How Does HBO Work?
Hyperbaric oxygen is 100% oxygen, delivered to your body, in a pressurized
environment. The air we normally breathe is only 21% oxygen and 79% nitrogen, at a
pressure of 14.7 pounds per square inch (psi). In hyperbaric treatments, the pressure is
typically increased to 2.4 times normal (may be up to 6 times, depending on the case), and
the patient breathes 100% oxygen through a clear hood, or mask. In the case of our
standard wound care treatment "dive" the patient receives 11 times the normal
amount of oxygen compared to breathing air. This increases the amount of oxygen carried by
the blood to all parts of the body. This also explains why simply placing a wounded area
in an oxygen "tent" cannot be effective: the oxygen must be delivered to all
parts of the body by the blood stream; otherwise it will simply be washed away from a
single part by the blood stream! When properly applied to specific conditions, hyperbaric
oxygen effectively helps promote healing and decreases infection. The following benefits
may apply to your particular case:
a) increased blood flow to injured tissue
b) formation of new blood vessels
c) reduced swelling
d) helps fight infection
e) enhanced wound healing
f) increased new bone formation
g) reduced effects of toxic substances
Oxygen delivered under pressure actually dissolves in your blood stream, and is carried in
solution like the fizz in a capped soda bottle! This is much different than the normal
method of carrying oxygen, in which your red blood cells transport oxygen like small coal
cars floating in a stream. While small blockages may prevent the red cells from delivering
oxygen to damaged tissues, oxygen dissolved in the "stream" of your tissue
fluids can reach those damaged areas and help fuel the healing process.
Treatment Goals
Treatment outcomes range from complete resolution of the medical problem,
to no change, and every combination between. In about 80% of the cases, significant
improvement or complete resolution of the problem is seen. This means that some patients
may not respond to hyperbaric oxygen therapy. Since it can be very difficult to predict
exactly who those patients might be, some treatments may be started when the outcome is
not certain. Except in unusual circumstances, if no improvement is seen within 15 to 20
treatment dives, the likelihood of success is greatly diminished. A patient may be
returned to their primary care provider in such cases to seek other treatment options.
After 20 to 30 dives where there is a good response, hyperbarics may be discontinued with
the full expectation that the wound healing started by hyperbarics can now continue on its
own due to the generation of new blood vessels. We may be able to provide post-hyperbaric
wound care in selected cases where total healing is imminent. In those cases where a wound
is not responsive to hyperbarics, or continues unimproved for several weeks, the patient
will be returned to their primary care provider to investigate other treatment options.
Other treatment plans, such as for chronic refractory osteomyelitis, may require continued
treatment for several weeks after it appears the problem has resolved on the surface!
Throughout your hyperbaric treatment period, you must remain in contact with your primary
health care provider to keep them apprised of your situation, and to care for your other
health needs. While our hyperbaric physicians are fully licensed doctors, their specialty
remains in the provision of hyperbaric therapy. For issues unrelated to wound care and the
capabilities of hyperbarics, your primary referring physician and his affiliated team of
specialists must remain your primary source of care.