Hyperbaric Oxygen Therapy

What is Hyperbaric Oxygen Treatment?

Hyperbaric oxygen treatment is the breathing of 100 percent oxygen at a pressure greater than one atmosphere, the pressure of air at sea level. In order to accomplish this treatment, a patient must be enclosed in a specially constructed chamber. Two types of chambers are commonly used to treat patients. The majority of hyperbaric oxygen treatments are administered in monoplace hyperbaric chambers, holding a single patient and made of acrylic and filled with 100 per cent oxygen. Patients may also be treated in multiplace chambers that are typically larger, hold multiple patients, and are filled with air. Patients in multiplace chambers breathe 100 percent oxygen by wearing a mask or hood during treatment.

Hyperbaric oxygen treatment was originally used to treat divers suffering from the “bends” or decompression sickness, but is now used to treat patients with a variety of wound healing problem,s including certain chronic bone infections (osteomyelitis) and certain rapidly progressive acute infections, such as those caused by “flesh eating” bacteria (necrotizing fasciitis).

What is hyperbaric oxygen treatment used for?

Hyperbaric oxygen treatment may be used to treat a number of clinical conditions. The Undersea and Hyperbaric Medical Society’s Oxygen Therapy Committee has recommended hyperbaric oxygen treatment as beneficial in the following clinical conditions, including:

  • Air or gas embolism
  • Decompression sickness
  • Carbon monoxide poisoning
  • Cyanide poisoning
  • Crush injury, compartment syndrome, and other acute traumatic ischemic injuries
  • Acute exceptional blood loss anemia
  • Compromised skin grafts or flaps
  • Thermal burns
  • Other problem wounds complicated by hypoxia and specifically diabetic foot ulcers
  • Necrotizing soft tissue infections
  • Gas gangrene
  • Refractory osteomyelitis
  • Osteoradionecrosis
  • Soft tissue radionecrosis

How does hyperbaric oxygen treatment work?

Normally, the air we breathe contains 21 percent oxygen. We are surrounded by a column of air stretching from the surface of the earth to infinity, exerted at a pressure that we refer to as sea level pressure or one atmosphere of pressure. During hyperbaric oxygen treatment, 100 percent oxygen is breathed at a pressure greater than sea level pressure or greater than one atmosphere of pressure. This increases the amount of oxygen dissolved in the liquid portion of the blood plasma, as much as three to five times over what is possible breathing oxygen at sea level pressure. The resulting increased oxygen carrying capacity is delivered to all tissues, where there is sufficient blood flow and produces a number of beneficial effects that improve the body’s elimination of certain poisons, such as carbon monoxide. It also improves the body’s response to infection and supports tissue growth and wound healing.

Are there any side effects or after effects of hyperbaric oxygen treatment?

The most common side effects are related to the direct effects of the pressure change during compression on the middle ear. If not recognized and managed effectively, injury to the ear drum (tympanic membrane) can occur. Oxygen breathing at increased pressure may also produce acute toxic reactions that are reversible and usually preventable by adjusting the oxygen dosing schedule. Side effects and potential complications will be discussed in detail with you by your physician prior to treatment.

What are hyperbaric oxygen treatments like?

Hyperbaric oxygen treatments include three phases: compression to the prescribed treatment pressure, the prescribed time at pressure, and decompression from the treatment pressure back to surface or atmospheric pressure.

  • Compression: During the compression phase patients feel a “fullness” in their ears, similar to what is experienced when a commercial airliner lands. This increase in pressure on the tympanic membrane or ear drum must be equalized by performing a valsalva maneuver or by swallowing or yawning. The temperature in the chamber also increases slightly during compression.
  • Treatment: The treatment phase begins when the pressure reaches the prescribed level. The patient breathes 100 per cent oxygen with brief interruptions to breath air to reduce the risk of any toxic reaction to prolonged oxygen breathing. During the treatment patients may rest, sleep, listen to music, or watch television.
  • Decompression: During decompression, the pressure within the chamber is reduced to that at the surface. Decompression results in mild cooling. Once the chamber pressure equals the outside or surface pressure, the treatment is completed and the patient is removed from the chamber.
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