Is Hyperbaric Oxygen Therapy (HBOT) safe?
Yes. Hyperbaric Oxygen Therapy takes place under appropriate medical surveillance by specialized personnel following specific procedures that secure patient safety
How should I prepare for this treatment?
After initial examination-assessment by the Hyperbaric Physician, the patient will receive detailed instructions about the treatment. The patient will be asked not to have hair cream or spray, perfume, make-up products, skin creams and ointments (unless prescribed by the physician for related condition), synthetic or nylon fabrics, petroleum or vaseline based creams. Non-diving watches may be damaged by pressure and should be left outside the chamber if in doubt. Lighters, matches, electrical devices are STRICTLY PROHIBITED inside the chamber during treatment (Mobiles, digital cameras, laptops and ipods are included). Any other device or special material not specified, should be left outside the treatment chamber unless discussed with specialized personnel. No specific limitations exist concerning food intake and therapeutic “dive” in the chamber, as long as the patient feels comfortable at the time of treatment.
What does a patient experience during treatment? (How does it feel?)
The first stage of Hyperbaric Oxygen Therapy is compression, in which the pressure inside the chamber is gradually increased. At this stage, the temperature increases but is later adjusted to a comfortable level. Also, you will feel a fullness in the ears. Using the instructions already given or guidance from the operator, you will easily clear the pressure and relieve any temporary discomfort. When desired pressure is reached and masks are put on, you can read, listen to music or just relax. When the treatment is completed, normal pressure is restored slowly. At this stage, temperature will decrease.
Are there any side effects?
The risks associated with hyperbaric oxygen are minimal. However, some patients may experience a few side effects. The most common complications include:
- Ear & sinus squeeze (easily prevented and overcome with appropriate guidance)
- Temporary changes in vision (reversible at the end of sessions-needs many sessions to appear)
- Fatigue (temporary)
Is it permitted to take anything with me inside the Hyperbaric Chamber during treatment?
Water, tissues, vision glasses and cotton clothes are permitted in all kinds of Hyperbaric Chambers. Books and magazines are allowed, too. Electrical devices (mobiles, buzzers, smartphones, radios, computers, mp3 players etc), food and cosmetics are not allowed for safety reasons. Patients bearing cardiac pacemakers implanted during the last decade, most probably will not be exempted – however, a written confirmation of hyperbaric testing by the manufacturer will be required before initiating treatment. In any case, personnel can provide answers and clarifications.
Is there any monitoring during the patient’s stay inside the chamber for HBOT and how?
There is continuous monitoring by the chamber’s operator who is a specialized nurse. This is done using audio-visual means available (cameras, speakers) that give the capability of communication at any time.
How long does a session last? And how often is hyperbaric oxygen administered?
Normally, each session lasts 80 – 100 minutes. Sessions take place every day due to its cumulative effects, 5 times per week
How many HBOT sessions will I need?
Various factors will determine the precise treatment protocol which is individualized. Acute or emergency cases require a few sessions but may need up to 10-20 sessions. For the full range of actions of HBOT needed in the chronic conditions treated, a minimum of 20 sessions is required (1 month in total). However, chronic conditions may need extended number of sessions, with repetitive treatment plan, lasting in total several months
Does hyperbaric oxygen therapy require hospitalization?
No, hyperbaric oxygen therapy can be administered on an outpatient basis, if allowed by the health status of the patient. This is true for the vast majority of patients undergoing this treatment.
Is my physician (other specialty e.g. Orthopaedic Surgeon) who gives referral for HBOT implicated in this treatment?
It is important that the treating physician is involved in the treatment plan of each patient. Hyperbaric physician is responsible for safe provision of HBOT and application of the appropriate treatment protocol, after discussing expected outcome and goals with referring physician. We expect and promote cooperation with each treating physician, as well as keeping him updated with the course of treatment.
How long after the end of each session must I wait before returning to my normal activities?
There are no limitations related to HBOT, and patients can go on with their expected level of performance and everyday tasks right after leaving the hyperbaric facility. Smokers should avoid smoking for 2 hours after the end of each session. This restraint facilitates actions of HBOT. Feeling of fatigue reported by some patients is of no significance and gradually disappears.
Do private insurance companies reimburse the cost of HBOT?
Yes, private insurance companies accept charges of HBOT for some indications – depends on the contract for each case. It is suggested to contact your insurance consultant to get information concerning reimbursement of HBOT. We can provide necessary explanation and medical reports.
What is Hyperbaric Oxygen Therapy and what does it involve?
Hyperbaric Oxygen Therapy is a medical (Treatment) modality, during which the patient inhales 100% Oxygen under conditions of increased ambient pressure, aiming to improve treatment outcome in various maladies. HBOT is used extensively for more than 5 decades in the treatment of various diseases.
Inhaling 100% (pure) Oxygen under increased pressure increases oxygen content of the arterial blood (oxygen partial pressure) by 15 times or more. When given at this “dosage”, oxygen has many beneficial effects. It enhances wound healing, improves host immune response, promotes new blood vessels formation and restores local oxygen availability – all the above are frequently compromised in suffering parts of the body.
How does Hyperbaric Oxygen Therapy help?
1.Restores – enhances wound healing capacity – HBOT promotes neovascularization (new blood vessel formation) and enhances collagen synthesis, due to increase of oxygen availability in hypo-perfused/hypoxic areas. It also reduces edema in the presence of inflammation and is useful against infections.
2.Bactericidal/bacteriostatic properties, useful against infections – Sufficient oxygen is necessary for killing of bacteria by white blood cells. Hyperbaric Oxygen is bactericidal for most anaerobic bacteria and has synergistic effects with many antibiotics. As a whole, HBOT improves host immune defense and response against infections.
3.Improves tissue perfusion – HBOT enhances wound healing, improves local tissue “detoxification” and increases energy reserve available to the tissues.
What is the history of HBOT?
Decompression chambers have been used for centuries, since 1662. However, HBOT is in extensive use for clinical purposes from the middle of the 20th century
Use of HBOT was developed at the end of WW I. It is used safely since the 30’s for the treatment of sick divers – decompression sickness.
Clinical studies done in the 50’s revealed the beneficial effects of HBO. Results of this period’s studies led to the modern use of HBOT in the clinical setting.
In 1967, Undersea & Hyperbaric Medical Society (UHMS) was formed. UHMS is an international scientific association and greatly promoted research and served as center of knowledge, in the field of hyperbaric and diving medicine. UHMS in 1976, appointed the Hyperbaric Oxygen Therapy Committee to study and oversee the expanding use of HBOT, serving also as the approval body for indications treated.
Nowadays, 14 conditions constitute the list of indications approved by UHMS and accepted worldwide. HBOT has been shown to be life- and limb-saving and has been repeatedly reported to be cost-effective and a unique treatment modality for various diseases.
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Are there different kinds of chambers?
Yes, there are different kinds of chambers. In general, types are:
Monoplace Chambers. This type accommodates one patient and is usually pressurized with 100% oxygen that the patient breathes directly (no mask needed). It is usually cylindrical in shape, with transparent walls (acrylic) and the patient enters using a tray lying down for the duration of the treatment
Multiplace Chambers. They accommodate more than one patient at a time depending on the size (4 to 24 patients) and in most cases patients are seated during the session. They are pressurized with air and patients breathe pure oxygen through a built-in breathing system using masks or hoods. These chambers are large enough to allow for wheelchairs, critical care patients and accompanying medical staff. They also offer the capability for staff or patients when needed, to enter or exit the chamber without interrupting the session. Last, such chambers have the capacity to reach increased pressures needed for treatment of severe diving incidents.
Is there an approved list of conditions where Hyperbaric Oxygen Therapy is used?
Air or Gas Embolism
Carbon Monoxide Poisoning and Carbon Monoxide Poisoning Complicated by Cyanide Poisoning
Clostridal Myositis and Myonecrosis (Gas Gangrene)
Crush Injury, Compartment Syndrome, and other Acute Traumatic Ischemias
Decompression Sickness
Enhancement of Healing in Selected Problem Wounds
Exceptional Blood Loss (Anemia)
Intracranial Abscess
Necrotizing Soft Tissue Infections
Osteomyelitis (Refractory)
Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
Skin Grafts & Flaps (Compromised)
Thermal Burns
Idiopathic Sudden Sensorineural Hearing Loss (Approved on October 8, 2011, by the UHMS Board of Directors)
Are there any other conditions where HBOT is helpful/used?
There are various other conditions where hyperbaric oxygen is used, and a big body of medical literature supports positive results. These conditions include:
Diabetic foot (included in Enhancement of Healing in Selected Problem Wounds) – contributes to wound healing, treatment of possible underlying osteomyelitis and avoidance of amputation
Avascular necrosis (AVN) or aseptic necrosis of the femoral head – avoidance of arthroplasty, resolution of lesions in most cases of stage I & II of AVN
Pyoderma Gagrenosum
Central Retinal Artery Occlusion
Some refractory Fungal Infections: Mucormycosis, Aspergillosis
Brown Recluse Spider bite-induced skin lesions
Traumatic Brain Injury and other CNS (brain, spinal cord) pathology
Nonunion and delayed union of fractures – fracture healing
Sickle cell crisis and other hypoxic complications of sickle cell disease (eg chronic ulcers)
Sport injuries – rehabilitation and quick return to action and work
Neurologic conditions resulting from inflammation and local hypoxia – includes Bell’s palsy and other mononeuropathies
Vascular pathology – Buerger’s disease, Raynaud’s syndrome
Inflammatory Bowel Disease – Crohn’s disease & Ulcerative Colitis (some cases)
Pneumatosis Cystoides Intestinalis