Diving into New Possibilities

Hyperbaric oxygen therapy surfaces as powerful therapy

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The multipatient chamber at HyOx Medical Treatment Center. (HyOx Medical Treatment Center)

The HyOx chamber is 31 feet long and 9 feet in diameter - the largest chamber in Georgia and one of the largest in the country.

The multipatient hyperbaric oxygen therapy chamber is large enough to accommodate 12 patients and a technician. Patients can watch movies on the video screen on the back wall.

From the control center outside the chamber, technicians control pressure and monitor patients.

It's hard to believe the healing power of atmospheric pressure and oxygen when administered in the proper amounts. For years physicians and scientists have been fascinated by this phenomenon, but only recently has hyperbaric medicine's potential raised eyebrows in interest.

Hyperbaric oxygen therapy can be traced back hundreds of years to a British physician known as Henshaw in 1662; however it has only received significant recognition within the last 40 years from the medical community. Initial fame stemmed from the benefits of hyperbaric oxygen (HBO2) therapy when used to treat decompression sickness in divers.

Today, HBO2 therapy has been accepted as an adjunct therapy for the treatment of a number of ailments, including chronic diabetic wounds, carbon monoxide poisoning, crush injuries and tissue damage, caused by radiation therapy. But some urge further exploration into its potential.

"Hyperbaric oxygen therapy can dramatically improve the quality of life for patients with certain conditions that have not responded well to standard treatment protocols," says Richard W. King Jr., MD, medical director of HyOx Medical Treatment Center in Marietta, Ga.

But what exactly is HBO2 therapy?

HBO2 is a medical treatment in which a patient breathes 100 percent pure oxygen intermittently while inside a pressurized hyperbaric chamber, which increases atmospheric pressure by up to three times the normal pressure.

While normal, breathable air is only 21 percent oxygen, pure oxygen combined with increased atmospheric pressure supersaturates the blood with oxygen. These high concentrations of oxygen work as a drug to heal weakened or damaged tissue.

By increasing the amount of oxygen carried by the blood to distressed areas, HBO2 therapy facilitates healing and fights infection by stimulating fibroblast proliferation – the tissues' protein factory that forms essential fibers in connective tissue cells.

"The key benefit for conditions ranging from chronic problem wounds to crush injuries is more rapid healing, and in some cases, the salvaging of limbs," explains King.

HBO2 therapy also helps to:

• Fight infection
• Encourage growth of new blood vessels
• Decrease risks of complications pre- or post-surgery
• Speed soft tissue and bone recovery after radiation therapy
• Reduce incidence of amputation in diabetic patients

"HBO2 therapy is considered an adjunct therapy to be introduced when standard care protocols do not produce the desired result," says King. Although patients shouldn't run to the nearest HBO2 facility for a common paper cut, hyperbaric oxygen medicine should remain on the horizon of possible prescriptions when certain conditions resist standard treatment.

Conditions treated at HyOx Medical Treatment Center and other hyperbaric oxygen therapy facilities include: acute ischemias: peripheral arterial insufficiency (blocked arteries); crush injury (e.g.. foot run over by a car); and air or gas embolism, decompression illness (the "bends"); chronic ischemias: diabetic wounds of the lower extremity (e.g., foot wounds); chronic non-healing wounds; and comprised skin grafts and flaps; delayed Radiation Tissue Injuries: radiation-induced cystitis, prostatitis and proctitis; infections: chronic refractory osteomyelitis; gas gangrene; and progressive necrotizing infections; poisoning: carbon monoxide; cyanide; and spider bites; and thermal burns and post-surgery healing (e.g., plastic surgery).

Once they have been evaluated, patients are put on a treatment schedule that varies depending on the condition. HBO2 should be performed like any other therapy – regularly. "Hyperbaric oxygen is a true therapy and needs to be performed daily, sometimes twice a day, to get the correct dosage of oxygen for the condition being treated," says King.

King reports that many patients with conditions that do not appear on the list of accepted conditions developed by the Undersea & Hyperbaric Medical Society (the field's standards and protocol setting organization) have still benefited from HBO2 therapy.

"Oxygen is used as a drug and the dose is dependent on the length of the treatment session and pressure level," says King. Severity of the condition and the body's responses to the treatment generally determine treatment length.

Combating Radiation Therapy

Hyperbaric oxygen therapy has been proven to help alterations in normal tissue physiology and anatomy caused by radiation. The increase in popularity of radiation treatment for certain types of cancer has also increased the incidences of complications resulting from radiation therapy that can significantly affect a patient's quality of life.

While radiation therapy targets cancerous cells, exposing healthy surrounding tissue is sometimes unavoidable. Exposing healthy tissue to radiation causes permanent damage: Oxygen and blood flow to the area decreases when the tissue constricts and the growth of new blood vessels slow.

"You liken it to the permanent damage caused by overexposure to the sun's UV rays: While a person may control their exposure later in life, early damage can still result in skin cancer," says King. And he says that radiation therapy can cause wear and tear on your cells that will not go away or lessen over time.

The Patient Experience

There are two types of clinical hyperbaric chambers offered to patients. Patients not sensitive to claustrophobia may choose a monoplace chamber, which requires the patient to lie still during treatments that average two hours each. Monoplace chambers treat one patient at a time. "Some patients prefer the privacy that a monoplace chamber offers, while others find it constricting and claustrophobic," King says.

Patients who are sensitive to claustrophobic conditions may prefer a multiplace chamber. Multiplace chambers can accommodate two or more patients at the same time and enable patients to sit or lie comfortably during treatment and the ability to stand, stretch and move about as needed. Medications and food can be provided to patients along with access to a bathroom. Both chambers generally provide television or movies as a way to pass the time.

Although "increased atmospheric pressure" may sound intimidating, hyperbaric treatment is painless and most patients only experience "the sensation of fullness in their ears, similar to what is experienced driving up or down a mountain road or changing altitudes in an airplane," according to King.

Evidence-Based Success

King recently performed a study, administering HBO2 therapy to 63 patients between 2000 and 2003. Patients all experienced complications following radiation therapy to the head and neck, breast or prostate.

Treatment varied depending on the location and severity of the radiation damage: The average treatment number was 40 therapy sessions over 67 days.

According to King, of the 63 case appraisals, 55 (87 percent) showed a significant reduction or elimination of pain and increased levels of emotional and physical well-being. King's study suggests HBO2 therapy is an effective treatment for complications associated with radiation treatment.

Emphasis on evidence-based medicine and research funding is leading to increased assessments and studies of hyperbaric medicine, King says; however, he feels that it is important that more members of the medical community learn about today's possible uses of this therapy.

"At this stage, the patient has often suffered a great deal of pain and restrictions in their lifestyles," says King. "We would like to work with care providers earlier in the process and evaluate at what state it is appropriate to introduce HBO2 therapy."

The sooner more people realize hyperbaric oxygen therapy is an option of treatment and not a last resort, the less pain patients will need to endure so they can improve their quality of life.

— Janine Kusza is a freelance writer living in New Jersey. Questions and comments can be directed to editorial@rt-image.com.