What is hyperbaric oxygen treatment ?
Hyperbaric Oxygen Treatment (HBOT) most commonly refers to the delivery of increased levels of oxygen at greater than ambient pressure for a prescribed duration of usually 60 to 90 minutes in an, specially designed enclosed chamber.
This process causes oxygen to be absorbed by all body fluids and by all body cells and tissues, even those with blocked or reduced blood flow.
This increased flow of oxygen stimulates and restores function to damaged cells and organs.
The air we normally breathe contains 21% oxygen, 78% nitrogen, with the remaining 1% being contributed by the noble gases and carbon dioxide. The concentration of these gases is determined by the atmospheric pressure which is determined by the weather and is reduced at altitude. Unfortunately the variations in this pressure are ignored in general medical practice. Atmospheric pressure is accorded the unit 1 to represent atmospheric pressure absolute (1 ata) and this unit is divided according to the percentages of the gases in air to give their 'partial pressures' that is the part of the total pressure each gas is responsible for - oxygen therefore being 0.21 ata (21% of 1) and nitrogen 0.78 ata (78% of 1).
How does breathing more oxygen help?
The air that we breathe usually provides enough oxygen for both normal body metabolism and repair to tissue damage after injury or illness. However increasing the pressure surrounding a patient in a hyperbaric chamber and using 100% oxygen can allow a very significant increase in the amount of oxygen dissolved in the bloodstream. This is in addition to the oxygen carried by haemoglobin. Normally the amount carried dissolved in plasma is about 0.3 ml per 100 ml of blood. At twice atmospheric pressure (2 ata) breathing 100% oxygen this increases to 3 ml oxygen in 100ml of blood. The increased concentration means that the gradient for the transport of free oxygen from blood into the tissues is increased 10 fold.
When tissues are damaged the capillaries within the tissues are also damaged which increases the distances for oxygen to diffuse. This can lead to a severe oxygen deficit in the tissues even when the amount of oxygen carried in the blood is normal. The object of using the increase in pressure and oxygen concentration is to raise tissue oxygen values towards normal to initiate normal cellular repair mechanisms. In fact oxygen, like glucose and water is an essential substrate.
How does HBOT lead to tissue recovery?
Oxygen is dissolved in the blood and transported, in combination with haemoglobin in the red blood cells throughout the body. This dissolved oxygen passes into the tissues. Breathing high levels of oxygen under hyperbaric conditions causes greater uptake of oxygen by the bodily fluids and so more can reach areas where the circulation is diminished or blocked and therefore improve recovery. The extra oxygen has additional benefits as it greatly enhances the ability of white blood cells to kill bacteria. It also reduces swelling and allows new blood vessels to grow more rapidly into the affected areas.
Severe tissue hypoxia (oxygen deprivation) has many adverse effects from abolishing normal cell activity as, for example, with loss of consciousness to disabling white blood cell activity in infection. Only the administration of oxygen can 'treat' hypoxia and the objective of the administration of oxygen is to establish tissue oxygen values compatible with the initiation of normal healing.
How is HBOT administered?
HBOT is a simple, non-invasive and painless treatment which most patients find comfortable and relaxing. You will be treated in a secure and comfortable purpose built chamber with a trained operator present to operate the barochamber. In certain circumstances the attendant will accompany clients into the chamber. There has been no recorded case of a patient suffering either a heart attack or a stroke undergoing hyperbaric oxygen treatment, and oxygen under hyperbaric conditions can be used as a treatment of both conditions.
The treatment session is conducted in three phases:
Compression: Once the door is closed, there will be some noise as the pressure increases. It will get warmer and you will feel fullness in your ears similar to when descending in an aeroplane. You will have been taught how to avoid discomfort by clearing or 'equalising' your ears. As soon as the chamber pressure increases, you will need to start making your ears 'pop'. There are several ways to do this and the chamber attendant will find the best way that suits you. Some people find that swallowing is sufficient. If you develop any discomfort inform the attendant and the rate of compression will be reduced. There may be a few unusual noises but this is normal as the chamber 'descends'.
Bottom time: On reaching the desired pressure (usually 1.5 to 2.0 ata) the client places a mask over the head and breathes oxygen for the duration of the session. The treatment begins when the pressure reaches the prescribed level.
You may then rest, sleep, read, play cards or other games with the other patients or staff or watch at a movie. The mask can be removed occasionally and the chamber can be decompressed at any time if necessary.
Decompression: After the prescribed amount of time has elapsed the attendant will let you know when the treatment is complete and the pressure will be lowered slowly, at a rate that is comfortable. A session usually lasts just over an hour and can be repeated daily. If a patient is receiving two treatments a day the second treatment follows the first after a three to four hour break outside the chamber. A patient receiving one treatment per day will spend about two hours at the treatment centre.
About the treatment
The number of treatments you will require varies between patients, depending on your particular problem. Some may only require 2 and others 40 treatments. We treat 5 days a week, Monday - Friday, with usually one treatment per patient per day. Several patients may participate in each session. Very rare , treatment times may vary due to emergency patient treatments.
Preparation for your treatment
The following recommendations are made to improve safety, comfort and the benefit you will obtain from the treatment.
Your fitness for treatment will be assessed by a hyperbaric medicine specialist prior to your first treatment. Subsequent assessments will occur as necessary. It is your responsibility to notify the doctor or nurse of any medications you are taking, as well as any change in your general health. This is very important should you develop a cold, have problems with clearing your ears or have new dental work.
You will be shown how to "clear" your ears. This is a technique to equalise the pressure on either side of your eardrum to prevent damage to the drum during pressurisation. By holding your nose shut and attempting to blow through it, or simply swallowing, air can enter the middle ear cavity via the Eustachian tube. It is only necessary to do this during the compression or pressurisation phase in first few minutes of a treatment.
Plenty of rest and a healthy diet are key elements in the healing process. These are recommended during HBO. Diabetic patients will be encouraged to eat prior to a treatment session, as HBO may cause a drop in blood sugar level. The blood sugar level will be checked prior to each session.
Smoking or the use of other tobacco products reduces the amount of oxygen carried by the blood, as well as causing blood vessels to narrow. The combination reduces the oxygen delivery to healing tissues, counteracting the benefit of HBO therapy. You are encouraged to cease smoking.
For maximum safetyThe following items are not permitted in the chamber:
Are there any side effects?
Side effects are uncommon. They relate to the increase in pressure (ear or lung barotrauma) or the use of increased amounts of oxygen (CNS or lung oxygen toxicity). Some patients may also experience visual changes that cause them to become more near-sighted (myopia); this is usually temporary and should disappear within 3-4 months of ceasing therapy. Your doctor will discuss these prior to your commencing treatment and at any time you are concerned.
If at any time during the treatment you feel uncomfortable or have any sensation that is not normal for you, please report it to the nurse, immediately.
How will it feel?
The first few minutes of the dive will be quite noisy, due to the pressurised air entering the chamber. It will seem warm at first and then the temperature will be adjusted to a comfortable level. You will feel the change in pressure in your ears, similar to that when descending in an aircraft. With effective equalisation, as coached by the nurse present, you will not have any discomfort. If you do have discomfort, please notify your nurse immediately.
At the end of the treatment, the chamber pressure is reduced to usual atmospheric pressure and the air will feel colder.You will feel your ears "popping" during this phase.
About the staff
A hyperbaric trained attendant, usually a registered nurse, will be inside the chamber during each treatment. The attendant is there to help with the equipment delivering the oxygen, instruct with equalisation of your ears, answer your questions and assist in any way necessary.
Send your comments and questions by filling out the form.
We will reply as quickly as possible