It’s common knowledge that our bodies need oxygen to function. Oxygen is just a percentage of the air we breathe (21 percent, to be precise), but for some suffering from certain medical issues, breathing 100% pure oxygen delivered in a highly pressurized environment can improve their conditions.

This treatment approach is called hyperbaric medicine, and it can enhance the body’s natural healing capabilities, says Crystal Stautzenberger, PAM Health’s Corporate Outpatient Program Director. When patients breathe pure oxygen in a specialized chamber during hyperbaric oxygen therapy (HBOT) treatments, that oxygen is able to penetrate more deeply into the body’s tissues, even in areas with compromised blood flow, explains Stautzenberger. “By increasing oxygen levels in the blood, HBOT promotes healing, reduces inflammation, and supports the growth of new blood vessels,” Stautzenberger says.

When can Hyperbaric Oxygen Therapy help?

PAM Health utilizes HBOT at its Advanced Wound Care & Hyperbaric clinics around the country. It is commonly used to help accelerate the wound-healing process for diabetic foot ulcers, radiation injuries, and other types of non-healing wounds but can also be beneficial beyond the scope of wounds.

HBOT can be effective in treating carbon monoxide poisoning, decompression sickness, crush injuries, and certain infections. Moreover, it has shown promise in neurological conditions like traumatic brain injuries, stroke, and multiple sclerosis, Stautzenberger says.

“The best candidates for HBOT are those who can benefit from increased oxygenation and improved tissue healing, and we offer this modality as part of our comprehensive treatment approach [at PAM Health],” says Stautzenberger. Typically, HBOT is considered when conventional treatments have not achieved desired results or to optimize healing outcomes, Stautzenberger says.

 

The timing of incorporating HBOT varies based on factors such as the patient's condition and response to initial treatments. It may be introduced early on or after initial treatments, depending on individual circumstances. At PAM Health, the decision to incorporate HBOT into a patient's treatment plan is unique to his or her needs and is made based on careful assessment by qualified medical staff, including hyperbaric medicine physicians, at each hospital where the treatment is available.

Often, HBOT is just one tool in a comprehensive treatment plan tailored to each individual patient. At PAM Health’s wound care clinics, for example, HBOT works in tandem with other healing modalities such as advanced wound dressings, bioengineered skin substitutes, negative pressure wound therapy, and specialized wound care products, Stautzenberger says.

What to expect during HBOT

HBOT is administered by spending time in specially designed chambers that can withstand increased atmospheric pressure while ensuring patient comfort and safety. PAM Health’s hyperbaric chambers are made of clear acrylic so patients can see out, and certified hyperbaric technologists remain present through the entirety of each session. Once the patient enters the chamber, the pressure gradually increases to the prescribed level. The chamber seals, and the patient begins to breathe pure oxygen. Some hyperbaric chambers deliver the oxygen via a mask or hood worn by the patient; others, called “monoplace” chambers, just hold one patient at a time, so the entire chamber is filled with 100% compressed breathable oxygen without the need for a mask or hood, says Ashley Flauss, RN, of PAM Health Specialty and Rehabilitation Hospital of Covington, Louisiana, which uses monoplace chambers. Flauss is the Director of Inpatient and Outpatient Rehabilitation and Hyperbaric Oxygen Services at PAM Health Covington.

No matter the type of hyperbaric chamber, patients can always communicate with staff outside the chamber via an intercom, and patient comfort is always top of mind, says Stautzenberger. Generally, an HBOT session – or “dive,” as hyperbaric medicine professionals refer to it - ranges from 60 to 120 minutes. It takes a few minutes on each end of a dive to “descend” to the prescribed atmospheric pressure and then to “ascend” back to surface-level pressure, says Flauss. During a session, patients can relax, read, watch TV, or even take a nap, all while the oxygen makes its way throughout the body.

Some of Flauss’ other tips for optimal comfort during an HBOT dive include eating a small meal 1-2 hours before a dive and using the bathroom before entering the chamber. Like flying in a plane or going underwater, the change in pressure during HBOT can cause ear pain, so Flauss recommends swallowing, pinching the nose, blowing, or bearing down if it occurs. A technician can also decrease the rate of pressurization, Flauss says.

“As for the overall treatment duration, it can vary depending on the severity and chronicity of your condition. Some patients may only require a few sessions, while others may benefit from treatment over several weeks or months,” Stautzenberger says.

Prospective patients should also consider that committing to HBOT involves treatment five days per week, says Flauss. The time until improvements in a patient’s condition are observed can “vary depending on diagnosis. However, we do expect to see results within the first 10-20 dives,” Flauss says. Some conditions, such as compromised skin flaps over wounds, can start to benefit after just the first or second dive, Flauss says.

Are there any risks associated with HBOT?

As with most medical treatments, patients should consider the potential risks and side effects of HBOT. According to Flauss, most of the side effects are not serious and can include:

• Barotrauma, which is a range of medical effects caused by changes in atmospheric pressure. “This is the most common side effect I have witnessed [during HBOT]. It normally occurs during descent or ascent,” Flauss says.
• Claustrophobia. Medications may help for patients who experience this, Flauss says.
• Low blood sugar levels, particularly for those with diabetes. Blood sugar levels are checked before and after each dive for every diabetic patient, Flauss says.
• Eye pain/pressure

Other rarer, more serious complications can include:

• Pneumothorax/collapsed lung, especially if the patient is already at an increased risk for this condition
• Oxygen toxicity

At outpatient wound care clinics around the country, PAM Health’s dedicated team of experienced hyperbaric medicine specialists provide personalized care and guidance throughout the entire HBOT treatment program at hospitals where it is available. Learn more about PAM Health’s wound care and other specialized treatment programs here. 

Bibliography:

Heyboer M 3rd, Sharma D, Santiago W, McCulloch N. Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified. Adv Wound Care (New Rochelle). 2017 Jun 1;6(6):210-224. doi: 10.1089/wound.2016.0718. PMID: 28616361; PMCID: PMC5467109.

“Complications of Hyperbaric Oxygen Treatment.” Johns Hopkins Medicine, 19 Nov. 2019, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/complications-of-hyperbaric-oxygen-treatment.