What is hyperbaric oxygen therapy?

Indications and Procedures

Hyperbaric oxygen therapy is used in cases that compromise the ability of a person’s red blood cells to distribute oxygen throughout the body. This situation usually results in hypoxia, a condition in which the tissues are starved of the life-giving oxygen that they require.

Adult humans consume about three pounds of food and three pounds of water every day. Through respiration, however, they routinely consume twice that amount of oxygen daily. At least one-third of this oxygen enters the bloodstream for distribution to tissues. If these tissues are deprived of oxygen, a condition called ischemia, then they may be destroyed, making people with lowered oxygen levels vulnerable to diseases and infections.

When the oxygen content of the tissues becomes dangerously low, as in cases of hypoxia, immediate treatment is essential. If such treatment is not given, then the results can be fatal. The most effective treatment, often provided in emergency situations, is to place the patient in a hyperbaric chamber, a sealed container in which the pressure is gradually increased to two or three times greater than that at sea level. Pure (100 percent) oxygen is pumped into the chamber. Patients are typically confined to such chambers from one hour to an hour and a half.

The air that humans usually breathe contains about 21 percent oxygen and 78 percent nitrogen. The air pressure within the hyperbaric chamber can increase the number of oxygen molecules in the bloodstream by up to 2,000 percent. With this dramatic increase, oxygen begins to enter oxygen-starved tissue and bone cells.

The hyperbaric chamber was initially used to save the lives of deep-sea and scuba divers who ascended too fast from the ocean’s depths, causing them to suffer from decompression sickness (the bends), a potentially fatal condition caused by the formation of nitrogen gas bubbles in the bloodstream. Those suffering from the bends are deprived of the life-sustaining oxygen that the body requires to function effectively. It was found that immersing sufferers in a pressurized environment enabled their red blood cells to absorb sufficient oxygen to nourish their tissues and bones.

Most hospitals set aside rooms into which pure (100 percent) oxygen is piped. Patients in need of hyperbaric oxygen therapy are placed in such rooms and may, through tubes in their noses, be fed the oxygen that they need directly. Such treatment is intermediate. When it proves insufficient, placing patients in pressurized atmospheres for specific lengths of time can result in dramatic increases in the amount of oxygen that they can absorb and in subsequent improvement in their conditions.

Uses and Complications

Besides its use in treating people suffering from the bends, the hyperbaric chamber is employed to treat several other life-threatening conditions. Such therapy is routinely used to treat injuries incurred in automobile or motorcycle accidents in which parts of the body are crushed. Treatment in a hyperbaric chamber heightens the delivery of oxygen to damaged tissues and bones. It can control swelling and limit infection.

Some people have wounds that refuse to heal, such as foot ulcers in diabetic patients whose circulatory systems are compromised, resulting in low oxygen levels. Hyperbaric treatment can increase the amount of oxygen in their bloodstreams and promote healing.

Similarly, such bone infections as osteomyelitis
that do not respond to conventional treatment are sometimes controlled by hyperbaric oxygen therapy. The oxygen that such treatment delivers to the bloodstream can control bacterial infections and increase the effectiveness of the body’s defensive white blood cells.

Cancer patients undergoing radiation
may suffer from scarring and compression of important blood vessels, thereby inhibiting the circulation of oxygen throughout the body. Hyperbaric oxygen therapy aids in increasing such circulation, permitting oxygen to reach damaged cells and keep them from dying. This treatment is often used in treating patients with head and neck cancers.

Carbon monoxide
poisoning is a pernicious and potentially fatal form of poisoning. Because carbon monoxide is colorless and odorless, it can affect whole families confined in closed houses with defective heating systems. When victims of such poisoning are rescued, immediate hyperbaric oxygen treatment is essential. Such treatment pumps essential oxygen into the bloodstream and aids the body in expelling carbon monoxide. If treatment is given without delay, then damage to the central nervous system and red blood vessels can be circumvented.

This therapy is being used increasingly in the treatment of burn victims, in whom it may reduce swelling, limit infection, and decrease the effects of lung damage resulting from inhaling smoke and overheated air. Because hyperbaric oxygen therapy is often a choice of last resort for people who are dangerously ill, the risks are high and the rate of fatalities is considerable.

Perspective and Prospects

With the remarkable growth of new procedures in medicine, the outlook for hyperbaric oxygen therapy is bright. Once used almost exclusively to treat the bends, such therapy currently is being found effective in dealing with any health problem in which the circulation of oxygen throughout the body is compromised.

Bibliography

A.D.A.M. Medical Encyclopedia. "Hyperbaric Oxygen Therapy." MedlinePlus, August 30, 2012.

Jain, K. K. Textbook of Hyperbaric Medicine. 5th ed. Cambridge, Mass.: Hogrefe, 2009.

Mayo Clinic. "Hyperbaric Oxygen Therapy." Mayo Foundation for Medical Education and Research, October 27, 2011.

Oregon Health and Science University Evidence-Based Practice Center. Hyperbaric Oxygen Therapy for Brain Injury, Cerebral Palsy, and Stroke. Rockville, Md.: Department of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, 2003.

Sheldon, Lisa Kennedy. Oxygenation. 2d ed. Sudbury, Mass.: Jones and Bartlett, 2008.

Stuart, Annie. "Hyperbaric Oxygen Therapy." Health Library, November 26, 2012.