Hyperbaric Therapy FAQs

Frequently-asked questions about Hyperbaric Oxygen Therapy (HBOT).

Click on any of the following toggles to get answers to some of the most common questions regarding HBOT.

HBOT is a method of delivering extra oxygen into the body, mainly through the process of increasing the pressure that the body is normally under. In terms of HBOT, pressure is normally quantified in ATA and currently we are all standardized to be under 1.0 ATA of atmospheric pressure. When someone undergoes hyperbaric therapy, the pressure becomes greater than 1.0 ATA and in hospitals and wound care centers can typically reach 2.0 or even 3.0 ATA. Each atmospheric pressure represents 33 feet of seawater so at 2.0 ATA, it would be equivalent for you to be at a depth of 33 feet below sea level. Once at this depth, 100% oxygen will be administered for the full duration of the treatment, which normally lasts for 60 to 90 minutes per session, and this procedure can be repeated twice per day with a 4-hour break in between. For chronic or hard-to-heal wounds, this dosage is typically repeated daily from anywhere between 10 and 80 hours.

The FDA approves hyperbaric treatments for the following 13 conditions: Decompression Sickness, Gas embolism, Carbon Monoxide. and Cyanide poisoning, Gas Gangrene, Selected aerobic and anaerobic soft tissue infections, Osteomyelitis, Intracranial abscess, Management of Fungal disease, Radiation injury to tissue, Exceptional blood loss/anemia, Crush injury/compartment syndrome, Ischemia reperfusion injuries, Skin grafts and flaps, Healing in selected problem wounds, Treatment of thermal burns.

Many doctors and clinical researchers in the field of hyperbaric medicine believe that HBOT may help many more conditions and improve quality of life. Please be aware that if you are using this to treat a medical condition other than the 13 above conditions, then the FDA considers this an ‘off-label’ treatment and wishes you to make sure that you have sought out all FDA-approved treatments first and fully understand the benefit to risk ratio before making your decision.

m-HBOT represents a lower pressurized chamber, generally under 1.5 ATA, and typically at 1.3 ATA. These lower atmospheric pressures (representing roughly only 10 feet below sea level) allow for greater safety, while still allowing for the delivery of much higher levels of oxygen into the tissues. The FDA has cleared m-HBOT as an approved treatment for those suffering from altitude sickness, where oxygen levels can become dangerously low at higher elevations — a condition that can be even be life threatening. The extra oxygen delivered through m-HBOT is so significant that it can be enough to help reverse this life threatening condition!

Again, one of the key determinants of HBOT is pressure and the greater the pressure, the greater the amount of dissolved oxygen into the body – Note, it does not take much pressure to deliver extra amounts of physiologically-available oxygen. During m-HBOT, the added pressure allows extra oxygen to be absorbed and transferred from the lungs into the blood, causing a greater saturation of blood oxygen levels. As this rich oxygenated blood makes its way to damaged tissue, extra oxygen is now readily available and can be potentially utilized for enhancing tissue repair and regeneration while also still being able to provide its potent anti-inflammatory and anti-bacterial effects. The FDA once again cautions the use of HBOT, including m-HBOT if it’s not used for one of the approved medical conditions, and in this case being ‘altitude sickness’. Although these lower pressures have been both reported to have significant benefits, which are now being supported and validated though clinical research trials, we would still encourage you to follow the FDA guidelines in looking in to ‘medically-approved’ options if you are looking at using m-HBOT to help with a medical condition.

t-HBOT is ‘targeted’ hyperbaric oxygen therapy. Here, near Infrared Light Therapy is combined with HBOT in order to increase the oxygen levels to localized tissue. Normally this is done in m-HBOT (low pressure chambers) to help increase the dose of oxygen delivered to localized tissue without increasing the systemic blood oxygen levels that would normally be required to reach these thresholds needed in localized tissue. Basically it ‘points’ to an area of the body to help deliver the effects of HBOT to that focused area. Both therapies have been individually shown to exert positive effects, but the combined approach has recently been reported to have much greater effects. While still in it’s research phase, t-HBOT may prove to be a powerful tool to localizing the effects of HBOT.

Traditionally, hyperbaric oxygen therapy is defined as breathing 100% oxygen under pressure. However, ambient air still contains 21% oxygen, and when you breathe it under pressure, more oxygen will get transferred into the body. More importantly, the extra oxygen is in the blood plasma (liquid) and gets oxygen into areas much deeper areas (ie, where inflammation impedes blood flow) and in places where red blood cells cannot physically get into. This is a great technique to achieve greater levels of oxygen without the associated risks of being in high oxygen environments.

The reported benefits using HBOT or m-HBOT have typically been from those who have had one to two sessions per day (with a 4-hour interval between the start of each session for those who have 2 sessions per day). People who live nearby may choose to do one session daily. The end result is the same. The leading proponents of HBOT recommend a minimum of 20 sessions and preferably up to 40 in the initial schedule. Following 40 sessions, you may re-evaluate for discernible benefits before proceeding. If you have local areas of concern, you may combine this procedure with Near Infrared Light therapy, providing a focused approach, which we have found has even provided noticeable benefits when applied once or twice per week.

Typically, sessions last a minimum of 60 minutes. Pressurizing the chamber takes 5-10 minutes (up to 25 min.). At the therapeutic depth you will receive a timed 60 minutes session (on average), after which we depressurize (for 5-10 minutes). Allow up to 1.5-hours for each treatment session.

In our wellness center, we use Oxyhealth hyperbaric chambers; the Fortius420 and the Vitaeris320. Our hard-shell chamber, the Fortius420, is our largest and most versatile chamber capable to treat up toc3.0 ATA (29 psi) operating pressure. This chamber has a nice and considerably large 42”cdiameter interior. With mirrored controls inside and out the Fortius420 offers remarkably safe functionality and it’s the only steel hyperbaric chamber in the world with the capability for patients to self-treat.

The Vitaeris 320 is our largest portable hyperbaric chamber with enough room for two adults to self-treat simultaneously. The sizeable 32” diametric chamber has a roomy interior and gives patients complete freedom of movement while maintaining Oxyhealth’s strict and impeccable safety specifications. The spacious design coupled with medical grade technology ensures durability and functionality that will last for years and peace of mind during each therapeutic session.

As the chamber is being pressurized, air presses on your eardrums and pushes them inwards. This pressure feels similar to the pressure that you feel in your ears when you are flying in an airplane. The majority of people (90%) automatically and easily adjust to these pressure changes, while reporting no adverse effects. If you are in the 10% minority, then the only problem that you may experience with this is either discomfort or pain in your ears or sinuses, similar to that which you would feel if you were congested while landing from an airplane. The only difference is that you ‘cannot tell the pilot on an airplane to stop’; however, in this case, we would encourage you to signal or radio the attendant immediately if you have discomfort in your ears or sinuses.

Don’t wait until it really hurts. The operator will stop pressurizing and decrease the pressure until you are comfortable and able to equalize the pressure. When you’re comfortable they will resume pressurizing. Our attendants are well experienced at dealing these cases and are willing to work with you as required. Here are some techniques in helping to equalize your ears:

• Try to swallow; yawn or drink sips of water. Turn your head to one side and swallow, then turn to the other side and swallow. Repeat if necessary.

• The Valsalva Maneuver – Pinch your nose closed, close your mouth and lift the front-tip of your tongue towards the roof of your mouth. Attempt to blow through your pinched nose (short and sharp) but not too forcefully. This directs air from your throat into your ears and sinus air spaces.

• A third method combines these techniques: try swallowing and wiggling your jaw while blowing gently against your pinched nose. Now that’s coordination.

• If you have a history of problems with the ear when flying or traveling in the mountains you may wish to use nasal decongestants before the first few treatments. With young children tilt their head back and you can put one drop of pediatric (baby) nose drops in each nostril one and a half to two hours before HBOT. Wait 5-10 min. and then put a second drop in each nostril. You can use Afrin or a similar nasal spray 20-30 minutes after the nose drops. Do not repeat the nasal spray.

Performed in a clinical setting, m-HBOT has repeatedly been shown to be extremely safe. The only noted side effects have been limited to higher-pressure chambers used to treat acute life-threatening conditions in hospitals, and even these side effects are very rare. It should be noted that the only absolute contraindication for undergoing HBOT is a collapsed lung (pneumothorax).

Areas of concern would be:

• Severe lung or heart disease: This is because we would not want fluid to build up into the lungs.

• Uncontrolled Diabetes: This is because we do not want the blood sugars to drop too low if HBOT was combined with overdose of diabetic drug therapy.

• History of Seizure or Uncontrolled fever: This is because we would be concerned with exacerbating seizure activity, particularly if blood sugars were low.

• Changes in Vision: This is rare and a temporary change in vision, that has been associated with higher pressure chambers and not m-HBOT. Changes in vision include getting either a little worse (Myopia) or better (Presbyopia). Note, these case are rare and associated with higher oxygen dosages. If you notice any changes, please let attendant know and don’t worry as the vision tends to go back to its original state within 3 months from discontinuing the sessions. For that reason, it is not advised to change prescriptions during this time period.

• History of Cataracts: Though HBOT cannot cause cataracts, this procedure may cause formed cataracts to mature quicker.

• Pregnancy: As a precautionary measure, HBOT is not used during pregnancy unless indicated for acute life-threatening conditions.

• Current upper respiratory infections, chronic sinusitis or sinus problems: These conditions cause a higher probability of problems during pressurization and are generally recommended to be treated before going into HBOT.

• Claustrophobia: Some clients may suffer from claustrophobia. This is managed by maintaining communication, use of relaxation techniques and mild sedation, if necessary. If you have a problem with this condition please let us know.

Your role is quite simple, to show up on time and communicate to our staff and attendants each time and let us know if there are any changes in your health. For example, you may have reported on your first visit that you were not pregnant, but when you come in for multiple visits it is your responsibility to let us know if there are any changes in your health, and of course in this example it would be ‘if you were potentially pregnant’. This is the reason why each of the initial screening questions must be answered each time you go into the hyperbaric chamber. This is for your safety and once again it is your responsibility to let us know each time you go in ‘if there are any changes’ in your health.

The air warms as we pressurize and cools as we depressurize. Ventilation keeps the air moving when it is warm, and blankets are available if you become cold.

Smoke and other odors on your clothes are accentuated within the confines of the pressurized chamber. Try to minimize the detrimental effect of smoking on HBOT results by abstaining within 1-hour pre and post treatment. Please do not use strong scented perfumes or deodorants.

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