Hyperbaric
oxygen therapy (HBOT) is breathing 100% oxygen while under increased
atmospheric pressure. HBOT is a treatment that can be traced back to
the 1600s. The first well-known chamber was built and run by a
British clergyman named Henshaw. He built a structure called the
domicilium that was used to treat a multitude of diseases.1 The
chamber was pressurized with air or unpressurized using bellows. The
idea of treating patients under increased pressure was continued by
the French surgeon Fontaine, who built a pressurized, mobile
operating room in 1879.2
Dr. Orville
Cunningham, a professor of anesthesia, ran what was known as the
"Steel Ball Hospital." The structure, erected in 1928, was 6 stories
high and 64 feet in diameter. The hospital could reach 3 atmospheres
of pressure.2 The hospital was closed in 1930 because of the lack of
scientific evidence indicating that such treatment alleviated
disease. It was deconstructed during World War II for scrap.
The military continued work with hyperbaric oxygen. The work of Paul
Bert, who demonstrated the toxic effects of oxygen (producing grand
mal seizures), as well as the work of J. Lorrain-Smith, who
demonstrated pulmonary oxygen toxicity, were used with Navy divers.
Exposure times to oxygen at different depths of water (and, hence,
different levels of pressure) were quantified and tested based on
time to convulsions.2
Oxygen Chambers
When a patient is given 100% oxygen under pressure, hemoglobin is
saturated, but the blood can be hyperoxygenated by dissolving oxygen
within the plasma. The patient can be administered systemic oxygen
via 2 basic chambers: Type A, multiplace; and Type B, monoplace.
Both types can be used for routine wound care, treatment of most
dive injuries, and treatment of patients who are ventilated or in
critical care.
Multiplace chamber
Multiplace chambers treat multiple patients at the same time,
generally with a nurse or another inside observer who monitors the
patients and assists with equipment manipulation or emergencies.
Patients in a multiplace chamber breathe 100% oxygen via a mask or
close-fitting plastic hood. Multiplace chambers can usually be
pressurized to the equivalent of about 6 atmospheres of pressure.
If a different mixture of gas (nitrogen or helium mixture) is
desired, the mixture can be given, via the mask, to only the
patient, not the employee. All equipment used with patients, such as
ventilators and intravenous lines, is put into the chamber with the
patient. Since the employee is breathing air during the treatment
(not using a mask), his or her nitrogen intake must be monitored, as
this presents a risk for problems similar to those sometimes
developed by scuba divers (eg, decompression sickness.
Jamaica,
Kingston
Waco, Texas
Singapore, Singapore
Bahrain, Manama
Kenya, Nairobi
Washington, District of Columbia
Solomon Islands, Honiara
Evansville, Indiana
Brazil, Brasilia
Umm al-Qaiwain, United Arab Emirates, Umm al-Qaiwain, UAE
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