Hyperbaric Oxygen Therapy
The Use of Pressurized Pure Oxygen for Various Clinical Indications
Jan 24, 2009
Hyperbaric oxygen therapy (commonly abbreviated HBOT or HBO) is a treatment that involves oxygen at a greater concentration and pressure than those of the Earth's atmosphere. It is often used by scuba divers for decompression sickness (the "bends"), though patients with other conditions can also benefit from this treatment. HBOT is administered by medical doctors who are specialized in undersea and hyperbaric medicine.
Definition
As defined by the Undersea and Hyperbaric Medical Society, HBOT delivers 100% oxygen at a pressure greater than one atmosphere absolute (atm abs). Typical HBOT sessions raise the pressure to approximately 2.5 atm abs, though no higher than 3 atm abs. The treatment occurs in special chambers that are large enough to fit the entirety of one patient (monoplace chamber) or multiple patients (multiplace chamber). Delivering 100% oxygen at normal atmospheric pressure or to only a portion of the body does not qualify as HBOT.
Clinical Indications
The uses of HBOT stem from the properties of oxygen. The gas can replace inert gases in the blood, supply tissues for aerobic metabolism, kill bacteria, and speed up healing of tissues. Based on these abilities and available strong evidence, HBOT is approved for the following clinical indications:
- Decompression sickness (dissolved blood nitrogen forming gas bubbles during rapid aquatic ascent to shallow depths)
- Carbon monoxide poisoning (carbon monoxide gas tightly binding to hemoglobin in red blood cells)
- Gas embolism (air bubbles getting trapped in lung circulation)
- Significant blood loss (for patients who refuse or are unable to receive blood transfusions)
- Necrotizing soft tissue infections (infections associated with death of soft tissue)
- Clostridia bacteria causing myositis or myonecrosis (muscle inflammation and death, respectively)
- Severe osteomyelitis (bone marrow infection)
- Intracranial abscess (walled-off infection in the skull)
- Poor healing of certain wounds
- Crush injuries or other conditions cutting off blood flow
- Delayed radiation injury
- Thermal burns
- Compromised skin grafts and flaps
Despite this list, some individuals may promote HBOT for other indications, including but not limited to stroke, autism, AIDS, chronic pain, and cancer. Until studies demonstrate safety and efficacy of HBOT for these indications, such use of the therapy should be considered experimental and investigational.
Complications
HBOT is often safe but it still has risks. Patients may experience mild headache, changes in ear pressure, and claustrophobia during treatment. More serious consequences include but are not limited to ear damage, lung damage, and altered eyesight. HBOT can even be a fire hazard due to the concentration of oxygen involved.
Reference
- American Cancer Society - Hyperbaric Oxygen Therapy
- Undersea and Hyperbaric Medical Society - Indications
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