie a.o.

Monitoring of Moderate Whole-Body Hyperthermia Hardware „IRAcom“

recording displaying documentation 3 temperatures ear / finger pulse oxygen saturation 6 radiator power data of treatment logbook print & data export

The Window „Treatment Data“ from Software „CIRA 4.x“

Monitoring of Moderate Whole-Body Hyperthermia Software „CIRA 4.x“

Procedure of Moderate Hyperthermia with Whole-body Hyperthermia System IRATHERM ® 1000

Preliminary and follow-up check of patient, diagnosis, education/information, check of load capacity of heart-ciculatory system (ergometry)

Sequence of events

Input patient data, toilet, undress, background music (stress  ) IRATHERM „ON“ (  40%): lay down on net, head and heels on towel, cover scars, fix sensors, cover patient with sheet + reflection blanket „START“ of hyperthermia: 1.Session with  75%, next increase corresp.how patient is, heating-up phase e.g. 45 min, T-increase < 0,06 °C/min, don‘t exceed the pre fixed borderline temperature (power  if necessary) Permanent care: ask for pain or smart (regional power  if necessary), wipe face periodically with dripping wet washcloth, movement Cooling –down phase: power  to  30%, blanket + sheet away, dry, rest