What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy is an innovative method of increasing oxygen delivery to diseased and damaged tissue in an effort to enhance healing and recovery of function. It is often an appropriate addition to a comprehensive treatment program including medical, nutritional, and other therapeutic modalities.
Hyperbaric, or high pressure, delivery of oxygen is a treatment used to increase the amount of oxygen delivered by the bloodstream to tissues throughout the body. Oxygen is required in every cell for normal function and increased amounts may be needed in areas of disease, infection, or injury in order to restore health.
How does hyperbaric oxygen therapy work?
Fig 1. - Pre- and Post- SPECT scans showing remarkable improvement after only 10 treatments.1
Under normal conditions, hemoglobin carries 97% of the oxygen in the circulation and an additional 3% is dissolved in the blood. Oxygen given by mask can increase the saturation of hemoglobin to 100%, but this does not appreciably increase the amount of oxygen dissolved in the plasma. Although this small increase in oxygenation is beneficial, it is minimally effective in the treatment of advanced disease.
The increased pressure in a hyperbaric chamber allows the level of oxygen carried by the blood plasma to increase considerably and breathing 100% oxygen while in the treatment chamber can allow the delivery of approximately 10 times the usual amount of oxygen in our circulation. This rapidly raises oxygen levels in all tissues to enhance energy production and the elimination of accumulated toxins. In disease conditions where inflammation and edema are present, circulation in the tissues involved is compromised and oxygen delivery often does not reach the level necessary for healing to occur. Increasing the amount of oxygen circulating in the bloodstream allows cells in areas of poor perfusion to receive the oxygen necessary for metabolism and decrease the probability of cell death.
What conditions might respond to hyperbaric oxygen therapy?
Clinical response to hyperbaric treatment has been reported in a wide variety of conditions. Clients with the following diagnoses often respond to treatment:
- Cerebral palsy
- Multiple sclerosis
- Attention deficit disorder
- Chronic fatigue
- Crohn's disease/colitis
- Crush injuries
- Myocardial infarction
- Surgical wounds
- Bone fractures
- Diabetic ulcers
- Mitochondrial disorders
- Ammonia toxicity
The use of hyperbaric oxygen therapy for the treatment of many of these conditions is considered investigational. Although recognized and accepted by a growing number of physicians, it is not covered by insurance.
What does the process involve?
The hyperbaric chamber used at care is spacious enough to accommodate a child and his or her parent. Individuals under 5' tall are usually able to sit up in the chamber if desired and taller clients will undergo treatment while supine. The procedure is comfortable and painless. A slight pressure may be felt on the eardrums, similar to that felt while on an aircraft. Yawning or swallowing alleviates this pressure sensation. Treatment sessions last just under one hour, but may vary according to the diagnosis and overall treatment strategy. In most cases, other treatments should be continued during HBOT, as neurological response to treatment will be optimal while oxygen levels are elevated. The chamber has multiple windows and clients can easily communicate to the healthcare provider while in the chamber. Patients often listen to music, read, play, rest, or sleep while undergoing treatment. The chamber is easily opened by either the client inside the unit or the staff providing the treatment.
Are there any risks involved?
A 10 year study of 1,505 patients who received 52,758 two hour hyperbaric oxygen treatments at 2.4 ATA once or twice per day (more aggressive treatment than the protocol used at care) revealed the following frequency of side effects:
- Inability to equalize inner ear pressure 0.37%
- Paranasal sinus blocks 0.09%
- Confinement anxiety (claustrophobia) 0.05%
- Oxygen convulsions 0.009%
More rare complications include a temporary form of nearsightedness. Research has shown that these unusual cases of visual changes resolve within 6-8 weeks following treatment.
Oxygen is a fire hazard and extensive precautions are taken to minimize the risk of sparks or fire. These include the avoidance of mechanical toys or devices within the chamber and the use of 100% cotton attire. In addition, the following personal items and hygeine products are to be avoided:
What pressure is used?
- Matches, cigarettes, lighters
- Jewelry and piercings
- Perfume, deodorant, lotion, Vaseline products
- Hair wax, oil, or spray
- Wigs or hair pieces
- Pantyhose or nylons
The chambers used at care utilize a pressure of 4 psi. This is considered "mild" hyperbaric oxygen therapy, which carries minimal risk of complications such as those described above, yet offers considerable therapeutic benefit to many clients.
How many treatment sessions will be needed?
Most conditions require a series of treatments to achieve meaningful and lasting results. Treatment often begins with 40 sessions in close succession, typically one to two sessions per day until completion of the series. Assessment of response and progress will then determine future treatment schedules.
How long will benefits last?
In the case of cerebral palsy, improvements in language and cognition were maintained after treatment was discontinued, but spasticity returned in many cases. Most individuals with significant diseases such as multiple sclerosis, autism, or cerebral palsy find that intensive initial treatment followed by a maintenance program of treatments on a weekly or monthly basis is the ideal combination. Other conditions such as wounds or infections are treated rapidly and do not require maintenance sessions.
What research has been done?
Much of the research regarding hyperbaric oxygen therapy relates to its use in the treatment of burns, carbon monoxide poisoning, osteomyelitis (infections of the bone), decompression sickness (the "bends"), air or gas embolism, skin grafts, gas gangrene, and acute blood loss, conditions for which its use is widely accepted. Exciting research is underway to investigate the use of hyperbaric oxygen therapy in the treatment of cerebral palsy, multiple sclerosis, autism, attention deficit disorder, and other neurological conditions.
How much does hyperbaric oxygen therapy cost?
Individual 50-minute treatment sessions are $100 each. A series of 40 sessions scheduled within a 3 month time period costs $3000. A discounted rate of $2500 is offered to clients who prepay for 40 sessions scheduled within a 3 month block of time.
Can two people undergo treatment simultaneously?
Children are often accompanied by a parent or sibling, who will also receive the benefit of increased oxygen delivery. The chambers used at care are spacious enough to accommodate two small children and a parent or caregiver, but the temperature inside the chamber increases with each occupant. It is generally best to plan treatment with one child and adult at a time. If a parent or caregiver is not available or able to accompany a child in the chamber during treatment, arrangements may be made to have a care staff member supervise them in the chamber. An additional cost will be incurred in these instances.
How should I prepare for hyperbaric oxygen therapy?
The benefits of hyperbaric oxygen therapy may be maximized by avoiding tobacco, alcohol, and other toxins during treatment. All medications should be reviewed with the physician supervising treatment to insure that they will not change the way in which you respond to therapy. A healthy diet, ample water intake, and adequate rest are advised during and after treatment and nutitional supplements specific to your medical condition will be recommended.
Avoid any individuals with illnesses and use precautions such as proper handwashing to reduce the risk of contracting an infection during the course of your treatment. Upper respiratory, ear, or sinus infections would require a delay in treatment.
Wear comfortable 100% cotton clothing without zippers or snaps during treatment, remove all jewelry, and empty all pockets. Do not bring valuables to the clinic during treatment sessions.
If you have any further questions regarding hyperbaric oxygen therapy, the staff at care will be happy to assist you.
- Heuser G, Heuser SA, Rodelander D, Aguilera O, Uszler M. Treatment of Neurologically Impaired Adults and Children with "mild" Hyperbaric Oxygen. Proceedings of 2nd Int. Symposium on Hypebaric Oxygenation for C.P. and Brain Injured Child. 2002.
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