CHAPTER 1

History and Facts of Hyperbaric Oxygen Therapy?

Hyperbaric medicine is not a new concept. Since the late 1800s, it has been used. However, until the second half of the twentieth century, it was only used to treat divers and those who had had decompression accidents. Its beneficial process was based on Boyle’s Law, a basic concept. Hyperbaric oxygen therapy was initially invented in the U.S. at the start of the 20th era. This was the time when Orville Cunningham used oxygen with utmost purity to treat a patient who had died of influenza. He built a hyperbaric chamber, later its use for other situations failed so he dismantled it. 

Dr. J. Leonard Corning created the first hyperbaric chamber in the United States in 1891 in New York. Corning became interested in HBOT after witnessing severe decompression disease among Hudson Tunnel construction workers, who suffered from acute muscle pain and paralysis after working below sea level all day. This was a quite good practice in bridge construction, with the Brooklyn Bridge in the 1889s being the most renowned example.

Soon after, Dr. Orval Cunningham, chairman of the Department of Anesthesiology at Kansas University Medical School, investigated the use of hyperbaric oxygen therapy for pandemic influenza after noticing that death rates from the 1918 “Spanish influenza” pandemic were greater in higher altitudes than in coastal areas, which he associated to barometric pressure.

In the 1930s, a Brazilian physician by the name of Álvaro Osório de Almeida, recognized the extreme benefits of hyperbaric therapy and published many papers on this study and the effects of high pressured oxygen for the body, especially on tumors on animals. Later the US Navy researched the use of HBOT to treat decompression sickness. A long report on this HBOT research was published by Behnke and Shaw in the late 1930s. In the 1960s, this therapy was also beneficial to combat carbon monoxide poisoning. It is still used to treat scuba divers and people who have been exposed to carbon monoxide, such as firefighters and miners. This has grown to treat several illnesses and finally been FDA approved by US Government Agencies.

The Undersea and Hyperbaric Medical Society (UHMS) was established in 1967. In the fields of hyperbaric and dive medicine, the UHMS is an international nonprofit organization that serves over 2,000 physicians, scientists, associates, and nurses from over 30 countries. The UHMS publishes policy guidelines and advocates for the use of HBOT in a diverse range of conditions including new uses and applications, in addition to serving as an important source of scientific and medical information pertaining to hyperbaric medicine through its bimonthly, peer-reviewed journal, seminars, curricula, credentialing, and sessions.

CHAPTER 2

What is Hyperbaric Oxygen Therapy?

Breathing oxygen with atmospheric pressure up to three times higher than normal is known as hyperbaric oxygen therapy (HBOT). HBOT can be used as a stand-alone treatment or as a supplement to surgical and/or pharmacological procedures. Hyperbaric oxygen is described by the Undersea and Hyperbaric Medical Society (UHMS) as “An operation in which someone respires almost 100% oxygen routinely while pressing pressure higher than sea level within a hyperbaric chamber (1 atmosphere absolute, or ATA). The pressure must equal or exceed 1.4 ATA for therapeutic purposes when breathing about 100 percent oxygen.” 

If you’re going through an FDA-approved HBOT treatment, then you will enter a singular space to inhale 100% pure oxygen in a pressurized environment, 1.6 to 4 times more pressure than sea level. Increased pressure will raise the oxygen levels in your body; the objective being to saturate the tissues with sufficient oxygen to patch up nerves and reinstate usual body function. 

Usually, real industry-approved high-pressure Hyperbaric Oxygen chambers use pressures of 2.0 to 3.0 ATA, while low-pressure therapy may be conducted at 1.5 to 2.0 ATA. When lower pressure chambers are used such as the inflatable HBOT’s, treatment time may be long and not very effective.

HBOT aims to break the cycle of inflammation, starvation of oxygen, and tissue death.

There are three main types of hyperbaric oxygen chambers available: 

  • Monoplace chambers 
  • Multiplace chambers 
  • Mild, or Soft chambers  

Monoplace Chambers

Monoplace Chambers are single person chambers. They can be pressurized by normal air or by medical oxygen. Monoplace chambers usually contain pressures between 1.5-3.0 ATA. If this chamber is pressurized by 100 percent oxygen, the patient breaths oxygen directly from the ambient chamber environment.  If the chamber is pressurized with medical grade air, the patient breathes 100 percent oxygen through a mask. Monoplace chambers can be made from steel, aluminum or acrylic.  At Under Pressure Hyperbarics our chambers are made of acrylic allowing patients to comfortably watch television (TV), with an audio system attached internally to monitor the patient through outside the chamber at all times which communicates with hyperbaric technicians. These chambers are found in both private and FDA-approved hospitals to treat different medical conditions.

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Multiplace Chambers

These chambers are built for multiple patients and more than one patient at a time. They can be smaller for two patients at a time, or more commonly six to twelve patients. Multi-place chambers are often able to be pressurized to greater pressure than Monoplace chambers.  These chambers are often used for divers who require greater pressures to undo the effects of decompression illness. Patients may lay down, sit down on a bench or maybe receiving therapy with the other patients which is accompanied by the hyperbaric technicians. Multiplace chambers are generally found in large hospitals, trauma centers and military bases.

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Mild Chambers(mHBOT)

These chambers are different from the other two due to their structure, capabilities, and pattern. These are also called soft chambers as a lot of mHBOT chambers are constructed from material which is typically elastic/plastic used to create a shell of chamber. These are usually approved to patients with acute mountain sickness up to 1.3 ATA (10 feet under seawater). These chambers are pressurized with air or oxygen concentrators as opposed to medical grade gases. Mild chambers have limited application because of the inability to reach therapeutic pressures.