Hyperbaric Oxygen Therapy (HBOT) is a non-invasive medical treatment administered by delivering 100% oxygen at pressures greater than two to three times the normal atmospheric (sea level) pressure to a patient in a chamber. Hyperbaric oxygen acts as a drug, eliciting varying levels of response at different dosages. Hyperbaric oxygen therapy has been proven to have numerous physiologic effects including hyperoxygenation of tissues allowing oxygen delivery to tissues with decreased blood flow or low hemoglobin (oxygen carrying component of the red blood cell).
Other effects include the promotion of new small blood vessel formation (angiogenesis) in tissues with low capillary density ( low number of small blood vessels) such as a diabetic foot, a leg with peripheral vascular disease, or body part that has been damaged by radiation therapy for cancer treatment. Hyperbaric oxygen therapy promotes vasoconstriction which is beneficial in the treatment of burns and crush injuries. It enhances the killing of bacteria by neutrophils (white blood cell) and increases the delivery of antibiotics across the cell wall of the bacteria which helps treat conditions such as refractory osteomyelitis (bone infection).
Hyperbaric oxygen therapy is an approved therapy by the FDA for numerous indications and it is prescribed under the supervision of a hyperbaric medicine physician. Although not totally without risk, hyperbaric oxygen therapy is considered to be safe and generally very well tolerated. HBOT is more than 350 years old and some modern therapeutic indications have been used for more than 50 years.
Delivery of hyperbaric oxygen therapy is performed in either a monoplace chamber where a single individual is treated at one time or a multiplace chamber where multiple patients are treated simultaneously. They are both equally effective and which chamber is best for you and your length of treatment will be determined by your treating physician.
What Is Hyperbaric Oxygen Therapy?
Hyperbaric chambers are used for administering hyperbaric oxygen therapy (HBOT). HBOT can be administered a few different ways: a mask or hood, a “soft” chamber,” or in a sealed (hard) chamber.
A mask, hood, or “soft” chamber can be used when a patient’s circulation is intact. These methods increase a person’s inhaled oxygen, allowing them to take in more than would be regularly breathed through room air. However, they can’t be pressurized in the same way a hard chamber can.2 Most health problems requiring HBOT involve poor circulation. Because of this, HBOT with masks, hoods, and soft chambers have limited uses.
A “hard” chamber can be used when a patient’s vasculature (blood flow to tissues) is poor or damaged. In this case, a patient rests in a chamber while it’s filled with pure oxygen. The atmospheric pressure is then raised to 2-3 absolute atmosphere (ATA). For reference, normal atmospheric pressure is 1 ATA. This pushes oxygen into the tissue of the person from the outside.
A chamber can also be used for health issues that require changing the atmospheric pressure around them for a certain length of time. This “depressurizing” can be used for patients suffering from the “bends.” This was one of the original uses of HBOT.
The pressure-building process is very similar to deep-sea diving or descending in a submarine. An HBO specialist (nurse, doctor, or technician) monitors you during your therapy sessions. The HBO specialist remains with you during the entire therapy. To comfortably get to pressure, the specialist guides you in ear pressure-relieving techniques. They coach you through swallowing, taking sips of water, and gently blowing while pinching your nose.
Therapy sessions can be from 90 to 120 minutes long, not including air breaks. Patients generally require 20-30 treatments. The full course of therapy usually lasts several weeks.
Inhaling pure oxygen brings the risk of oxygen toxicity. To help reduce this risks, HBOT sessions have “air breaks.” During these few-minute breaks, you will be able to wear a mask inside the chamber that provides room air.
Can you use an oxygen mask instead of going into a hyperbaric chamber?
No. An oxygen mask will not do the same thing as a hyperbaric chamber. Oxygen via a mask will only get to your tissues through your bloodstream. If your bloodstream is compromised, the oxygen won’t make it to the needed area. Areas like exposed bone or crush injuries have a high need for oxygen, but few intact vessels to get it there. HBOT helps get oxygen to your tissues even if you don’t have circulation to the high-need areas.
What can you take in the hyperbaric chamber?
Very little. Facilities limit what can be brought into the chamber due to the serious fire hazard. It’s similar to being inside an aerosolized can. Anything that could generate a spark or be fuel poses a risk for a fire. You can sleep in the hyperbaric chamber, or spend time watching TV. Many patients enjoy “taking it easy” and treat their HBOT like a break in the day.
Can you get fewer HBOT therapies than 20-30?
Generally, no. Like many therapies, HBOT is not a one-and-done. Repairing damaged tissue is a long process and not one that can be solved in a few days. Having fewer than the recommended therapy number may not be enough to help your health issue. However, if you struggle to tolerate treatments, your doctor will be happy to make adjustments to your care plan.
How long does it take to get up to pressure and come down from pressure?
It takes about 10-15 minutes to comfortably get to pressure. It takes about the same amount of time to get back to normal pressure. The specialist working with you will make sure you’re comfortable “diving down” and “coming up.” If there is an immediately life-threatening event, the process can be sped up substantially. This is only used in cases of extreme danger, such as the patient being on fire.
Can I do HBOT in a chamber if I have claustrophobia?
Yes, you can. Claustrophobia can affect some patients who do HBOT, but many report not having this issue.8 Others manage it by napping though their session. Chambers are mostly glass, allowing you to see your HBO specialist and the surroundings. During your consultation, the physician will discuss claustrophobia with you. Many facilities let you tour the chambers before committing to HBOT.
Can I use a soft chamber at home for cheap hyperbaric oxygen therapy?
Soft chambers are appealing when it comes to cost and convenience. But they’ve not proven nearly as effective as hard chamber therapy. The ATA can’t be raised high enough for effectively treating health problems requiring HBOT. They can even be dangerous without appropriate administration and monitoring.9 If you believe you would benefit from HBOT, put your therapy in the hands of professionals that would be happy to help you!
Are there common complications of hyperbaric oxygen therapy?
Complications can also come up if you have an ear infection, low blood sugar, or recent alcohol consumption. You might also experience some vision changes. The specialist will screen you before each dive for your safety. They’ll also assess you after each dive.
There is a risk of oxygen toxicity, but it isn’t common. If this occurs, it’s most often as a seizure.10 The HBOT specialist will be monitoring the treatment for signs of this, ready to intervene if needed.
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