The beginning
The Navy used hyperbaric oxygen chambers in the early 1940s, to treat Navy divers who experienced decompression sickness, or DCS, while participating in military training dives. Hyperbaric oxygen therapy (HBOT) continues to be employed for addressing low-altitude challenges, benefiting not just Navy divers and SCUBA divers but also individuals facing high-altitude conditions, such as mountain climbers and fighter jet pilots. When subjected to pressure that causes air bubbles in the bloodstream or tissues, due to decompression sickness (DCS), prompt treatment with elevated oxygen levels typically leads to full recovery for individuals experiencing DCS.
How does this process contribute to wound healing?
By reducing the size of swollen, fluid-filled tissue, thereby depriving it of oxygen, hyperbaric oxygen therapy (HBOT) effectively diminishes the tissue under pressure. Additionally, it introduces healing oxygen gas at an elevated pressure compared to sea level. The oxygen-starved tissue becomes saturated with oxygen, reversing the effects of tissue death and oxygen deprivation. Patients can be placed in either a single-person chamber or a multi-person chamber. Once the patient descends to the attainable depth of 33 feet or 2-3 atmospheres of absolute pressure, the chamber emulates a dive by substituting water for pressure, simulating the conditions at a depth of 33 feet or 2-3 atmospheres of absolute pressure. After reaching the desired pressure, the patients commence their oxygen therapy.
Although not a rapid solution, the effectiveness of HBOT typically requires patients to undergo treatment at least 40 times or more. Therapy sessions can range from 30 minutes to 2 hours.
While it might appear to be a substantial commitment if a patient is confronted with the potential amputation of a lower extremity due to a non-healing wound, the dedication to HBOT may be deemed highly worthwhile.
HBOT is effective not only for treating DCS and non-healing wounds but also for addressing various other injuries:
· Carbon Monoxide Poisoning
· Compartment Syndrome
· Gas gangrene or necrotizing fasciitis
· Radiation injury
· Osteomyelitis
· Burns
· Severe anemia
Side effects of HBOT may include:
· Ear, sinus, and tooth pain
· Muffled hearing, tinnitus, or hearing loss
· Chest pain
· Shortness of breath
· Dizziness
· Seizure
· Dry cough
· Fatigue or tiredness
What to expect before, during, and after treatment
Patients will be given a 100% cotton gown that must be worn during the treatment. In a single-person chamber, they can recline comfortably, enjoying TV, movies, or music, all while receiving 100% oxygen pumped into the chamber. A technician will be present outside the chamber throughout the treatment to assist the patient and to communicate in case of any mentioned side effects. Before the dive, the patient will be instructed on ear-clearing techniques to prevent discomfort during the descent. After the completion of the treatment, the hyperbaric technician will gradually decrease the pressure in the chamber, and the patient will slowly ascend.
Similarly, in a multi-person chamber, a technician is not only positioned outside but another technician also dives inside with the patients. This allows the technician to assist by placing specialized oxygen helmets over the patient's heads. Patients are required to wear a 100% cotton gown and are permitted to bring in specific reading materials and games for entertainment, but electronic devices or anything flammable are prohibited. The external technician manages the operation of the multi-person chamber before, during, and after the dive, gradually depressurizing the chamber after the treatment has finished.
In conclusion
The application of HBOT in addressing injuries beyond DCS has been a gradual progression, and the future of HBOT appears promising as ongoing scientific research continues to unveil its benefits in the realm of medicine, particularly in the treatment of chronic, non-healing wounds, and various other conditions.
References:
Assessed and Endorsed by the MedReport Medical Review Board
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