Hyperbaric Chambers

Hyperbaric chambers are devices that allow for the breathing of pure oxygen under increased atmospheric pressure. There are two types of hyperbaric chambers: monoplace, designed for one person, and multiplace, which can accommodate multiple patients. The primary purpose of hyperbaric oxygen therapy (HBOT) is to increase the amount of oxygen delivered to the body’s tissues.

Scientific Rationale:

  1. Increased Oxygen Dissolution: Under increased pressure in the hyperbaric chamber, more oxygen can be dissolved in the bloodstream. This leads to a higher amount of oxygen being delivered to the tissues, which can be especially beneficial in areas with reduced blood flow or oxygenation.
  2. Enhanced Wound Healing: The increased oxygen delivery can aid in wound healing. Oxygen is essential for cellular functions, including collagen synthesis and angiogenesis (formation of new blood vessels), both of which are vital for wound repair.
  3. Anti-inflammatory Effects: Some studies have shown that HBOT can reduce inflammation, potentially by decreasing the production and release of certain inflammatory mediators.
  4. Bactericidal Effect: The high levels of oxygen can inhibit the growth of certain anaerobic bacteria, helping to reduce or prevent infections.
  5. Neovascularization: HBOT can promote the development of new blood vessels in areas with reduced circulation, improving oxygen and nutrient delivery to tissues.

Beneficial Effects (with associated studies):

  1. Treatment of Decompression Sickness: Traditionally used for divers who ascend too quickly, causing nitrogen bubbles to form in the bloodstream.
  2. Chronic Wounds: Especially in cases of diabetic foot ulcers. Studies have shown improved wound healing rates with HBOT ([1] – Thom SR. Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg. 2011;127 Suppl 1:131S-141S.).
  3. Radiation Injury: Can be used to treat damage from radiation therapy in cancer patients, such as osteoradionecrosis or radiation cystitis.
  4. Carbon Monoxide Poisoning: HBOT is beneficial in acute carbon monoxide poisoning, decreasing the neurological sequelae. ([2] – Weaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med. 2009;360(12):1217-25.).
  5. Brain Injuries: Some preliminary studies have indicated potential benefits in traumatic brain injuries, though more research is needed ([3] – Rockswold SB et al. A prospective, randomized clinical trial to compare the effect of hyperbaric to normobaric hyperoxia on cerebral metabolism, intracranial pressure, and oxygen toxicity in severe traumatic brain injury. J Neurosurg. 2010;112(5):1080-94.).

Harmful Effects:

  1. Oxygen Toxicity: Breathing pure oxygen under increased pressure for extended periods can lead to oxygen toxicity, affecting the lungs or central nervous system.
  2. Barotrauma: Due to the changes in pressure, barotrauma can occur, impacting the ears, sinuses, or lungs.
  3. Myopia: Temporary nearsightedness has been reported after HBOT.
  4. Cataract Maturation: There are some reports that HBOT might speed up the maturation of cataracts.
  5. Risk of Fire: Since oxygen supports combustion, there’s an increased risk of fire in hyperbaric chambers.

The evidence for HBOT in treating various conditions is mixed, and while it’s beneficial for certain indications, its utility for others remains controversial or unproven. Always consult relevant clinical guidelines and primary research when considering the indications and contraindications of HBOT.