How HBOT Works?

Hyperbaric oxygen therapy, within a Sechrist hyperbaric chamber, has assumed an ever-expanding role in modern medical practice, offering numerous advantages to physicians, surgeons and patients. Its clinical use in a growing number of indications demonstrates its effectiveness in primary and adjunctive care. A hyperbaric chamber, combined with the team approach of a hyperbaric specialist and the referring physician, provides very effective treatment of various conditions.

Hyperbaric oxygen therapy involves the systemic delivery of oxygen within the hyperbaric chamber at values two to three times greater than atmospheric pressure. Patients are placed in the hyperbaric chamber and breathe 100 percent oxygen while exposed to elevated ambient pressures. As an application of an established technology, hyperbaric oxygen therapy is helping to resolve a growing number of difficult, expensive or otherwise hopeless medical problems.

Physiological Basis of Therapy and Mechanisms of Action

Hyperbaric oxygen therapy within a Sechrist hyperbaric chamber results in a variety of physiological activities. Some are related directly to elevated pressures; others are related to increased oxygen effects in the blood stream, tissues and cells. Treatment pressures greater than sea level results in:

• Elimination of intravascular and tissue gas bubbles, which trigger coagulopathy and other mechanisms in the complex diving disorder, decompression sickness.
• Restoration of CNS perfusion by compression of intravascular gas emboli in pulmonary over-pressure diving accidents or iatrogenic intravascular gas embolism.
• Increased partial pressure of oxygen (tension) which increases the amount of oxygen dissolved in plasma. This can increase oxygen levels to approximately 450 mmHg at the tissue level.
• CVasoconstriction and reduction of edema in the area of trauma. Oxygen tension may be 10 to 20 times that achieved by normobaric oxygen breathing.
• Rapid dissociation of carbon monoxide molecules from hemoglobin and cytochrome A3 oxidase (23 minutes at 3 ATA) as well as greatly improved delivery of dissolved oxygen in the plasma.
• Stimulation of growth and occurrence of fibroblasts, osteoclasts and granulocytes, resulting in wound healing. The resulting angiogenesis enhances healing skin grafts, select problem wounds and compromised flaps.
• Cessation of alpha toxin production by the clostridial organisms in gas gangrene.

Trends in Hyperbaric Medicine

Because oxygen inspired under increased atmospheric pressure is a potent drug, hyperbaric oxygen must be administered carefully to avoid toxic effects.

A patient’s clinical response and other factors often dictate the number of treatments required. Emergency cases, such as carbon monoxide poisoning or cerebral arterial gas embolism, may only require one or two treatments in a hyperbaric chamber. Non-healing problem wounds may call for as many as 20 to 30 treatments. Radiation tissue injury may require 60 or more hyperbaric oxygen treatments for optimal benefit.

Except for decompression sickness and cerebral arterial gas embolism, treatments in a hyperbaric chamber last about two hours. Treatments are administered once or twice a day. In some cases, treatments are administered every eight hours. Most acute conditions are treated in less than 10 days. Chronic conditions may require 30 or more treatments. In some cases, patients can watch TV/movies within the hyperbaric chamber or listen to the radio during therapy.

• Air or Gas Embolism
• Carbon Monoxide Poisoning, Carbon Monoxide Poisoning Complicated by Cyanide Poisoning
• Clostridal Myositis and Myonecrosis (Gas Gangrene)
• Crush Injury, Compartment Syndrome, and other Acute Traumatic Ischemias
• Decompression Sickness
• Enhancement of Healing in Selected Problem Wounds
• Severe Anemia
• Necrotizing Soft Tissue Infections
• Refractory Osteomyelitis
• Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
• Compromised Skin Grafts & Flaps

In addition, Medicare coverage determinations will reimburse in the U.S. for the following conditions :

• Patient has type I or type II diabetes and has a lower extremity wound that is due to diabetes;
• Patient has a wound classified as Wagner grade III or higher; and
• Patient has failed an adequate course of standard wound therapy.
• Acute Thermal Burn Injury

Hyperbaric Oxygen Therapy: Hyperbaric Guide for Physicians and Surgeons

Sechrist has been integral to the research and development of hyperbaric medicine for more than 35 years. In that time, Sechrist hyperbaric chambers have been used to assist physicians in the pursuit of lifesaving applications of hyperbarics.

Hyperbaric oxygen therapy offers you and your patients a modality for treating a broad range of conditions in which oxygen breathed under increased atmospheric pressure can reverse wound healing failure and speed recovery.

Effective for treatment of persistent infection, selected problem wounds, necrosis and ischemic conditions, including:

• Chronic non-healing wounds, especially where hypoxia is present
• Wagner III and greater diabetic foot ulcers*
• Refractory osteomyelitis
• Radiation necrosis of bone or soft tissue*
• Soft tissue infection with tissue necrosis due to anaerobic infections*
• Gas gangrene (clostridial myonecrosis)*
• Compromised skin grafts or fl aps*
• Acute traumatic ischemia/crush injury/compartment syndrome*
• Acute Thermal burn injury

Other indications include:

• Acute carbon monoxide poisoning*
• Acute gas embolism*
• Decompression sickness*
• Acute cyanide poisoning*
• Rapid dissociation of carbon monoxide from hemoglobin and central nervous
• System cytochrome enzymes
• Elimination of intravascular and tissue gas bubbles, and restoration of
• CNS perfusion in gas embolism
• Reversal of local tissue hypoxia
• Enhanced collagen production, fibroblast proliferation, and neovascularization to provide support for the growth of granulation tissue.
• Suppression of bacterial function and toxin production
• Enhanced leukocyte and macrophage function