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Hyperbaric Oxygen Therapy

Updated on June 12, 2014

The Use Of Hyperbaric Oxygen

Hyperbaric Oxygen Therapy has been around for many years. It is best known for treating decompression sickness (the bends) and wound healing. There are other legitimate uses for HBOT and uses still being researched. Many articles describe ailments that improve from this therapy, but like anything else you must research what are the facts and what is advertisement. This lens I hope will help you.

History Of HBOT

In 1662 the British clergymen Henshaw built a hyperbaric and hypobaric chamber called the domicilium but it used air. Oxygen was discovered in the early 1700's and it started to be used by Thomas Beddoes in 1798 in his pneumatic laboratory. Beddoes didn't seem to have good results, probably due to over reaching and by claiming it worked for too many diseases. His laboratory closed in 1802. By the late 1800s more chambers were introduced, including a mobile one used for operations by the French physician Fontaine. He seemed to have better results than Beddoes. Unfortunately he died due to an accident at his facility.

In the 1930s the hyperbaric chambers using oxygen became safer to use. In the 1950s studies showed that HBOT helped in the healing of anaerobic infections and in the 1960s it was shown to aid in the treatment of carbon monoxide poisoning.

As Hyperbaric treatment grew in popularity there was a backlash from the medical community due to inappropriate usage and unsubstantiated claims of cures from some proponents of the therapy. HBOT lost some of its credibility at this time. To fight this, in the 1970s guidelines to cover legitimate uses were established by the Undersea Medical Society. In 1986 the Undersea Medical Society changed its name to the Undersea and Hyperbaric Medical Society (UHMS).

What Is Hyperbaric Oxygen Therapy

Hyperbaric Oxygen therapy uses 100% oxygen at a pressure higher than that of the atmosphere at sea level in an enclosed chamber. Atmospheric pressure is defined as one atmosphere absolute (1 ATA). The pressure can be increased up to three times or three atmosphere absolute (3 ATA). The normal amount of oxygen in air is approximately 21%, and the amount that is used in this therapy is 100%. The goal is to increase the availability of oxygen to the tissues and organs. It encourages capillary growth. Also the inhibition of anaerobic bacteria toxins, wound healing from increased collagen synthesis and decreased lipid peroxidation and protection against the effects of oxygen free radicals.

In order for it to be really considered HBOT the whole body must be exposed to the treatment and not just a section or a limb. Most of the pressurized wound healing used in hospitals is just sectional healing. Usually you would need to make a series of visits to accomplish a goal. You would need to check with your insurance to see if it is covered. Only certain diseases are approved and will normally get reimbursed by third part insurance. If, on the recommendation of a physician it can be used "off-label". That is, used for illnesses not yet recognized but with reasonable expectations of being therapeutic.

Staff who works with HBOT must be competent and have proper training in order to do the job correctly and safely. A physician must be available during all sessions. Others involved would be hyperbaric nurses and hyperbaric technicians. They can get certified after completing a program and passing the national exam. The National Board of Diving and Hyperbaric Medical Technology (NBDHMT) certifies workers in hyperbaric medicine.

If you feel the therapy will be of help, be sure to research the facility you will be using. As stated some are definitely better than others.

It is Not A Panacea

Hyperbaric Oxygen treatment is not a miracle cure all. It will not cure everyone from every disease known to man and it can be expensive. Unscrupulous people are getting involved with this who are untrained in its real benefits, not doing studies or writing down real results and looking only at profits they can make. People who are looking for help are easy prey for these types of hucksters. Because it has approved and unapproved uses they manipulate diagnosis in order to get reimbursed from insurance. They give out misinformation in order to sway decisions their way. The term used, as with other in vogue "magic bullets" is a therapy looking for a disease. Or, if you have a chamber you need to have folks use it even if it is not evidence based.

HBOT has great uses and continued potential if used correctly by competent clinicians who understand the benefits and pitfalls. There are many serious proponents of the therapy and their work is being cheapened by these profiteers.

Approved Indications

In The US Only Certain Conditions Are Approved For Use

Here are The Undersea and Hyperbaric Medical Society list of conditions that are approved. Medicare and third party insurers will reimburse for these.

1. Air or Gas Embolism

Air bubbles enter the blood stream and travels to any organ and block the vessels.This treatment will dissolve the bubbles in the blood.

2. Carbon Monoxide Poisoning

CO poisoning causes less oxygen availability to the tissues and this therapy helps lower the CO faster than non-hyperbaric oxygen therapy.

3. Clostridial Myonecrosis and Myositis (Gas Gangrene)

HBOT reduces the amount of necrotizing tissue toxins and increases oxygenation.

4. Crush Injury, Compartment Syndrome, and other Acute Traumatic Ischemias

5. Decompression Sickness

This is the standard of care for this illness. During resurfacing nitrogen gas bubbles form in different areas of the body causing problems. If they form in the lung they can disrupt blood flow or damage blood vessel lining. This treatment reduces the size of the bubbles.

6. Intracranial abscess

Can be caused by sinus or other infections and are usually caused by bacteria that thrives in a low oxygen (anaerobes) environment. HBOT helps the white blood cells kill the bacteria and make a less hospitable environment for the anaerobic bacteria by increasing the oxygen levels.

7. Arterial Insufficiencies:

a.Enhancement of Healing in Selected Problem Wounds

Helps in wound healing by providing a oxygen enriched environment which helps in fibroblast function, capillary angiogenisis and reduce swelling. It prevents the growth of necrotizing anerobes which hinder healing.

b. Central Retinal Artery Occlusion

8. Exceptional Blood Loss (Anemia)

In cases where anemia is present and blood transfusion is not an option, Hbot will supply enough oxygen for the tissues to use despite the lack of blood, until the body naturally restores more red blood cells.

9. Necrotizing Soft Tissue Infections

10. Osteomyelitis (Refractory)

11. Delayed Radiation Injury

Promotes increased oxygenation to the damaged tissue. Radiation changes normal tissue so multiple treatments are recommended to increase capillary density.

12.Compromised Skin Grafts and Flaps

If the tissue is normal than HBOT is not indicated. If skin graft or flap is compromised then it has been shown to be useful.

13.Thermal Burns

14. Idiopathic Sudden Sensorineural Hearing Loss

Other Uses For Hyperbaric Oxygen Therapy Not Yet Approved

Data is still being gathered to see if there is validity to use HBOT. Some have more clinical studies behind them than others. You would have to contact your insurance company to see if they reimburse any off- label uses and which one. Also you can petition your insurance company to cover it showing improvements due to the therapy and clinical studies to back you up.

  1. Autism
  2. Multiple sclerosis
  3. Cerebral palsy
  4. Strokes
  5. Cancer
  6. AIDS
  7. Fibromyalgia
  8. Migraines
  9. Lyme disease
  10. Chronic fatigue syndrome

Informative Videos

Gives you an idea about the cost involved especially if insurance won't cover it.

Health care setting

A veterans experience

Side Effects of Therapy

The most common side effect is barotrauma to the middle ear and painful sinuses caused by the change in pressure. There are Inflationary techniques to promote ear clearing (popping) during treatment. If it continues or is painful tubes might have to be inserted or special ear plugs might have to be used. The problem is temporary and resolves when HBO treatment is completed. If not recognized and treated some damage can ensue. Decongestants might help the patient with sinus problems.

Feeling light headed happens but will last only a few minutes. Fatigue also happens so it is best to conserve your strength while getting treatments.

Sometimes there is a feeling of claustrophobia inside the chamber. There are techniques to help or some medication to calm the patient down.

After multiple sessions there may be temporary changes to your eyesight, things might look somewhat blurry from onset of near sightedness (myopia) known to last at most a couple of weeks after treatment ends. If the patient has cataracts they could be made worse.

Another problem could be oxygen toxicity from breathing high levels of oxygen. This happens even with oxygen that is not under pressure.

The Medical Uses Of Oxygen

Oxygen was discovered in 1772 by the Swedish apothecary Karl W. Scheele and separately by the English chemist Joseph Priestley in 1774. Antoine-Laurent Lavoisier was able to describe its use in respiration and named it.

Oxygen is a gas that in nature is 21 percent of room air. In other words air has other gases but only 21% of it is composed of oxygen. The mistake some people make is thinking air is the same thing as oxygen. When oxygen is used in medicine it is a classified drug and is given by prescription and is usually administered at a higher concentration then room air. Oxygen at 100% is pure oxygen not diluted with air. Oxygen can be combined with other gases like helium to make the bio availability better in some people with lung problems.

Supplemental oxygen is given when the body has low levels and needs a higher concentration in order to increase the saturation in the tissues. People with COPD, asthma, heart disease, cancer and many others get benefits from supplementary oxygen.

The delivery systems are liquid oxygen, oxygen concentrators and compressed into tanks and of course hyperbaric oxygen. It can be administered by mechanical ventilators, nasal cannulas, various masks and manually via an ambu bag.

Oxygen for the most part is safe but there are instances where it can cause harm. There are people who cannot tolerate a lot of oxygen. The carbon dioxide goes up and their breathing becomes depressed or stops and they do not properly ventilate. Another is oxygen toxicity where there can be lung and neurological damage from high concentrations of oxygen.

Oxygen needs to be handled correctly. Oxygen supports combustion so it should not be around flames or anything that sparks. The tanks should not be dropped or if metal taken anywhere near an MRI machine.

Accidents are rare but they do happen usually from improper handling. People have died from smoking at the same time as using oxygen. Recently a young boy and his grandmother died from a hyperbaric chamber explosion and during Hurricane Rita in 2005 the death of 23 elderly evacuees. They were riding in a badly maintained bus that had caught on fire and caused the oxygen tanks to explode and engulfed the bus in flames.


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      RinchenChodron 8 years ago

      Very informative! I like this lens so I have given it a Fav.