What is Hyperbaric Oxygen Therapy?
Hyperbaric Oxygen Therapy or HBOT is a medical treatment, which is given by placing the patient’s entire body in an enclosed chamber. The patient breathes 100% oxygen while under increased pressure. Most patients are treated at a pressure equivalent of 2-2.5 times the normal atmospheric pressure.
How does Hyperbaric Oxygen Therapy Work?
Hyperbaric oxygen therapy delivers a high concentration of oxygen systemically. The increased pressure changes the normal cellular respiration process and causes oxygen to dissolve in the blood plasma to that it carries oxygen in addition to red blood cells. This results in a substantial increase in tissue oxygenation. This provides several benefits; stimulates the growth of new blood vessels, increases oxygenation that can arrest certain types of infections, reduce inflammation, and enhance wound healing.
What are the clinically accepted indications For HBOT?
In the United States, almost all health care plans/third party payors reimburse for HBOT treatments listed below. There are numerous conditions reimbursed by commercial payors and workman’s compensation. In addition, other areas in the world are using HBOT for numerous other conditions.
- Diabetic wounds
- Radiation tissue damage (Osteoradionecrosis)
- Osteomyelitis (Refractory)
- Skin grafts and flaps (Compromised)
- Necrotizing soft tissue infections
- Thermal burns
- Crush injury, compartment syndrome, and other acute traumatic ischemias
- Clostridial Myonecrosis (Gas gangrene)
- Air or gas embolism
- Carbon monoxide poisoning
- Smoke inhalation
- Decompression sickness
- Severe anemia
- Cyanide Poisoning
Is there research being done on other conditions being treated with HBOT?
HBOT is now experiencing widespread use throughout the world for a number of acute and chronic conditions. Aggressive federally and privately supported clinical trials are being conducted in the United States and abroad. Worldwide applications or research has been done on such conditions as: Autism, Chronic Traumatic Brain Injury, TBI (Traumatic Brain Injury), Post Concussion Syndrome, Post Traumatic Stress Disorder, Chronic Post Traumatic Stress Disorder, Diabetes Mellitus, Chronic Ulcers of the Lower Limb, Acute Thermal Burns, Osteoradionecrosis, Brain Injury, Sequelae, Stroke, Anoxia, Trauma, Retinitis Pigmentosa, Periodontal Disease, Radiation Injuries, Laryngeal Cancer, Glioblastomas, Gliosarcoma, Trigeminal Neuralgia Pain, Radiation-Induced Xerostomia, White Matter Hyperintensities (WMH), Osteoradionecrosis, Osteonecrosis and more. Please click here for more information on clinical studies.
- Diabetic wounds
- Bone and soft tissue infections
- Radiation tissue damage
- Failed grafts and flaps
- Pre and post surgery for faster healing and better patient outcome
- Poisonous snake and spider bites
- Lyme Disease
- Memory and Alzheimer’s
Do I need a prescription for Hyperbaric Oxygen Therapy?
Yes for conditions that are covered by insurance or Medicare. Please call the clinic for questions about this. Patients can be referred to us by their personal physician or can have a consultation by our Medical Director to determine if HBOT is a recommended therapy for their condition.
How many treatments are required?
The number of treatments is determined by the condition being treated and how well the patient is responding to the therapy. Example, the protocol for wound care is generally 20-40, 2-hour treatments. Treatments are done everyday five days a week. Therapy for a sports injury is 1 hour per day until the problem is resolved.
What can I do during my treatment?
Patients rest comfortably during the treatment watching TV , listening to music or napping.
What does a Hyperbaric Oxygen Treatment feel like?
During the first beginning and again at the end of the treatment the patient will notice the pressure change in the need to “pop” “clear” their ears, much the same as in an airplane on decent. During the majority of the treatment while at pressure, the patient will rest comfortably as if they were just sitting in the room. Patients should let the staff know if they have a cold or allergies that is causing plugged ears or sinus. Precautions should be taken to insure ears and sinus are clear prior to treatment.
Do patients suffer from claustrophobia?
Most HBOT patients do not experience confinement anxiety or claustrophobia in our chambers. We have the largest acrylic monoplace chambers on the market. A 6 ft patient can sit at a comfortable 45 degrees in the clear optically perfect chamber.
Will family members be able to remain in the hyperbaric room during treatments?
No. Family members can wait in our comfortable waiting room or leave and return at the end of the treatment time.
What if I’m a smoker?
Smoking even one cigarette, causes blood vessels to constrict. This decreases the blood supply to the tissue, counteracting the benefits of the hyperbaric treatments. Patients are encouraged to not smoke during the course of their therapy.
The only absolute contraindication to hyperbaric oxygen therapy is untreated pneumothorax. Also, the treatment may raise the issue of Occupational health and safety (OHS), which has been encountered by the therapist.
Patients should not undergo HBO therapy if they are taking or have recently taken the following drugs:
- Doxorubicin (Adriamycin) – A chemotherapeutic drug.
- Cisplatin – Also a chemotherapeutic drug.
- Disulfiram (Antabuse) – Used in the treatment of alcoholism.
- Mafenide acetate (Sulfamylon) – Suppresses bacterial infections in burn wounds
The following are relative contraindications — meaning that special consideration must be made by specialist physicians before HBO treatments begin:
- Upper respiratory infections – These conditions can make it difficult for the patient to clear their ears, which can result in what is termed sinus squeeze.
- High fevers – In most cases the fever should be lowered before HBO treatment begins.
- Emphysema with CO2 retention – This condition can lead to pneumothorax during HBO treatment.
- History of thoracic (chest) surgery – This is rarely a problem and usually not considered a contraindication. However, there is concern that air may be trapped in lesions that were created by surgical scarring. These conditions need to be evaluated prior to considering HBO therapy.
Malignant disease: Cancers thrive in blood rich environments but may be suppressed by high oxygen levels. HBO treatment of individuals who have cancer presents a problem, since HBO both increases blood flow via angiogenesis and also raises oxygen levels. Taking an anti-angiogenic supplement may provide a solution. A study by Feldemier, et al. and recent NIH funded study on Stem Cells by Thom, et al., indicate that HBO is actually beneficial in producing stem/progenitor cells and the malignant process is not accelerated.
Middle ear barotrauma (MEBT) is always a consideration in treating both children and adults in a hyperbaric environment, but most children currently being treated with HBOT are being pressurized to 1.3 ATA, which reduces the risks of side effects.