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.
Understanding Hyperbaric Oxygen Therapy Protocol
Hyperbaric oxygen therapy is a treatment in which the patient breathes pure oxygen in a pressurized environment. Medical staff must follow a process to achieve this environment. HBOT is typically an adjunctive therapy that should be used as a part of an overall treatment plan. Additional hyperbaric oxygen therapy treatments can include surgery, medication management, and wound care, depending on the patient’s need.
HBOT works because when pure oxygen is pressurized, it allows oxygen to be dissolved into plasma. Typically, the plasma does not carry oxygen, but that is left to hemoglobin or red blood cells. By supersaturating the blood with oxygen, more can reach the cells. Studies suggest that oxygen can perfuse four times further into body tissues than usual, and oxygen concentration increases by up to 1200%.
The standard atmospheric oxygen that is present at sea level is 21%. This allows for healthy individuals to sustain normal body functions. However, in situations where an individual has another health issue, the body may not utilize as much oxygen, or medical treatment may be assisted by increased oxygen to the affected tissues. This allows the patient’s body to heal more effectively and reduces the amount of time it takes to recover from an injury, sickness, or disease.
Indications for Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy can be used to treat a variety of different conditions. However, it is crucial to work with your doctor to determine if you are a candidate for HBOT to be included in your treatment plan. The FDA (Food and Drug Administration) in the United States carefully oversees the specific uses for HBOT. The FDA has approved several different uses for hyperbaric oxygen therapy. One of the primary uses of HBOT can be as a therapy in CO poisoning. Carbon monoxide is particularly harmful because it binds to the cells and holds the place where oxygen would typically adhere. When the cell’s receptors already contain carbon monoxide, they cannot add oxygen. HBOT overloads the blood with oxygen. Due to the volume of oxygen in the blood and the pressurized environment, oxygen can forcefully eject the carbon monoxide and take its place, restoring normal body function.
What is the Most Common Complication of Hyperbaric Oxygen Therapy?
While HBOT is considered one of the safest natural treatments, there are still some potential side effects that patients should know. These include a negative pressure injury to the ear or lungs. There can also be some potential for changes in blood sugar levels, particularly with individuals who have diabetes. Some people also describe some mild to moderate changes to their vision. However, the vision changes are generally temporary, and your vision should return to normal. While the side effects of HBOT are usually very mild, it is vital to communicate any changes or discomfort that you feel while undergoing your therapy.
Hyperbaric Oxygen Therapy Benefits
While each patient seeks HBOT for their treatment, there are several universal benefits for patients. Even if you go for a specific treatment, you may find that this specialized approach helps you feel better in many other ways! Here are some of the benefits that patients see during their treatment.
Reduced Inflammation – Because HBOT helps constrict blood vessels, it reduces the leakage of the fluids that cause swelling. Many patients will be able to notice these changes almost immediately. However, some studies suggest that long-term HBOT can help turn off the genes responsible for creating additional inflammation.
As a side benefit of reduced swelling, the body responds with less inflammation with a more robust immune system and improves mitochondrial function.
Antimicrobial – HBOT helps to improve the immune system because it weakens the bacteria responsible for infections. Additionally, hyperbaric oxygen therapy increases free radical scavengers and natural antioxidants in the body. This increase helps the body fight disease and illness and improves the efficacy of certain antibiotics.
New Blood Vessel Growth – Hyperbaric oxygen therapy helps the body grow new blood vessels. Additional blood vessels allow the body to increase blood circulation and revitalize tissues by perfusing them with more blood. While this is the aim of HBOT as an active treatment, many patients have improved blood vessel perfusion after their treatment has concluded.
Stem Cell Circulation – Stem cells are the cells in your body that have not differentiated into the type of cell they will become. Stem cells can be a critical component of helping your body heal by replacing dead or damaged cells with healthy cells. Studies suggest that hyperbaric oxygen therapy can increase the stem cells in circulation eight times as much as expected. The increased number of stem cells circulating through the body can improve healing time and overall patient outcomes.
Assists Mitochondria – The mitochondria in our cells are considered the powerhouse of the cell. Mitochondria produce ATP or adenosine triphosphate. This substance is a chemical that stores energy for our cells to use. If you have damaged cells, they cannot transfer oxygen or produce ATP. However, HBOT therapy allows more oxygen to fuel healthy and damaged cells. With the high levels of oxygen reaching the cells, they can increase oxygen production and improve your overall ATP production.
Are You a Candidate for Hyperbaric Oxygen Therapy?
If you have any of the conditions listed above or think that HBOT could help improve your health, call today to schedule a consultation. We want to help you achieve the health and quality of life you deserve.
There are some conditions that the FDA has not approved, but patients may see the benefits of HBOT. Additionally, while these therapies may help patients with specific issues, HBOT may not be covered by insurance for these conditions.
- Chronic pain
- Lyme disease
- Spinal injuries
- Cerebral palsy
- Chronic fatigue
- Crohn’s disease
- Ulcerative colitis
- Interstitial cystitis
- Migraine headaches
- Multiple sclerosis (MS)
- Inflammatory bowel disease
- Some types of cancer treatment
- Concussions or other brain injuries
If you suffer from any of these conditions, talk to your doctor to see if hyperbaric oxygen therapy may be an option for you.
Some of the additional approved treatments include:
- Gas gangrene
- Some types of burns
- Intracranial abscesses
- Acute traumatic ischemia
- Embolisms (either air or gas)
- Tissue damage from radiation
- Central retinal artery occlusion
- Chronic refractory osteomyelitis
- Decompression sickness (the Bends)
- Injuries resulting from a crushing force
- Infections causing the death of soft tissue
- Lower extremity wounds in diabetic patients