Hyperbaric Oxygen Therapy (HBOT) Defined
Hyperbaric Oxygen Therapy (HBOT) is a treatment in which the patient is placed in a chamber to breathe in oxygen at a higher-than-atmosphere pressure (100 % oxygen under a pressure greater than 1 atmosphere) to stop bacteria from growing and, kill the same at high enough pressure.
To further define this systematic treatment, its history, policies, recommended duration of treatment, contraindications and risks, are found below.
This treatment can be traced back to the 1600s. The first well-known chamber called the domicilium was built and run by a British clergyman named Henshaw.
French surgeon Fontaine continued the idea of treating patients under increased pressure and built a pressurized, mobile operating room in 1879. Dr. Orville Cunningham, a professor of anaesthesia, ran what was known as the “Steel Ball Hospital.” A six stories high structure and 64 feet in diameter was erected in 1928.
The work of Paul Bert, who demonstrated the toxic effects of oxygen (producing grand mal seizures), as well as the work of J. Lorrain-Smith, who demonstrated pulmonary oxygen toxicity, were used in the military specifically with Navy divers. Exposure times to oxygen at different depths of water were quantified and tested based on time to convulsions.
I. This treatment is medically necessary for acute air or gas embolism, acute carbon monoxide poisoning, compromised skin grafts and flaps, cyanide poisoning, among others.
II. However, this treatment is considered experimental and investigational for: acute coronary syndrome, arthritic diseases, autism, cancer, cardiogenic shock, cerebral palsy; (not an all-inclusive list) because of insufficient evidence in medicine which establish that the treatment is more effective than conventional therapies.
III. The treatment is considered experimental and investigational for people with any of these contraindications, concurrent administration of doxorubicin, cisplatin, or disulfiram, premature infants (birth prior to 37 weeks gestation) and untreated pneumothorax; because the safety of the treatment for persons with these contraindications has not been established.
IV. Because the efficacy of the treatment has not been established through well-controlled clinical trials, administering the treatment through open wound, and limb-specific pressurization in small limb-encasing devices, is considered experimental and investigational.
Duration of Treatment
Responses of individual patient varies, depending on that and the severity of the original problem, treatment range from less than 1 week to several months’ duration, the average being 2 to 4 weeks. Treatment for more than 2 months is usually not necessary.
Absolute contraindications to the treatment include: untreated pneumothorax, concurrent administration of disulfiram; concurrent administration of the antineoplastic agents doxorubicin and cisplatin; and administration to premature infants . Relative contraindications to the use of HBOT include prior chest surgery, lung disease, viral infections, recent middle ear surgery, optic neuritis, seizure disorders, high fever, congenital spherocytosis, and claustrophobia.
Generally the treatment is a safe procedure. Complications are rare. But this treatment carry some risk. Potential risks include temporary nearsightedness; middle ear injuries, including leaking fluid and eardrum rupture, seizures as a result of too much oxygen in your central nervous system.