Hyperbaric oxygen (HBO2) therapy is a unique treatment approach for certain infections, poisoning and complicated wounds. During HBO2, patients are given 100 percent oxygen at pressures two to three times greater than that at normal sea level. LDS Hospital’s hyperbaric service uses monoplace (single person) hyperbaric chambers made of clear acrylic to administer this high oxygen dose.
When a patient breathes 100 percent oxygen under pressure, greater amounts of oxygen are dissolved into the bloodstream and delivered to the body tissues in amounts sufficient to promote healing. The benefit comes from the breathing of the oxygen under pressure, not from the oxygen being in direct contact with the skin or wound. The pressure used and the number of hyperbaric sessions depends on the problem being treated.
How it Works
HBO2 therapy works by:
- Saturating the plasma with oxygen, resulting in increased oxygen delivery to the tissues
- Dissolving sufficient oxygen in the plasma to support cellular function without utilizing hemoglobin
- Increasing the oxygen tension in hypoxic areas such as chronically infected, irradiated or compromised tissues
- Enhancing the white blood cells' capacity to kill bacteria
- Reducing edema through vasoconstriction
- Increases vascular endothelial growth factor
- Increases growth factor receptors on fibroblasts
When it is Used
HBO2 therapy is used for:
- Acute gas embolism
- Clostridial myositis and myonecrosis (gas gangrene)
- Crush injury, compartment syndrome, and other acute ischemias
- Decompression sickness
- Acute central retinal artery occlusion
- Enhancement of healing in selected problem wounds
- Exceptional anemia
- Intracranial abscess
- Necrotizing soft tissue infections
- Osteomyelitis (refractory)
- Delayed radiation injury (soft tissue and bony necrosis)
- Skin grafts and flaps
- Thermal burns
- Idiopathic sudden sensorineural hearing loss
What happens during an HBO2 treatment?
To get HBO2, a patient lies on a padded stretcher and slides into a clear acrylic tube (monoplace HBO2 chamber). A trained technician operates the chamber and stays with the patient for the duration of the treatment. It usually takes 5 to 7 minutes to reach the target pressure once the door is closed. The chamber is filled with 100 percent oxygen. Patients can watch TV, relax, listen to music or even sleep inside. After the time at pressure has elapsed, the patients are decompressed and the treatment is over.
Most patients spend 90 minutes at pressure, but the length of treatment, depth (amount of pressure), and the number and frequency of treatments vary according to the condition of the patient being treated. For example, some emergencies like diving accidents or gas embolisms require only 1 or 2 treatments, but for wound healing, 20 to 40 treatments may be needed. The actual number of treatments will depend on how the patient responds to the therapy. Most patients get one treatment per day, but for some medical problems, they could get 2 or 3 treatments per day. A trained physician must determine how many treatments a patient should receive and how often he or she should be treated, as well as the pressure and session duration used.
Because 100 percent oxygen is in use during the treatment, staff and patients must observe certain safety precautions. Certain items cannot be taken into the chamber. Among them are lighters or matches, cigarettes, nylons, synthetic materials, wigs or hairpieces, petroleum jelly, ointments, hearing aids, watches, makeup, lipstick or lip balm, lotions, hairspray, hair oil or relaxers, or hard contact lenses.
Because nicotine causes small blood vessels to constrict and limits tissue blood supply, patients are asked to not smoke during the entire course of HBO2 therapy. Smoking in the chamber is absolutely forbidden.
As with any treatment, side effects are possible; however, serious side effects are very rare.
The most common is injury or pain in the ears and sinuses caused by pressure changes. The chamber staff will teach patients how to equalize the pressure in their ears to avoid this complication. If the patient has ear pain or is unable to clear their ears, the insertion of tympanostomy tubes may be necessary before treatment continues.
The high doses of oxygen used can cause seizures and lung complications. Seizures are rare and will cease when the patient is no longer breathing the pure oxygen. Pulmonary oxygen toxicity may occur, but is very rarely seen with the treatment protocols used.
Some patients may suffer claustrophobia. This is managed by maintaining communication, the use of relaxation techniques and mild sedation if necessary.
Some patients who have an extended course of HBO2 (typically at least 30 treatments) develop temporary changes in eyesight. Vision usually returns to normal within a few months. Patients with cataracts may experience accelerated maturation of the cataract, but the treatments do not cause cataract formation.
Some patients may have underlying medical problems that could make them more likely to have complications with HBO2. The HBO2 medical team carefully evaluates each patient’s risk for complications so that patients can make an informed choice about receiving treatment. The medical staff working in the unit is skillfully trained to manage problems that may occur.
Clinic Contact Information
Contact the Hyperbaric Department to schedule an appointment to meet with one of the advanced practice clinicians and a physician.
Your current and past medical history information will be helpful. Please bring this information with you to facilitate your initial consult. We will also gather data from your referring physician.
Please use the free valet parking at the hospital’s main entrance. Our office can provide directions and a map to the hyperbaric department.
The Intermountain Hyperbaric Medicine Center at LDS Hospital
8th Avenue & C Street
Salt Lake City, UT 84143
Phone: (801) 408-3623
Fax: (801) 408-8578
Emergency: (801) 408-6410