Whether you know a whole lot about Hyperbaric Oxygen Therapy, or you are new to this God-given treatment involving oxygen and pressure…. here are 10 amazing facts about the treatment.
During the 2021 Symposium on Advanced Wound Care fall meeting, Jayesh B. Shah, MD, the president of South Texas Wound Associates, in San Antonio, shared the top 10 things that every provider should know about HBO therapy.
- The FDA Just Approved 2 New Indications – The FDA approved two new indications for HBO: acute central retinal artery occlusion and idiopathic sensorineural hearing loss. There are now 14 approved indications.
- Topical Oxygen Therapy Is Not HBOT – Topical oxygen has gained traction as a technique to facilitate wound healing dynamics, and there is evidence to support its benefits, but the approach should not be confused with HBO therapy.
- HBO Therapy Is Extremely Safe – Complications occur in less than 1% of HBO treatments, and the most common complication is ear pain.
- Only 1 Absolute Contraindication – The only absolute contraindication to HBO is untreated pneumothorax, which needs to be treated prior to HBO therapy.
- Most Approved Indications Are Emergency Indications – Although the majority of indications approved for HBO therapy are emergency indications, the number of HBO treatment centers treating emergency indications has decreased. Fewer than 10% of HBOT centers with at least one chamber are available for emergency HBO therapy.
- Infrared Spectroscopy to Monitor Oxygenation – Infrared spectroscopy may be useful to monitor oxygenation within the wound beds and surrounding tissue.
- tcpO2 Predicts Failure to Heal Better Than ABI – The ankle brachial index (ABI) is the ratio of blood pressure at the ankle to blood pressure in the upper arm and is used to noninvasively check for peripheral artery disease. Transcutaneous oximetry (tcpO2), on the other hand, is the only method to measure the local oxygen released from the capillaries through the skin. “tcpO2 measures oxygen molecules, not saturation, it outperforms ABI in predicting the healing of foot ulcers and in predicting limb amputations.”
- HBO Is More Than the Correction of Hypoxia – Under normal atmospheric pressure, hemoglobin binds to oxygen. However, in a hyperbaric environment, resting cellular oxygen requirements can be met by plasma dissolved oxygen alone. As pressure increases, the number of molecules of oxygen in the plasma also increases, which can be extracted by the body to help heal hypoxic wounds.
- Life Can Exist Without Blood – In the 1960s, Boerma et al conducted an experiment that showed that life without blood is possible under hyperbaric conditions. Pigs breathing pure oxygen at 3 ATA (atmosphere absolute) were completely exsanguinated, but the volume of fluid in the circulatory system was maintained, and the oxygen supply remained sufficient (Ned Tijdschr Geneeskd. 1960;104:949-954). After being reinfused with their own blood, the pigs “lived happily ever after”
- HBOT Is Old – HBO therapy has been around for more than 150 years in the United States, but its history spans much longer. In fact, the first record of a pressurized chamber used to treat medical conditions dates to 1662 in England.