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Hyperbaric Oxygen Therapy

Sept 26, 2023, By Michael Grant White

Learn more about Hyperbaric Oxygen Therapy, its indications, working, effects of increased pressure, and possible complications of HBOT. This article also discusses the types of hyperbaric chambers and their characteristics.

What is Hyperbaric Oxygen Therapy?

Hyperbaric oxygen therapy (HBOT) is the intermittent inhalation of up to 100% oxygen at pressures FAR greater than at sea level. The technique may be implemented in a multiplace chamber (usually a large steel cylinder) highly pressurized with air while the patients breathe 100% oxygen.

Alternatively, a monoplace (1-person) chamber, highly pressurized with 100% oxygen, may be utilized. A variation is the "'mildly/soft" pressurized chamber, but is way less effective than the hard chambers.

How does it work?

Normally, the air we breathe is 21 percent oxygen. During HBOT, you will breathe pure oxygen (100 percent) and the pressure surrounding your body will slowly increase to two or three times sea level.

The increased oxygen you breathe and absorb through your skin and into your bone marrow will also increase the oxygen your blood carries to body tissues. This abundance of oxygen in your tissues enhances the repair of tissue damage.

Oxygen inhaled at pressures greater than room air pressure dissolves in plasma. At the pressure equivalent of 3 ATA (66 ft of seawater), an arterial pO2 of 1900 to 2100 mm Hg may be achieved. Up to 6.8 vol% of oxygen may be forced into solution, a quantity sufficient to maintain tissue viability in the absence of hemoglobin.

Normal tissue O2 tensions vary widely and depend on the rate of local blood flow, capillary density, cellular metabolic rate, pH, and arterial O2 content. Ventilation with 100% oxygen at sea level can raise the O2 tissue level to approximately 2 vol%. High tissue oxygen levels can be achieved only with hyperbaric oxygen.

What is the mechanical effect of increased pressure?

Any free gas trapped in the body will decrease in volume as the pressure exerted on it increases (Boyle's Law). Reduction in bubble size may allow it to pass through the circulation or at least travel into a smaller vessel, which will reduce the size of any resulting infarction. This effect is useful in the management of gas embolism and decompression sickness.

Flooding the body with oxygen forces the rapid elimination of other gases, thus reducing damage caused by toxic gases such as carbon monoxide. The elevated pressures used during hyperbaric oxygen therapy further accelerate the elimination process.

Hyperbaric oxygen acts as an alpha-adrenergic drug. Vasoconstriction can result in the reduction of edema following burns or crush injuries. Even with a reduction in blood flow, enough extra oxygen is carried by the blood, so a net increase in tissue oxygen delivery occurs with hyperbaric oxygen.

Anaerobic bacteria don't contain the natural defenses to protect them from the superoxides, peroxides and other compounds formed in the presence of high oxygen tensions.

More importantly, many of the body's bacterial defense mechanisms are oxygen-dependent. When tissue pO2 drops too low, effective ingestion and killing by phagocytic leukocytes is retarded. Reoxygenation of those tissues allows phagocytosis and other host defense mechanisms to come back into play.

Hyperbaric oxygen physically dissolves extra oxygen into the plasma (Henry's Law). The quantity of oxygen carried and transferred to ischemic tissue by the blood is increased.

Relieving the ischemia with this increased oxygenation promotes osteoclastic and osteoblastic activity, collagen matrix formation, and the breakdown of many toxins. The extra oxygen also helps the ischemic tissue meet the increased metabolic need required by healing processes.

What is the mechanical effect of increased pressure?

There are three risk factors:

The absence of exertion can permit imbalances in respiratory gas exchange in CO2 and O2. Problems are rare - but can occur in extremely health-compromised individuals.
Too rapid increases or decreases in pressure can cause pain or injury in air compartments in the body, specifically the ears or lungs. Users should not hold their breath during depressurization, just like divers should exhale during ascent.
Nitrogen dissolves into the blood. Medical hyperbaric users are usually advised not to travel by air for 24 hours to avoid the bends.

Taken from a 10-year study of 1,505 patients who received 52,758 2-hour HBO tx at 2.4 at once or twice daily (The maximum treatment protocol used for problem wounds around the world.).

Inability to equalize Middle Ear Pressure - 0.37%
Paranasal Sinus Blocks - 0.09%
Confinement Anxiety - 0.05%
Oxygen Convulsions - 0.009% - (All Ceased After Removing Hoods/Masks)
Pulmonary Oxygen Toxicity - 0.00%
Permanent Ocular Refractive Changes

So. How much is enough?

Acquired naturally, how much gold is enough?

How much is too much?

As a practical matter, unless you have severe lung dysfunction, it is almost impossible to get too much oxygen. Too little oxygen is almost always the case. The technicians operating the hard chambers have strict guidelines to ensure safe parameters.

Indications For Usage

Air or gas embolism
Decompression sickness (the bends)
Carbon Monoxide Poisoning and Smoke Inhalation
Gas gangrene
Crush injury and traumatic wounds
Problem wounds
Compromised skin grafts, flaps, and replants
Necrotizing soft tissue infections
Refractory osteomyelitis
Radiation tissue damage
Thermal burns
Exceptional blood loss anemia
Adjunctive hyperbaric oxygen in intracranial abscess
Post heart attack rehabilitation
Stroke rehabilitation
Preventive medicine
Cerebral palsy and some other brain damage issues
COVID-19

I strongly suggest that the hyperbaric industry develop breathing before, during, or after these sessions to maximize their benefits.

Develop Your Breathing Today!

I strongly suggest that the hyperbaric industry develop breathing before, during, or after these sessions to maximize their benefits.

Coronavirus - Hyperbaric Treatment

In the wake of a recent case report in Wuhan successfully treating critically ill COVID-19 patients, hyperbaric oxygen therapy (HBOT) has now joined the fight against COVID-19 in the US and other countries. Physicians and major hospitals are now employing HBOT to treat critically ill patients and record symptomatic relief.

Opelousas General Hospital in Louisiana is one example of using HBOT for COVID-19. Read More

More and more physicians are vocalizing the use of HBOT for COVID-19. Dr. Van Meter is currently performing an official study on HBOT for COVID-19 and patients are responding well to the therapy. Read More

The International Hyperbarics Association (IHA) is thrilled to see mainstream physicians and major hospitals using HBOT for COVID-19 patients. As the IHA is dedicated to furthering the awareness and science of HBOT, we need more physicians and medical professionals to follow this new trend to save as many lives as possible.

Hyperbaric Oxygen Hard Chambers

Note the two hoses feeding the masks, and you see why I invented my Dual Hose Mega Flow Mask.

Israeli doctor claims to ‘reverse’ aging with pure oxygen treatment study Volunteers aged 65-plus ended up with sharper brains after sessions in a special oxygen chamber, says Shai Efrati.

I had a few sessions in 1977 in San Francisco. The theme for me then was preventive. One of my faculty members was the head of a hyperbaric chamber facility near Charlotte, NC.

With the recent Nobel prize around the benefits of oxygen, it seems relevant to revisit how it is used in very effective ways.

In either hard chamber situation, the arterial pO2 will approach 1500mm Hg at the pressure equivalent of 33 ft of seawater (2 ATA): less depth is possible, but this decreases its effectiveness and increases the time needed for treatment. 3 ATA is possible for some chambers. Hyperbaric oxygen is the treatment of choice for decompression sickness ("the bends") and arterial gas embolism.

It has been a useful adjunct in the treatment of gas gangrene, osteomyelitis, radiation damage, severe carbon monoxide poisoning, Lyme disease, certain forms of brain damage, anaerobic infections, and immune-compromising conditions.

THE BEST APPROACH FOR "FRAIL COMMUNITY", BRAIN DAMAGE (TBI), STROKES, AND HEART ATTACKS IS A HARD CHAMBER.

Mild Hyperbaric Chambers (Soft Chambers)

Primarily for recovery from injury when exercise is impossible, or the Hard Chamber is not affordable.

Not to be confused with a Hard Chamber, which is a great and high-end product for commercial use. The soft/mild Hyperbaric Chamber can be quite beneficial, but it may take longer to get results. (depending on the indication/application and based on the Doctor’s Protocol). The general public, as well as physicians, can now afford their own Hyperbaric Chamber for home use as well as their Private Practice.

Unlike the traditional hyperbaric chambers in hospitals or some facilities where it uses 100% pure oxygen to pressurize the chamber and goes to higher pressure, Mild Hyperbaric Chamber, aka “soft” chambers, does not require the operator/user to be a Certified Technician. The user/patient can perform a self-treatment (when able) without the need for assistance outside of the chamber.

To summarize how a Hyperbaric Chamber works. Begin with the words “Hyper = More” and “Baric = Pressure,” hence “More Pressure.” When the body is inside a Hyperbaric Environment, it forces it to absorb more Oxygen, in this case, Room Air (which is about 21%), into the plasma, which is fluid in our body.

Oxygen in our body is carried by the Red Blood Cells, which have a maximum capacity. When there is extra Oxygen in the plasma, the Red Blood Cells will then capture the Oxygen as much as they can at a Cellular level. With that said, being consistent with the therapy is “KEY.”

This means that by going in the chamber for just once a week will be challenging for the user to gauge if it’s working/helping. Keep in mind as well that the protocol for the frequency and duration of the treatment(s) will have to be determined by your physician/doctor.

The Portable/Mild Hyperbaric Chambers come in different sizes/models depending on the user’s comfort level and the type of patient that needs the therapy. There are several factors to keep in mind when choosing the right size/model.

Patient/Person’s Body Frame (shoulder width)
Claustrophobia (fear of enclosed space)
Mobility issue

FAQ

I may be claustrophobic, which model should I choose?

A large size/model is the most popular model because it provides the most room and comfort level as well as temperature for those who need the space. The user can also bring in any portable electronics inside the chamber because it is very safe.

What type of % Oxygen does it provide?

The compressor that comes with the chamber takes room air, filters it down to .01 microns then compresses it before it goes into the chamber. Therefore, based on the pressure that the chamber provides, which is 1.3 ATA x 21% room air = 27.3% (inside the chamber)

How do I get more Oxygen if I need to?

If the doctor recommends an additional source of Oxygen based on the indication/application that you’re using the chamber for, an Oxygen Concentrator can be used compatible with the chamber by having the patient wear a mask/cannula inside the chamber

How Portable is a Portable Chamber?

One of the models/sizes, it’s portable enough that it can be traveled with. Some parts are not required to be taken while traveling (i.e., frames, mattresses, and bolsters) – products may vary based on the manufacturer.

What kind of programs are available?

There are monthly rentals (Rent-To-Own) on selected models available, and/or simply purchasing the chamber outright. (Programs may vary within companies.)

How do I know which company to choose?

Carefully do your research as to the location and facilities as well as their experiences in manufacturing these Chambers, as well as asking as many questions as you can think of. Check out Evolution Hyperbarics

Are used/refurbished units available?

Certainly! If there’s no preference for a new/used chamber, our company may have them based on availability, and the price will vary depending on the age of the chamber. My experience and research have convinced me that if you can exercise, the TURBO OXYGEN Enhanced Exercise approach will give far better benefits with much less cost.

The easiest way to think of hyperbaric oxygen versus exercising with the Turbo Oxygen System is that exercising with oxygen performs the same purpose of pushing oxygen into the cells that the chambers do; only it's far superior if you can exercise.

If you can exercise, exercise is far superior to lying down or just sitting there, chatting, watching TV, or at the computer.