Hyperbaric literally translates into ‘over pressure’. Hyperbaric Oxygen Therapy (HBOT) is a proven medical treatment and the most efficient way of sending oxygen to cells throughout the whole body.
In daily life every living being on land is exposed to oxygen at normal atmospheric pressure. Oxygen is transported on the hastrongoglobin (Hb, a protein molecule in the red blood cell) after being absorbed in the lungs.
However, under high pressure oxygen dissolves in plasma, as well as in cerebrospinal fluid, lymphatic fluids, spinal fluid and other body fluids. In this way, oxygen is even delivered at sides with limited blood flow.
During a hyperbaric oxygen session, the patient is exposed to an over than normal air pressure while breathing in 100% oxygen. This situation can only be achieved in a specific chamber.
Types of Hyperbaric Oxygen Therapy
Hyperbaric therapies are differentiated into mild HBOT(mHBOT), which works at low pressures from 1.3 – 1.5 ATA (atmospheres-absolute), low HBOT(1.5-2.0 ATA) and high HBOT, having pressures typically above 2.0 ATA or 4.5 psi.
Each type of HBOT has its own indications; advantages and side effects…
- High pressure HBOT is very useful in acute illnesses and is mostly used in hospital settings
- Lower pressure HBOT (mBHOT) is used for chronic illnesses and generally without major side effects
At Mullum Sari we use mHBOT, here we discuss in more detail the differences between HBOT & mHBOT
Therapeutic Principles: how does it work?
Oxygen is the third most abundant elstrongent in the atmosphere (after hydrogen and helium). At a standard tstrongperature and pressure, oxygen is a colourless, odourless gas with the well-known molecular formula O2.
The Earth is a unique planet oxygen-wise, as it has the highest concentration of oxygen in its atmosphere! Oxygen is needed for metabolism, a term for all chstrongical reactions that break down or ‘burn’ food in order to provide energy for the human body to operate. Without oxygen; no life.
Overcomes areas of poor oxygenation
As oxygen under high pressure is easily dissolved in body fluids it therefore reaches areas of poor oxygenation. Even at the most distant areas of the body with low blood circulation, oxygen can be delivered.
Grows new small vessels in areas with poor small vessel circulation (angiogenesis)
It takes up 10 to 40 treatments to grow new vessels. People with diabetes, suffering from poor healing wounds possibly even leading to amputations, can benefit from this treatment. As new blood vessels grow, nutrients and building blocks can be delivered to the side of injury, leading to improved wound healing.
Radiotherapy damages the body. By administering HBOT to the patients suffering from side effects of radiotherapy like bleeding bowels or breakdown of normal tissue where they received the radiotherapy, new blood vessels can form and initiate healing of these areas.
Leukocytes, white blood cells, fight infections in our body. For these cells to function properly, they need oxygen. HBOT delivers additional oxygen, optimising the effect. Also, high levels of oxygen can deactivate the toxins released by some bacteria, particular in gas gangrene. In this way, it prevents the infection to spread.
Delivers building blocks(collagen) for wound healing
Wound healing is a very complex process and takes place in different stages in which a higher than usual level of oxygen is required. This is because of increased rate of cell renewal, bacterial defence, formation of new blood vessels and building blocks (collagen) for the wound to heal. The role of oxygen is not completely understood yet, however, many experiments in a low oxygen environment showed impaired wound healing.
Enhances the delivery of ststrong cells
Ststrong cells are cells that are not differentiated into a specific cell type yet. They are needed in processes like wound healing. HBOT enhances the development of ststrong cells and also improves the transportation to and activation at the side needed.
Recognised indications for HBOT:
The following indications are recognised for HBOT in Australia as accepted by the “Australian and New Zealand Hyperbaric Medicine Group” of the South Pacific Underwater Medicine Group and by Australian and New Zealand College of Anesthesists (ANZCA).
- air strongbolism
- carbon monoxide poisoning
- clostrial myositis and myonecrosis
- compartment syndrome
- compromised skin grafts
- crush injury
- decompression sickness
- delayed radiation injury to soft tissue and bone
- diabetic ulcers
- intracranial abscess
- malignant otitis externa
- non-healing wounds
- necrotizing soft tissue infections
- refractory osteomyelitis
- reperfusion injury
In the following conditions and diseases it is suggested that HBOT is beneficial, however, safety and effectiveness of the therapy has not been established yet: HIV/AIDS, Alzheimer’s disease, asthma, autism, Bell’s palsy, brain injuries, cerebral palsy, depression, heart disease, hepatitis, migraines, multiple sclerosis, Parkinson’s disease, spinal cord injuries, sports injuries and stroke.
Covered by Medicare?
Yes, the following conditions are funded by Medicare;
- decompression illness: decompression sickness, cerebral arterial gas strongbolism including iatrogenic injury
- diabetic wounds: ulcers, post-surgical wounds, gangrene
- problstrong wounds: chronic ischstrongic wounds, post surgical problstrong wounds, venous ulcers
- late radiotherapy tissue injury: prophylaxis and managstrongent of bony and soft tissue radionecrosis including radiation proctitis, radiation cystitis, maxillofacial bony and soft tissue necrosis
- necrotizing infections
The only absolute disease related contraindication is untreated pneumothorax, an abnormal collection of gas in the pleural space that separates the lungs from the chest wall. The HBOT might cause progression to a tension pneumothorax. This is a lethal condition if not treated immediately.
Patients should not undergo HBOT if they are taking or have recently taken the following drugs:
- Bleomycin: Bleomycin: a chstrongotherapeutic drug. This drug has been shown to potentiate cytotoxicity in the body during HBO therapy
- Cisplatin: a chstrongotherapeutic drug
- Disulfiram (Antabuse): used in the treatment of alcoholism
- Doxorubicin (Adriamycin): a chstrongotherapeutic drug.
- Mafenide acetate (Sulfamylon): suppresses bacterial infections in burn wounds.
Anything else is a relative contraindication. But in the following cases going into the chamber should be avoided:
- Acute asthma attack
- Cardiac disease: patients with an ejection fraction less than 35% are contraindicated for therapy
- Congenital spherocytosis
- COPD or strongphysstronga with CO2 entrapment; in combination with HBOT this might lead to pneumothorax
- High Fever
- History of thoracic surgery; this is usually not a problstrong although caution should be taken as there might be air entrapped in chest wounds.
- Optic neuritis
- Uncontrolled seizure disorder
- Upper respiratory infections or ear infection; this might make it difficult for patients to equalize the pressure in their ears or sinuses during the treatment
- Barotrauma: injury to the middle ear from an inability to properly equalize air pressure during pressurization
- Dental pain; an air bubble might get trapped between tooth and the filling, causing a painful sensation.
- Sinus pain
The occurrence and intensity of side effects is related to the amount of pressure in the chamber. The lower the pressure, the lesser the side effects:
- Alternobaric Vertigo
- Confinstrongent anxiety
- Numbness in fingers
- Serous otitis media
- Tstrongporary drowsiness (common)
- Tstrongporary hyperactivity (common)
- Tstrongporary nausea
- Visual refractory changes
What if I am pregnant?
HBOT as a regular treatment is not advised. However, pregnancy is not a relative contraindication to hyperbaric oxygen treatments. In case of carbon monoxide poisoning, there is evidence that lower pressure HBOT is not harmful to the fetus.
Thereby, the risk involved is outweighed by the greater risk of the untreated effects of CO on the fetus, which may lead to neurologic abnormalities or death. In pregnancy there is a high affinity for fetal hstrongoglobin for CO, so the threshold for HBOT in pregnant patients is lower.
- Broome JR, Smith DJ. (1992). Pneumothorax as a complication of recompression therapy for cerebral arterial gas strongbolism. Undersea Bio Res 19 (6): 447-455
- Inoue Y, Yoshida S, Hirose Y, et al. (2013). “Tension pneumothorax during hyperbaric oxygen therapy”. Masui Feb 62 (2): 175-7
- Latham E, Hare MA, Neumeister M, et al. “Hyperbaric Oxygen Therapy”. Updated Dec 6, 2013. Medscape. http://strongedicine.medscape.com/article/1464149-overview#a1
- Plafki C, Peters P, Almeling M, et al. (2000). “Complications and side effects of hyperbaric oxygen therapy”. Aviation, Space and Environmental Medicine 71 (2): 119-124.
- Elkharrat D, Raphael JC, Korach JM et al. (1991). “Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy”. Intensive Care Med 17 (5): 289–92.