Hyperbaric Oxygen Therapy - The Nebraska Medical Center
Hyperbaric oxygen therapy does help with several different things, predominantly; we use it here for chronic wounds, diabetic ulcers, poor vasculature and radiation injury. It does help with acute carbon monoxide poisoning and also diving accidents where it classically was developed. There are things that we consider emergents, such as a plastic surgery procedure going poorly because of bad circulation, a crush injury, compartment syndrome from trauma and certain burns can be treated with this, to increase oxygen to the injured tissue.
We found out that it was helpful before we figured out why. In forcing oxygen into areas that aren’t getting enough oxygen because of poor circulation or radiation damage, that oxygen helps with healing and basically rebuilds the damaged tissue. Additionally, it helps the immune system, enhances the white blood cells and their ability to attack bacteria and clean up debris. As blood flow starts to get back to an area there is often a problem called reperfusion injury and hyperbaric oxygen seems to help with that. It seems to suppress that reaction of the body. It is a fairly simple thing they are basically breathing oxygen under pressure. We are taking them down to at least double the atmospheric pressure, sometimes as high as three times, using 100 percent oxygen.
In essence it is like breathing 200 or 300 percent oxygen because of the pressure effect. This allows for more oxygen to be dissolved into the serum of the blood, not into the blood cells themselves, but actually into the fluid of the blood, which can get into areas the blood cells aren’t getting in to. It allows more oxygen to be diffused out from the capillaries.
We are able to tremendously increase the area of oxygen penetration through tissues to areas that don’t have good capillary beds, such as damaged tissue, radiated tissue and poor vasculature. You are getting much more oxygenation to the tissues around what capillaries are there. They really don’t feel anything at all. When patients go down and make the descent it is like descending in an airplane or diving deep into a swimming pool. They will feel some pressure in their ears and will have to clear that pressure. We generally help them with that if they are having any problems we can slow the descent and teach some maneuvers to clear the ears. Other than that pressure sensation there is nothing much a patient feels.
We’re using chambers that are clear plastic tubes so we set up TVS outside the tube, pipe the sound in and they get to watch a movie each day. We try to limit what they take in. We are real careful about deodorants, perfumes and any else that would give off a vapor.
We are very particular about what they can wear. We give them a gown and that’s what they get. Nothing else goes in the chamber. Gangrene or necrotizing vasculitis or carbon monoxide poisoning and diving accidents we tend to treat them very aggressively up front, sometimes two or three times a day or with longer periods of time. The standard wound care stuff that is our bread and butter we generally treat five days a week on a daily basis. People will generally get 30 to 40 treatments so they are looking at six to eight weeks of treatment. In its early years, the joke was that hyperbaric oxygen therapy was a therapy looking for diseases to treat. We have now found quite a few that it does very well with.
There is still research going on in other things, for instance, traumatic brain injury where research is ongoing. Overall, there are really impressive results. Basically, you’re getting past the problem that’s keeping it from healing. The problem is they aren’t getting enough oxygen to that area and by essentially forcing the oxygen in, we allow the normal healing process to occur.
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