Hyperbaric Oxygen Therapy, also known as
HBOT, is a medical treatment that delivers 100% oxygen to a
patient’s pulmonary system while they are within a pressurized
chamber. The patient is breathing oxygen at levels far greater than
the 21% which is found at a normal sea level atmosphere.
Hyperbaric Therapy is based on two basic laws of physics.
“Henry’s Law” states that the amount of a gas dissolved in a liquid
is in proportion to the pressure of the gas above the liquid,
provided that no chemical action occurs.
“Boyle’s Law” states that at constant temperature, the volume and
the pressure of a gas are inversely proportional.
This means a gas will compress proportionately to the amount of
pressure exerted on it. Using these laws Oxygen Therapy allows more
oxygen to be delivered to the tissues and organs.
This increase of the partial pressure of oxygen at the cellular
level can accelerate the healing processes and assists in the
recovery from numerous indications.
Side effects are minimal and rarely last very long. Hyperbaric
Medicine is not a cure for most indications but it has demonstrated
to increase immune capabilities, assisting patients with problems
ranging from chronic wounds to complex disabilities and neurological
impairment.
Hyperbaric Oxygen Therapy History
This medical treatment that can be traced back to the 1600’s.
In 1662, the first Hyperbaric Chamber was built and operated by a
British clergyman named Henshaw. He erected a structure titled, the
Domicilium, that was used to treat a variety of conditions.
In 1878, Paul Bert, a French physiologist, discovered the link
between decompression sickness and nitrogen bubbles in the body.
Bert later identified that the pain could be ameliorated with
recompression.
The concept of treating patients under pressurized conditions was
continued by the French surgeon Fontaine, who later built a
pressurized mobile operating room in 1879. Fontaine found that
inhaled nitrous oxide had a greater potency under pressure, in
addition to his patients having improved oxygenation.
In the early 1900’s Dr. Orville Cunningham, a professor of
anesthesia, observed that people with particular heart diseases
improved better when they lived closer to sea level than those
living at higher altitudes.
He treated a colleague who was suffering from influenza and was near
death due to lung restriction. His resounding success led him to
develop what was known as the “Steel Ball Hospital” located along
the shore of Lake Erie. The six story structure was erected in 1928
and was 64 feet in diameter. The hospital could reach 3 atmospheres
absolute ( 44.1 PSI ). Unfortunately, due to the depressed financial
status of the economy, it was deconstructed during in 1942 for
scrap.
Hyperbaric Chambers were later developed by the military in the
1940’s to treat deep-sea divers who suffered from decompression
sickness.
In the 1950’s, physicians first employed Hyperbaric Medicine during
heart and lung surgery, which led to its use for carbon monoxide
poisoning in the 1960’s. Since then, over 10,000 clinical trials and
case studies have been completed for numerous other health-related
applications with the vast majority of results reporting resounding
success.
The UHMS defines
Hyperbaric Oxygen Therapy (HBOT) as an intervention in which an
individual breathes near 100% oxygen intermittently while inside a
hyperbaric chamber that is pressurized to greater than sea level
pressure (1 atmosphere absolute, or ATA).
For clinical purposes, the pressure must equal or exceed 1.4 ATA
while breathing near 100% oxygen.
The United States Pharmacopoeia (USP) and Compressed Gas Association
(CGA) Grade A specify medical grade oxygen to be not less than 99.0%
by volume, and the National Fire Protection Association specifies
USP medical grade oxygen.
In certain circumstances it represents the primary treatment
modality while in others it is an adjunct to surgical or
pharmacologic interventions.
Treatment can be carried out in either a Monoplace Hyperbaric Oxygen
Therapy Chamber or Multiplace Hyperbaric Oxygen Therapy Chamber.
Monoplace Hyperbaric Oxygen Therapy Chambers accommodates a single
patient; the entire chamber is pressurized with near 100% oxygen,
and the patient breathes the ambient chamber oxygen directly.
Multiplace
Hyperbaric Oxygen Therapy Chambers hold two or more people
(patients, observers, and/or support personnel).
Multiplace Chambers are pressurized with compressed air while the
patients breathe near 100% oxygen via masks, head hoods, or
endotracheal tubes.
According to the UHMS definition and the determination of The
Centers for Medicare and Medicaid Services (CMS) and other third
party carriers, breathing medical grade 100% oxygen at 1 atmosphere
of pressure or exposing isolated parts of the body to 100% oxygen
does not constitute Hyperbaric oxygen therapy .
The Hyperbaric patient must receive the oxygen by inhalation within
a pressurized chamber. Current information indicates that
pressurization should be to 1.4 ATA or higher.
