Hyperbaric oxygen therapy

Overview

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room or tube. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a hazard of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, bubbles of air in your blood vessels, and wounds that won't heal as a result of diabetes or radiation injury.

In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Under these conditions, your lungs can gather more oxygen than would be possible breathing pure oxygen at normal air pressure.

Your blood carries this oxygen throughout your body. This helps fight bacteria and stimulate the release of substances called growth factors and stem cells, which promote healing.

Why it's done

Your body's tissues need an adequate supply of oxygen to function. When tissue is injured, it requires even more oxygen to survive. Hyperbaric oxygen therapy increases the amount of oxygen your blood can carry. An increase in blood oxygen temporarily restores normal levels of blood gases and tissue function to promote healing and fight infection.

Hyperbaric oxygen therapy is used to treat several medical conditions. And medical institutions use it in different ways. Your doctor may suggest hyperbaric oxygen therapy if you have one of the following conditions:

• Anemia, severe
• Brain abscess
• Bubbles of air in your blood vessels (arterial gas embolism)
• Burn
• Decompression sickness
• Carbon monoxide poisoning
• Crushing injury
• Deafness, sudden
• Gangrene
• Infection of skin or bone that causes tissue death
• Nonhealing wounds, such as a diabetic foot ulcer
• Radiation injury
• Skin graft or skin flap at risk of tissue death
• Vision loss, sudden and painless

The evidence is insufficient to support claims that hyperbaric oxygen therapy can effectively treat the following conditions:

• AIDS/HIV
• Allergies
• Alzheimer's disease
• Arthritis
• Asthma
• Autism
• Bell's palsy
• Brain injury
• Cancer
• Cerebral palsy
• Chronic fatigue syndrome
• Cirrhosis
• Depression
• Fibromyalgia
• Gastrointestinal ulcers
• Heart disease
• Heatstroke
• Hepatitis
• Migraine
• Multiple sclerosis
• Parkinson's disease
• Spinal cord injury
• Sports injury
• Stroke

Risks

Hyperbaric oxygen therapy is generally a safe procedure. Complications are rare. But this treatment does carry some risk.

Potential risks include:

• Temporary nearsightedness (myopia) caused by temporary eye lens changes
• Middle ear injuries, including leaking fluid and eardrum rupture, due to increased air pressure
• Lung collapse caused by air pressure changes (barotrauma)
• Seizures as a result of too much oxygen (oxygen toxicity) in your central nervous system
• In certain circumstances, fire — due to the oxygen-rich environment of the treatment chamber

How you prepare

Pure oxygen can cause fire if a spark or flame ignites a source of fuel. Because of this, you can't take items such as lighters or battery-powered devices into the hyperbaric oxygen therapy chamber. In addition, to limit sources of excess fuel, you may need to remove hair and skin care products that are petroleum based and potentially a fire hazard. Ask a member of your health care team for specific instructions before your first hyperbaric oxygen therapy session.

What you can expect

During hyperbaric oxygen therapy

Hyperbaric oxygen therapy typically is performed as an outpatient procedure and doesn't require hospitalization. If you're already hospitalized and require hyperbaric oxygen therapy, you'll remain in the hospital for therapy. Or you'll be transported to a hyperbaric oxygen facility that's separate from the hospital.

Depending on the type of medical institution you go to and the reason for treatment, you may receive hyperbaric oxygen therapy in one of two settings:

• A unit designed for 1 person. In an individual (monoplace) unit, you lie down on a table that slides into a clear plastic tube.
• A room designed to accommodate several people. In a multiperson hyperbaric oxygen room — which usually looks like a large hospital room — you may sit or lie down. You may receive oxygen through a mask over your face or a lightweight, clear hood placed over your head.

During hyperbaric oxygen therapy, the air pressure in the room is about two to three times normal air pressure. The increased air pressure will create a temporary feeling of fullness in your ears — similar to what you might feel in an airplane or at a high elevation. You can relieve that feeling by yawning or swallowing.

For most conditions, therapy lasts approximately two hours. Members of your health care team will monitor you and the therapy unit throughout your treatment.

After hyperbaric oxygen therapy

You may feel somewhat tired or hungry following your treatment. This doesn't limit normal activities.

Results

To benefit from hyperbaric oxygen therapy, you'll likely need more than one session. The number of sessions depends on your medical condition. Some conditions, such as carbon monoxide poisoning, might be treated in three visits. Others, such as nonhealing wounds, may require 20 to 40 treatments.

Hyperbaric oxygen therapy alone can often effectively treat decompression sickness, arterial gas embolism and severe carbon monoxide poisoning.

To effectively treat other conditions, hyperbaric oxygen therapy is used as part of a comprehensive treatment plan and administered with other therapies and drugs that fit your individual needs.