“Hyper” means increased and “baric” is pressure
Medical use of oxygen or air at a level higher than atmospheric pressure.
HBOT involves breathing oxygen or air in a pressurized chamber. The earth’s atmosphere normally exerts one atmosphere absolute (1 ATA). In HBOT, the pressure is increased upto 3 ATA. At increased pressures, breathing 100% oxygen can substantially increase arterial blood PO2 levels.
The undersea and Hyperbaric Medical Society defines hyperbaric oxygen treatment as breathing 100% oxygen delivered at pressures greater than 1.4 ATA.
|pO2 at 1 ATA||pO2 at 2 ATA||pO2 at 3 ATA|
|Ambient Air (21% O2||160 mmHg||319 mmHg||479 mmHg|
|35% O2||266 mmHg||532 mmHg||798 mmHg|
|95% O2||722 mmHg||1444 mmHg||2166 mmHg|
DIRECT PRESSURE TO OXYGEN MOLECULES
Normally, only the red blood corpuscles are capable of transporting oxygen throughout the body. Therefore the body cannot take oxygen more than the volume of hemoglobin. In HBOT, more oxygen dissolves in all body fluids according to Boyle’s law. This extra oxygen dissolved in the body fluid results in the direct delivery of oxygen to the tissues even under
FDA approved indications:
- Air or gas embolism
- Carbon monoxide (CO) poisoning
- CO poisoning complicated by cyanide poisoning
- Clostridial myositis and myonecrosis (gas gangrene)
- Crush injury, compartment syndrome and other acute traumatic ischemias
- Decompression sickness
- Central retinal artery occlusion
- Sensorineural hearing loss
- Enhancement of healing in selected problem wounds
- Severe anemia
- Intracranial abscess
- Necrotizing soft tissue infections
- Osteomyelitis (refractory)
- Delayed radiation injury (soft tissue and bony necrosis)
- Compromised grafts and flaps
- Acute thermal burn injury
Off label indications
- Lyme disease
- Acute coronary syndrome
- Alzheimers diseases
- Cerebral palsy
- Multiple sclerosis
- Parkinson’s disease
- Traumatic brain injury
- Vascular dementia
- Chronic fatigue syndrome
- Complex regional pain syndrome
- Smoke inhalation
Hybrid 4000 Features
- 40″ Inside Diameter
- Integrated Stretcher – 750-pound capacity
- Gurney not required
- ASME – PVHO-1 – National Board
- FDA-510(k) Cleared
Hyperbaric medicine is medical treatment in which an ambient pressure greater than sea level atmospheric pressure is a necessary component. The treatment comprises hyperbaric oxygen therapy (HBOT), the medical use of oxygen at an ambient pressure higher than atmospheric pressure, and therapeutic recompression for decompression illness, intended to reduce the injurious effects of systemic gas bubbles by physically reducing their size and providing improved conditions for elimination of bubbles and excess dissolved gas.
The equipment required for hyperbaric oxygen treatment consists of a pressure chamber, which may be of rigid or flexible construction, and a means of delivering 100% oxygen. Operation is performed to a predetermined schedule by trained personnel who monitor the patient and may adjust the schedule as required. HBOT found early use in the treatment of decompression sickness, and has also shown great effectiveness in treating conditions such as gas gangrene and carbon monoxide poisoning. More recent research has examined the possibility that it may also have value for other conditions such as cerebral palsy and multiple sclerosis, but no significant evidence has been found.
Therapeutic recompression is usually also provided in a hyperbaric chamber. It is the definitive treatment for decompression sickness and may also be used to treat arterial gas embolism caused by pulmonary barotrauma of ascent. In emergencies divers may sometimes be treated by in-water recompression if a chamber is not available and suitable diving equipment to reasonably secure the airway is available.
A number of hyperbaric treatment schedules have been published over the years for both therapeutic recompression and hyperbaric oxygen therapy for other conditions.
Hyperbaric medicine includes hyperbaric oxygen treatment, which is the medical use of oxygen at greater than atmospheric pressure to increase the availability of oxygen in the body; and therapeutic recompression, which involves increasing the ambient pressure on a person, usually a diver, to treat decompression sickness or an air embolism by eliminating bubbles that have formed within the body.
In the United States the Undersea and Hyperbaric Medical Society, known as UHMS, lists approvals for reimbursement for certain diagnoses in hospitals and clinics. The following indications are approved (for reimbursement) uses of hyperbaric oxygen therapy as defined by the UHMS Hyperbaric Oxygen Therapy Committee:
- Air or gas embolism;
- Carbon monoxide poisoning;
- Carbon monoxide poisoning complicated by cyanide poisoning;
- Central retinal artery occlusion;
- Clostridal myositis and myonecrosis (gas gangrene);
- Crush injury, compartment syndrome, and other acute traumatic ischemias;
- Decompression sickness;
- Enhancement of healing in selected problem wounds;
- Diabetically derived illness, such as short-term relief of diabetic foot, diabetic retinopathy, diabetic nephropathy;
- Exceptional blood loss (anemia);
- Idiopathic sudden sensorineural hearing loss;
- Intracranial abscess;
- Mucormycosis, especially rhinocerebral disease in the setting of diabetes mellitus;
- Necrotizing soft tissue infections (necrotizing fasciitis);
- Osteomyelitis (refractory);
- Delayed radiation injury (soft tissue and bony necrosis);
- Skin grafts and flaps (compromised);
- Thermal burns.
Evidence is insufficient to support its use in autism, cancer, diabetes, HIV/AIDS, Alzheimer’s disease, asthma, Bell’s palsy, cerebral palsy, depression, heart disease, migraines, multiple sclerosis, Parkinson’s disease, spinal cord injury, sports injuries, or stroke. A Cochrane review published in 2016 has raised questions about the ethical basis for future clinical trials of hyperbaric oxygen therapy, in view of the increased risk of damage to the eardrum in children with autism spectrum disorders. Despite the lack of evidence, in 2015, the number of people utilizing this therapy has continued to rise.
There is limited evidence that hyperbaric oxygen therapy improves hearing in patients with sudden sensorineural hearing loss who present within two weeks of hearing loss. There is some indication that HBOT might improve tinnitus presenting in the same time frame.
HBOT in diabetic foot ulcers increased the rate of early ulcer healing but does not appear to provide any benefit in wound healing at long-term follow-up. In particular, there was no difference in major amputation rate. For venous, arterial and pressure ulcers, no evidence was apparent that HBOT provides a long-term improvement over standard treatment.
There is some evidence that HBOT is effective for late radiation tissue injury of bone and soft tissues of the head and neck. Some people with radiation injuries of the head, neck or bowel show an improvement in quality of life. Importantly, no such effect has been found in neurological tissues. The use of HBOT may be justified to selected patients and tissues, but further research is required to establish the best people to treat and timing of any HBO therapy.
As of 2012 there is insufficient evidence to support using hyperbaric oxygen therapy to treat people who have traumatic brain injuries. In stroke, HBOT does not show benefit. HBOT in multiple sclerosis has not shown benefit and routine use is not recommended.
A 2007 review of HBOT in cerebral palsy found no difference compared to the control group. Neuropsychological tests also showed no difference between HBOT and room air and based on caregiver report, those who received room air had significantly better mobility and social functioning. Children receiving HBOT were reported to experience seizures and the need for tympanostomy tubes to equalize ear pressure, though the incidence was not clear.
In alternative medicine, hyperbaric medicine has been promoted as a treatment for cancer. A 2012 review article in the journal, Targeted Oncology, reports that “there is no evidence indicating that HBO neither acts as a stimulator of tumor growth nor as an enhancer of recurrence. On the other hand, there is evidence that implies that HBO might have tumor-inhibitory effects in certain cancer subtypes, and we thus strongly believe that we need to expand our knowledge on the effect and the mechanisms behind tumor oxygenation.” However, a 2011 study by the American Cancer Society reported no evidence it is effective for this purpose.
Low-quality evidence suggests that hyperbaric oxygen therapy may reduce the pain associated with an acute migraine headache in some cases. It is not known which people would benefit from this treatment, and there is no evidence that hyperbaric medicine can prevent future migraines. More research is necessary to confirm the effectiveness of hyperbaric oxygen therapy for treating migraines.