About Hyperbaric Medicine
What is Hyperbaric Medicine?
Hyperbaric medicine (also known as hyperbaric oxygen therapy or hyperbarics) is a medical sub-specialty that delivers 100 percent oxygen under pressure to supersaturate a patient’s body tissues devoid of oxygen from injury or disease to advance the healing process, optimize clinical outcomes and improve quality of life.
The power of clinical hyperbaric medicine is accomplished in a chamber (multi-patient, like the chambers at HyOx, or monoplace, for one patient only in a reclined position) pressurized with compressed air to the equivalent of 45 feet below sea level. Breathing 100 percent oxygen with time and pressure limits provides a 10 to 15-fold increase in body oxygen content than the normal air we breathe to help heal infected, injured or compromised areas.
In other words, hyperbaric oxygen therapy helps get oxygen to the places in the body that lack oxygen and need more of it to heal. Without adequate oxygen tissues and cells starve and may die. The good news is hyperbaric oxygen therapy provides the body with 100 percent oxygen delivered at a high level of pressure to enable those starved tissues and cells to live by creating new pathways via blood vessels, called angiogensis, to get oxygen where the body needs it the most.
Hyperbaric oxygen therapy can be used as the primary treatment for healing or as an adjunctive treatment to other forms of traditional treatment modalities, such as surgery or antibiotic therapy.
“We collaborate with our referring physicians to help optimize patient outcomes by adding hyperbarics to traditional treatment plans,” said Dr. Richard W. King, Jr, medical director of HyOx Medical Treatment Center. “Over more than two decades of serving patients and medical specialities in Atlanta, they’ve seen the positive results from this multi-disciplinary approach to wound healing that literally has helped hundreds of patients regain their health and quality of life.”
How does prescribing pressurized 100 percent oxygen as a drug work to help expedite healing? The air we breathe is made up of only 21 percent oxygen. The power of hyperbaric oxgyen therapy is its ability to provide patients with 15 times more oxygen they are able to breathe in at sea level to supersaturate the body.
The pressure reached in the hyperbaric chamber (equivalent to 45 feet below sea level) enables oxygen to dissolve into the liquid portion of the blood (plasma) delivering the life-giving oxygen to the places in the body that need to heal.
Hyperbaric oxygen therapy is widely recognized by the medical community as a highly effective modality of rehabilitative therapy for evidence-based conditions. It is covered under most major insurance plans, as well as Medicare, Tricare, Workers Compensation, State Merit, and other payment programs.
According to an abstract published online at the National Institutes of Health, “With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, hyperbaric oxygen therapy should be considered in these situations (approved conditions) as an essential part of the overall management strategy for the treating surgeon.”
A word diagram of the phrase hyperbaric oxygen helps clarify the treatment’s meaning:
How Does Hyperbaric Oxygen Therapy Work?
Under normal atmospheric conditions, the air we breathe is composed of 21 percent oxygen and 79 percent nitrogen. During hyperbaric oxygen therapy, those conditions are altered. The barometric pressure can be increased up to three times normal atmospheric pressure, while the air is changed to 100 percent oxygen.
The increased chamber pressure and pure oxygen breathed by the patient combine to greatly increase the oxygen-carrying capacity of the patient’s blood. Essentially, the blood becomes supersaturated with oxygen and the supply of life-giving oxygen to the tissues significantly increases. This boost of oxygen stimulates and accelerates the body’s natural healing process.
What is a Hyperbaric Chamber?
Hyperbaric oxygen therapy is delivered through treatment sessions, or “dives,” in a pressurized vessel known as a hyperbaric chamber. HyOx Medical Treatment Center uses multi-patient chambers at both its Atlanta hyperbaric centers (Marietta and Gwinnett). Regardless of their specific configuration, hyperbaric chambers are designed to safely create a pressurized environment (equivalent to 2-3 times the pressure of air at sea level) for the patient. Despite this similarity, there are differences among hyperbaric chambers. The major differences are in the manner in which oxygen is delivered to the patient and the comforts associated with each chamber.
HyOx multi-patient chambers can accommodate up to 12 patients at the same time. Patients either sit in “airline-style” seats or lay on a stretcher if warranted by their condition. The chamber is pressurized with compressed air and patients breathe oxygen through specially-designed hoods, face masks or endotracheal tubes. Since they are not in a confined space, patients are free to stand, move about and stretch during the treatment. In case of a medical emergency, hands-on treatment is provided instantaneously, without the decompression wait time associated with monoplace single-patient chambers.
HyOx operates Georgia’s largest multi-patient hyperbaric chambers. HyOx’s chambers are 31 feet in length and 9 feet in diameter. The chambers can comfortably accommodate 12 sitting patients plus attendants, who remain with patients throughout the treatment. During treatment, patients can read, listen to music, or watch videos on the chamber’s entertainment system. Medications, beverages, snacks, and a private restroom are available at all times during treatment in HyOx’s multi-patient hyperbaric chambers. Engineered and manufactured by Gulf Coast Hyperbarics, a Florida firm whose clients include NASA’s Johnson Space Center, HyOx’s chambers are made with the same materials used in the construction of high-pressure oil pipelines.
Monoplace chambers treat one patient at a time. Patients typically must lie flat in one position during the treatment in a glass cylinder-shaped chamber. Usually, the chamber is pressurized with 100 percent oxygen which the patient breathes directly.
Key Benefits of Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy can help:
- Accelerate healing of chronic wounds by increasing the amount of oxygen carried by the blood to wounded, injured, and diseased areas
- Help fight infection and increase the effectiveness of certain antibiotics
- Encourage growth of new blood vessels in hypoxic (low oxygen despite adequate blood supply) tissue
- Decrease the risk of complications prior to and following certain surgeries
- Speed the recovery of soft tissues and bones affected by radiation therapy
- Reduce the incidence of amputation in diabetic patients with lower extremity wounds
Are There Side Effects to Hyperbaric Oxygen?
The medical textbook Hyperbaric Medicine Practice states that “of all the medical treatments carried out in hospitals, hyperbaric oxygen therapy is one of the most benign when it comes to side effects. The contraindications are relatively few.”
The most common side effect that may occur is middle ear barotraumas. Clearing the ears during compression minimizes the risk of barotraumas to the ears and sinuses. Although rare, other side effects may include oxygen toxicity (poisoning), claustrophobia, temporary changes in sight, and accelerated maturation of cataracts.
The following conditions and medications may not be compatible with hyperbaric oxygen treatments:
- Untreated pneumothorax – free air in the chest / outside the lung that requires aspiration of the free air and/or placement of a chest tube to evacuate the air
- Congenital spherocytosis – a genetic disorder of the red blood cell membrane characterized by anemia, jaundice (yellowing), and splenomegaly (enlargement of the spleen)
- Disulfiram (Antabuse®) – an oral tablet used to treat chronic alcoholism
- Doxorubicin (Adriamycin®) – a medication used in cancer chemotherapy
- Cis-Platinum – a chemotherapy agent most often used to treat lung cancer
- Mafenide Acetate (Sulfamylon®) – a topical cream used to prevent and treat bacterial or fungal infections (primarily from burns)
How Effective is Hyperbaric Oxygen Therapy?
Hyperbaric oxygen therapy promotes the growth of new capillaries (neovascularization), fibroblast proliferation and collagen / new tissue development. In addition, white blood cell bactericidal activity at the wound site is elevated.
High blood oxygen levels work synergistically with antibiotics to inhibit the growth of a number of anaerobic and aerobic organisms at the wound site. The pressurized oxygen saturates hypoxic areas of the body. Hyperbaric oxygen therapy increases diffusion of oxygen through ischemic tissues with inadequate microcirculation by providing sufficient oxygen tensions to meet the metabolic needs and heal tissues.
Hyperbaric oxygen also causes constriction of the blood vessels, decreasing intra-cranial pressure and edema in injured tissues while still increasing the total amount of oxygen to the injured area. Again, the elevated air pressure leads to a 10- to 15-fold increase in plasma and tissue oxygen levels.
As with all medical treatments, results of hyperbaric oxygen therapy vary from patient to patient depending on the severity and duration of the condition. Results also can depend on whether hyperbaric oxygen therapy is used as a primary treatment or as an adjunctive treatment to surgery or antibiotics.
Results also depend on the patient’s commitment to attend all consecutive treatment sessions. As with all therapies, there are no immediate results. The number of prescribed treatments is evidence-based and the protocol must be completed for the best clinical outcome.
In studies noted in a medical review on the safety and efficacy of hyperbaric medicine in chronic wound management cited “…results of (these) studies on hyperbaric oxygen thearpy for diabetic ulcers support the suggestion that hyperbaric oxygen used adjunctively with standard wound care improves healing, particularly for foot ulcers, and possibly reduces the need for major amputation.”
For more information about your specific condition and how it could benefit from hyperbaric medicine, contact HyOx at 678-303-3200, fill out the form on our Contact Us page or consult with HyOx’s board-certified physicians during your initial consultation at one of two Atlanta hyperbaric centers in NW Atlanta (Marietta) and Gwinnett.