Overview
Reviewed by Dr. James Whynot
Hyperbaric Oxygen Therapy (HBOT) involves inhalation of 100% oxygen at pressures exceeding the normal (sea level) environment. These conditions represent a substantial increase of oxygen uptake compared to breathing normal air (19-21% oxygen), and have a number of recognized, beneficial effects in individuals suffering from certain afflictions.
Detailed Description
The Food and Drug Administration (FDA) has approved the use of HBOT for the following problems:
· Air or gas embolism (obstruction of a blood vessel by an air or gas bubble)
· Carbon monoxide poisoning and carbon monoxide poisoning complicated by cyanide poisoning
· Clostridial myositis and myonecrosis (anaerobic bacterial infections)
· Crush injury, compartment syndrome, and other acute traumatic ischemias (decrease of blood supply to organ, tissue or other area)
· Decompression sickness (such as divers experience)
· Enhanced healing of selected problem wounds
· Exceptional blood loss anemia
· Necrotizing soft tissue infections (destruction of soft tissue)
· Osteomyelitis (inflammation of bone and bone marrow)
· Delayed radiation injury (soft tissue and body necrosis)
· Skin grafts and flaps (compromised)
· Thermal burns
· Intracranial abscess (skull damage)
In all cases, the process of HBOT saturates blood plasma levels with oxygen, which amplifies oxygen delivery to bodily tissues. In conditions where an anaerobic (no oxygen) environment is creating the problem, for example, proliferation of anaerobic bacteria, crush injury or anemia, a sustained, forced influx of oxygen is directly beneficial. The advantages in wound treatment are subtler; the increased oxygen content enhances white blood cell activity around the injury and thus promotes healing. Other effects include a blockage of the unhealthy conditions generated by carbon monoxide, and the promotion of new blood vessel growth in “dead” or non-oxygenated areas.
The process of hyperbaric oxygen administration must be carefully monitored at all times by an experienced physician. Individuals recommended for HBOT will be requested to not to use hair oils, hair spray, perfume, make-up, nylons, ointments, petroleum, Vaseline products, wigs, after-shave, synthetic clothes, watches, or smoke during the therapy. The therapy itself generally occurs in a steel, aluminum, or clear plastic room, which can service individuals or groups of people. During the initial increase in pressure and oxygen content, patients will generally experience a “dive” period, during which the room will feel warm and the pressure change is felt in the ears (such as in an airplane). The physician may advise several methods for easing the adjustment to the higher pressure, and after several minutes the body will adjust. The rest of the time spent in HBOT is usually spent fully relaxed, reading, sleeping or even watching TV.
Treatment sessions normally last approximately two hours, but the number of sessions and duration is subject to the physician’s discretion. The entire process of HBOT must be carefully monitored, as there is some risk for potential side effects. These may include barotrauma (pressure trauma) to the ears and sinuses, or accelerated progression of cataracts. Changes in vision can also result but are usually only temporary. Patients should be certain to divulge their medical history and any current complications (cold, flu, sinus or nasal congestion, pregnancy, a change in or lack of usual medications) to assist the physician in determining the appropriate program of HBOT.
HBOT centers are located throughout the country, and a primary care physician will generally refer patients requiring this method of treatment to a center.
Last updated: 14-Jul-03
