The Complete Guide To Hyperbaric Oxygen Therapy

Introduction

Your body has a remarkable ability to heal naturally with a little help and under the right conditions. Hyperbaric oxygen therapy uses the most abundant element on earth – oxygen - at increased pressures to effectively enhance your body’s healing powers to rehabilitate an injury or chronic condition, or to rejuvenate your body to optimal health and peak performance. This non-invasive treatment can increase your body’s oxygen concentration by 1,200 percent, leading to a variety of benefits, such as increased blood flow, tissue regeneration, stem cell mobilization, decreased inflammation, and more. 

Hyperbaric oxygen therapy is delivered in a specialized chamber, where you simply breath oxygen at an increased atmospheric pressure. Hyperbaric Medical Solutions has put together this extensive guide to help you determine if hyperbaric oxygen therapy is right for you. This guide provides information on this revolutionary treatment, including the conditions it can treat; health goals you can achieve; what to expect before, during, and after each session, and any possible side-effects. 

What Is Hyperbaric Oxygen Therapy?

Hyperbaric oxygen therapy involves breathing 100 percent oxygen while pressurizing the body to pressures greater than normal (the pressure at sea level). The process is achieved inside a specialized chamber within which the patient comfortably breathes 100% medical grade oxygen while the pressure inside the chamber is gradually increased.  Based on laws of physics – Boyle's law, Henry’s law, and Dalton’s Law – breathing oxygen under pressure allows oxygen to be dissolved into plasma portion of the blood.  Under normal conditions, plasma does not carry oxygen, that is left to the red blood cell and hemoglobin.  Dissolving oxygen into plasma allows it to carry oxygen at least four times further into the body’s tissues which results in a much higher concentration of oxygen within the body – as much as 1,200% higher! 

But why would you need or want to increase the concentration of oxygen in your body? Under normal conditions, the air we breathe contains a mixture of gases, of which only about 21% is oxygen. This is generally sufficient for the body’s basic functions in those with normal lungs.  However, elevating the oxygen level in the body creates a whole cascade of benefits both in the immediate short term as well as more long term (if done enough times).  It is this cascade of benefits that enhances and accelerates the body’s ability to repair itself, generate energy, and create an environment in which inflammation is suppressed and regenerative healing is promoted. 

Benefits of HBOT

The power of HBOT is that it provides the body with the necessary energy and the optimal environment to heal wounds no matter where they are or how they got there; from the inside out.  This healing power can help those struggling with a variety of diseases as well as those seeking to simply optimize their health.

Hyperoxygenation

As discussed above, HBOT increases the amount of oxygen carried into the blood stream, enabling more oxygen to dissolve deep into the body’s tissues, including the lymphatics and the cerebrospinal fluid surrounding the brain and spinal cord. This reverses hypoxia (areas of the body that are low in oxygen) helping to oxygenate cells and tissue that are at risk of dying (such as tissue damaged during surgery, or from loss of blood supply) or that are in a quiescent or non-functioning state.  

Anti-Inflammation

In the short term HBOT downregulates inflammatory pathways and constricts blood vessels to allow less leakage of fluid thus decreasing swelling.  In the long term HBOT has epigenetic effects turning off the genes responsible for inflammation.  Inflammation is a key factor in why our body’s degrade with time.

Reducing inflammation and swelling, strengthens the immune system and enhances mitochondrial function.

Antimicrobial Effect

Hyperbaric oxygen therapy improves the immune system by weakening infection-causing bacteria. It also increases the body’s natural antioxidants and free radical scavengers, which increases the ability to fight disease and infection.  It can also synergize with certain antibiotics improving their efficacy.

Neovascularization

Hyperbaric oxygen therapy stimulates the growth of new blood vessels in the body, which increases circulation, allowing revitalized tissue to thrive even after the treatment protocol has been completed.  

Stem Cell Mobilization

During treatment, HBOT has the power to increase stem cells in circulation eight-fold. These stems cells already exist in the body and have the unique ability to differentiate into any type of tissue, making them a valuable tool for regeneration and healing.  

Mitochondrial Support

HBOT allows mitochondria, the batteries of our cells, to generate adenosine triphosphate, or ATP. ATP is the chemical that stores and releases energy necessary for many cellular processes and is the main energy source for our body. When you have experienced cellular damage and oxygen-carrying capacity is threatened, your body is in jeopardy of not creating enough ATP.  Breathing 100% oxygen under pressure allows 1,200% more oxygen to enter your circulatory system directly into your plasma. Thus, by providing super high levels of oxygen, HBOT helps optimize cellular energy production.

For more information about the benefits of HBOT, contact Hyperbaric Medical Solutions today!

What Conditions Can HBOT Treat?

Hyperbaric oxygen therapy can treat a wide variety of illnesses, injuries, and other conditions. However, there are only 14 indications approved by the FDA. Although the others are not yet approved, there is extensive research citing HBOT’s ability to heal other indications.  

Approved Conditions

These conditions, which can be referred to as “on-label”, are approved by the FDA and are generally covered by insurance. 

• Air or Gas Embolism
• Carbon Monoxide Poisoning 
• Central Retinal Artery Occlusion
• Chronic Refractory Osteomyelitis
• Crush Injury & Other Acute Traumatic Ischemias
• Decompression Sickness
• Diabetic Lower Extremity Wounds
• Failed Skin Grafts & Flaps
• Gas Gangrene
• Necrotizing Soft Tissue Infections
• Radiation Tissue Damage
• Severe Anemia (Acute anemia used as a bridge therapy)
• Sudden Sensorineural Hearing Loss
• Thermal Burns (severe)
• Intracranial Abscess

Off-label Conditions

These conditions, which can be referred to as “off-label”, have not yet been approved by the FDA. They are generally not covered by insurance. 

• Anoxic Brain Injury
• Arthritis
• Cancer (Treatment Synergy)
• Cerebral Palsy
• Chronic Fatigue Syndrome
• Chronic Pain
• Complex Regional Pain Syndrome
• Concussion & Traumatic Brain Injury
• Crohn’s Disease
• Fibromyalgia
• Inflammatory Bowel Disease
• Interstitial Cystitis
• Lyme Disease
• Migraine/Headache
• Multiple Sclerosis
• Spinal Cord Injuries
• Sports Injuries
• Stroke
• Surgery Preparation & Recovery
• Ulcerative Colitis

What to Expect During Treatment

Hyperbaric oxygen therapy is simple – just sit back, relax, and breathe normally.  Prior to your first session you will first have a consultation with a certified physician, nurse practitioner, or physician assistant. This consult, which is generally covered by insurance for all types of conditions, is to evaluate you for HBOT, confirm there are no contraindications, and establish a protocol most appropriate for your condition(s) to meet your health goals. In general, this appointment will last about one hour. 

During this time, your consulting provider will also explain how the science behind hyperbaric oxygen therapy works to help the body, and receive an orientation on what is needed before you start treatments, as well as the daily process of preparing for each session.  Finally, there will be a review of potential insurance coverage and/or any costs associated with your care. 

At the beginning of each session, a technician will check your vitals and review a safety checklist, affirming you have removed all jewelry, watches, and electronic devices, and are free of lotions and perfumes. They will also provide you a 100% cotton gown and blanket for a safe and comfortable experience, a water bottle to take with you into the chamber, and a grounding bracelet to prevent static electricity. The water bottle can be helpful to clear your ears as the chamber pressurizes. 

Once in the hyperbaric chamber, the technician will turn on music, a movie, or a television show of your choice. Or, you can simply choose to take a nap. During the entire treatment, a technician will be present by the chamber to guide you, particularly while you descend to your prescribed depth, where you may experience an ear-popping sensation (like when flying on any airplane), as well as attend to any needs or questions you have during your session. Finally, at the end of your session, the technician will again take your vitals. 

A Brief History of HBOT

The first documented use of HBOT was in 1662. A British physician developed a domicilium, which was the first hyperbaric chamber. However, it was not until the 1800s that the foundations of hyperbaric oxygen therapy were laid. French engineer, physician, and scientist Paul Bert wrote La Pression Barometrique in 1872. 

The first United States hyperbaric chamber was built in New York in 1891 by Dr. J. Leonard Corning. 

Corning’s interest in HBOT stemmed from witnessing severe decompression illness among the Hudson Tunnel site workers, who would often experience severe muscle pain and paralysis after working below sea level all day. This was also a well-known phenomenon in bridge building, the most famous of which was the Brooklyn Bridge in the 1889’s.  

Not long after, chairman of the Department of Anesthesiology at Kansas University Medical School Dr. Orval Cunningham researched the use of hyperbaric chambers for the influenza pandemic after observing that morbidity and mortality rates from the “Spanish influenza” pandemic of 1918 were greater in higher elevations than in coastal areas, which he attributed to the barometric pressure. 

In the 1930s and 1940s, the United States Navy began conducting research on the use of HBOT to treat deep-sea divers with decompression sickness. Twenty years later, the treatment also became known to treat carbon monoxide poisoning.

In 1967, the Undersea and Hyperbaric Medical Society (UHMS) was formed. The UHMS is an international nonprofit association serving approximately 2,000 physicians, scientists, associates, and nurses from more than 30 countries in the fields of hyperbaric and dive medicine. In addition to acting as an important source of scientific and medical information pertaining to hyperbaric medicine through its bimonthly, peer-reviewed journal, symposia, courses, certifications and workshops, the UHMS also puts out policy guidelines and advocates for the use of HBOT in a variety of settings, including new uses and applications. 

Today, HBOT is used to treat a wide range of conditions. The Food & Drug Administration (FDA) has approved 14 conditions to be treated with HBOT. This group of conditions are typically covered by insurance, pending certain qualifications per condition (check with your insurance company to confirm coverage under your plan). However, there are many studies supporting the effectiveness of HBOT in treating many other indications, and many countries around the world have approved its use for upwards of 50 different conditions.

The Science of HBOT

HBOT is the use of prescribed high-pressure oxygen to help treat a variety of health conditions and diseases. Each cell in the body needs oxygen to preserve, repair, and enhance cellular function. Breathing 100% oxygen at pressures greater than sea level helps flood the body with enriched oxygen, creating a cascade of positive benefits.

According to the UHMS (Undersea and Hyperbaric Medical Society), along with the Centers for Medicare and Medicaid services and other third party providers, hyperbaric oxygen therapy is defined as when a patient breathes 100% oxygen in a pressurized chamber at 1.4 ATA or higher.

The mechanisms of action of HBOT are based on several gas laws, and the physiological and biochemical effects of hyperoxia.

Boyle's law states that at a constant temperature, the pressure and volume of a gas are inversely proportional. This is the basis for many aspects of hyperbaric therapy.

Henry's law states that the amount of gas dissolved in a liquid or tissue is proportional to the partial pressure of that gas in contact with the liquid or tissue. This is the basis for increased tissue oxygen tensions with hyperbaric oxygen treatments. 

Dalton's law states that in a mixed gas each element exerts a pressure proportional to its fraction of the total volume (partial pressure).

Most oxygen carried in the blood is bound to hemoglobin, which is 97% saturated at normal atmospheric pressure. At increased pressure, oxygen can be carried in the plasma of the blood (Henry’s law), enabling oxygen to reach areas of the body not ordinarily reached to promote healing. This can particularly be the case for patients who have medical conditions that limit the oxygen carrying capacity of the blood. 

Types of Hyperbaric Oxygen Chambers

There are three main types of hyperbaric oxygen chambers available: monoplace chambers, multiplace chambers, and mild , or soft, chambers.  

Monoplace Chambers

A monoplace chamber is built and approved for one person at a time. These chambers can be pressurized by medical grade oxygen or by regular room air. If pressurized by 100% oxygen, patients breathe the oxygen directly while receiving care. If pressurized by regular air, patients will breathe 100% oxygen through a breathing mask. Each patient is uniquely prescribed a specific atmospheric pressure for each session, as set by the ordering physician. Monoplace chambers typically utilize pressures from 1.5 to 3.0 ATA. 

Commonly, monoplace chambers are made with an acrylic tube, enabling patients can see through to watch TV through, with an internal audio system communicate with a hyperbaric technician who monitors patients from the outside the chamber at all times. Monoplace chambers are commonly found in both hospital and private office settings and are FDA-approved to treat 14 different conditions.  

Multiplace Chambers

Multiplace chambers are built to hold more than one patient at a time. The size of a multiplace chamber varies greatly and can be as small as for two people, and go up to eight, twelve, or even twenty-four people. Given the size of these chambers, they are pressurized with regular room air and each patient wears a specialized mask or hood to breathe the 100% oxygen. All patients who are treated at the same time will be treated at the same atmospheric pressure, so it is common for patients to be grouped by their condition. The maximum pressure inside a multiplace chamber can reach 6 ATA.  Inside the chamber, depending on their condition and the configuration of the chamber, patients may sit on a bench or individuals chairs or recliners while receiving treatment and may be accompanied by the hyperbaric technician along with other patients. Also inside, many multiplace chambers will have a TV for patients' entertainment with all patients viewing the same content. Multiplace chambers can be found in private office centers, but are more commonly found in hospitals or trauma centers. 

Mild Chambers

Mild hyperbaric chambers are different in their structure, configuration, and capabilities than the other two types described above. Mild chambers are often called "soft" chambers - a reference to the material, which is typically a canvas or elastic plastic, used to create the shell of the chamber. Mild chambers are FDA-approved for only the temporary treatment of Acute Mountain Sickness and are pressurized with room air up to 1.3 ATA, or 10 feet under seawater. Unlike in the hard chamber where 100% oxygen is utilized, patients in a mild chamber breathe compressed air. Due to the limited pressure and use of compressed air, rather than 100% oxygen, mild hyperbaric chambers have a more limited range of applications.

Risks, Side Effects, & Recovery

Hyperbaric oxygen therapy is a natural treatment without many associated risks or side effects. It is one of the safest medical treatments offered. Only in rare cases do patients experience negative effects such a pressure injury to the ear or lungs, low blood sugar or temporary vision changes

HBOT is not a surgical operation and there is no recovery time needed after each session. 

Hyperbaric Medical Solutions makes safety a top priority. One of our technicians will always remain in visual and voice contact throughout your treatment.

The Cost

There are a number of factors that contribute to  the cost for hyperbaric oxygen therapy. The first of which is if the condition being treated is considered on-label or off-label. If the condition being treated is considered on-label, meaning it is FDA-approved, it’s more likely to be covered by insurance and the cost to you will depend on your insurance plan Alternatively, because HBOT has the ability to treat a wider range of conditions, there are many off-label illnesses, injuries, and other purposes to use HBOT that are not yet approved by the FDA. These are typically not covered by a patient’s insurance and the treatment would be an out of pocket expense to the patient.

The type of provider and their location can also impact the cost of your treatment. Hospitals only provide HBOT for on-label conditions, and generally accept most insurance. However, hospitals often carry greater fees than at a physician or specialist’s office. If a patient receives HBOT treatments at a hospital, they typically are charged both hospital and specialist co-pay fees for each session. However, when receiving treatments at a private center there is only one co-pay per visit and/or a lower co-insurance responsibility. The total out-of-pocket cost will depend on what your insurance plan will cover. 

When treatments are not covered by insurance, the cost of each treatment typically falls in the range of about $300-$450. The type of condition, its severity of symptoms, and your ultimate health goals will determine the number of treatments you need. 

Hyperbaric Medical Solutions accepts most insurance plans including Aetna, Cigna, Oxford/United Healthcare, Empire Blue Cross and Blue Shield, The Empire Plan, Medicare, Fidelis, Healthfirst, and Workers' Compensation. Plans vary by state and are subject to change. If your HBOT treatment is not covered by insurance, HMS offers prompt-pay discounts and financing options like CareCredit.

Is HBOT Right for you?

The application and potential of Hyperbaric Oxygen Therapy (HBOT) reaches a wide array of patients, conditions, and uses. This guide was created to help you learn and develop an understanding of this revolutionary therapy as a first step to seeing if it’s right for you or a loved one. The next step is to have a consultation with one of our experienced certified  medical professionals to completely evaluate if HBOT is appropriate for you in reaching your health goals. At HMS, we use this opportunity to ask many in depth questions of each patient and encourage our patients to do the same. If determined that HBOT is appropriate for the patient, we then create a customized treatment protocol that includes the expected number of sessions, at a specifically prescribed pressure. It should be noted as well, that HBOT can be used as either a primary or adjunctive treatment. 

If you need further information to decide if hyperbaric oxygen therapy is right for you, check out our blog, listen to our radio and podcast interviews, or watch our videos available on our website.  

Other FAQ on HBOT

How often should you do hyperbaric oxygen therapy?

The frequency of hyperbaric oxygen therapy (HBOT) sessions can vary depending on the specific condition being treated. Typically, HBOT is administered as a series of 60-90-minute sessions rather than a one-time treatment. The total number and frequency of sessions can range from a few to several dozen, depending on the treatment condition and the individual's response to the therapy. It's important to consult with a medical professional who can evaluate your situation and provide appropriate guidance on the frequency and duration of HBOT sessions.

It's worth noting that HBOT should always be conducted under the supervision of a trained healthcare professional in a specialized medical facility. They will be able to assess your condition and monitor your progress and safety during the treatments.

How long do the effects of hyperbaric oxygen therapy last?

The effects of HBOT can vary depending on the condition being treated and individual factors. Here are some general considerations regarding the duration of HBOT effects:

Immediate effects: After a session of HBOT, you may experience short-term effects that can last for a few hours. These may include a temporary increase in energy levels, improved cognitive function, and a feeling of relaxation. 

Cumulative effects:  The therapeutic benefits of HBOT accumulate. This means that the impact of HBOT may become more pronounced and longer-lasting with repeated treatments. New blood vessel formation (angiogenesis) and other signs of healing occur after multiple treatments.

Condition-specific effects: The duration of HBOT effects can also vary depending on the condition being treated. For acute conditions, such as decompression sickness or carbon monoxide poisoning, the effects of HBOT may be immediate and can last until the situation is resolved. In chronic conditions, such as non-healing wounds or neurological disorders, the effects of HBOT may be more long-term but could require ongoing or periodic treatments to maintain the benefits.

Individual response: Each person's response to HBOT can differ. Some individuals may experience longer-lasting benefits, while others may see more temporary effects. Factors such as overall health, underlying medical conditions, and compliance with post-treatment care can influence the duration of HBOT effects.

It's important to note that the research on the long-term effects of HBOT is still evolving, and the duration of benefits may vary depending on individual circumstances. It is best to consult with a healthcare professional who can assess your specific situation and provide more tailored information regarding the potential duration of HBOT effects in your case.