Hyperbaric Oxygen Therapy – FAQs

Hyperbaric Oxygen Therapy is a form of medical treatment in which the patient breathes 100% Oxygen at a pressure greater than the atmospheric pressure .The term is self-explanatory , the Hyper denoting High pressure ( higher than the normal atmospheric pressure ) Oxygen Therapy . Treatment is given in “treatment chambers” which can deliver oxygen concentrations to tissues at levels higher than any existing Oxygen delivery methods

During Hyperbaric Oxygen Therapy, due to higher pressure the oxygen dissolves more in the liquid part of blood (plasma) and its level increases 10-20 times of normal level. This floods the tissues with oxygen, revitalizing their cells and enhancing the body’s natural healing process. This oxygen reaches all areas of the body – including those places also where it was not reaching earlier due to inadequate blood supply or less haemoglobin.

Normally blood carries 19 ml of O2 in combination with Hb and 0.3 ml dissolved in plasma. If inspired O2 concentration is increased to 100 % , O2 combined with Hb increases to a maximum of 20 ml when the Hb is 100% Saturated and the amount of O2 dissolved in plasma increases fivefold to 1.5 ml. During HBO in addition to the Hb which is 100% saturated the amount of O2 carried in solution will increase to 4.3 ml % at a pressure of 2 ATA ** to 6 ml %. at 3** ATA is the unit of Pressure and 1 ATA is equal to 760 mm of Mercury or pressure at sea level.

When used in standard protocols hyperbaric oxygen therapy is safe. Commonest side effect may be slight discomfort or pain in the ears (aural barotrauma) if the ears are not able to equalize pressure.

Hyperbaric oxygen therapy enhances the healing and improves the quality of life of the patients in many well-defined areas

Hyperbaric oxygen therapy is used for treatment of non-healing wounds due to many causes and especially for diabetic foot ulcer, gangrene or radiation tissue. Other conditions treated with HBOT include serious infections, bubbles of air in your blood vessels, Acute Hearing Loss and Retinal Artery Obstruction.

Hyperbaric oxygen therapy requires a hyperbaric chamber with strict safety protocols and treatment monitored by a doctor trained in hyperbaric medicine. So, the treatment cannot be done at home.

Commonest side effect is slight discomfort or pain in the ears (aural barotrauma) if the ears are not able to equalize pressure.

No, hyperbaric oxygen therapy does not make the lungs weaker.

Hyperbaric oxygen therapy is safe when given under controlled conditions with following strict protocols and the success rate of therapy will depend patient to patient based on multiple factors such as indication for treatment, patient’s age, any other medical problems, etc.

A patient’s clinical response and other factors often dictate the number of treatments required. Emergency cases, such as carbon monoxide poisoning, arterial gas embolism or decompression sickness, may only require one or two treatments. Non-healing wounds may call for as many as 20 to 30 treatments.

A doctor trained in hyperbaric medicine will examine you before your treatments begin. You may need to have a few tests to make sure it is safe to expose you to oxygen under pressure. These tests include:Check of ears for ability to equalize pressure Check of lungs i.e. chest x-ray and / or pulmonary function tests Blood tests An eye examination (if you will be receiving a long series of treatments. Any other tests depending on your general state of health e.g. ECG. How do I prepare for my treatment?

Do’s and Don’ts during treatment

DO’S

• Bring a book or reading material with you.
• Plan on spending 2 hours at the Department .

Let us know

• If you have flu , ear nasal or chest congestion,
• Develop nausea , vomiting or diarrhoeas
• Are pregnant
• What medicines you are on .
• If you are a diabetic
• Any history of head injury or seizures
• Any history of lung disease, asthma etc.

DONTS

• Don’t drink alcohol for 8 hours before HBO2
• DON’T SMOKE while having HBO2 therapy.
• Don’t use alcohol and petroleum based skin products
• Don’t wear clothes other than cotton
• Don’t start / stop any medications without informing us.
• Do not carry watch, dentures, hearing aid ,electronic items, jewellery ,contact lens ,Cigarettes, lighters, or matches into treatment area .

You Need To Know This About Smoking….

The purpose of HBOT is to deliver high doses of oxygen to your body through your blood. Smoking inhibits this oxygen delivery in the following ways. We strongly advise you to stop smoking during the entire period of hyperbaric therapy, continuing to smoke during your treatment period will make your therapy less effective. The smoke inhibits oxygen uptake in the Lungs. Most important, the nicotine in cigarettes narrows the diameter of the blood vessels. This greatly reduces the amount of blood that can reach your tissues. Smoking increases lung congestion and risk of complications. Smoking decreases the amount of oxygen that your blood carries. Do not smoke while receiving hyperbaric oxygen treatment. Smoking is not permitted in the Hyperbaric Unit.

There is no need to disrupt your medication routine because of HBOT treatments. Bring your medications with you when you come. If you have to have shots or IV medications our nursing staff can help you.

Hyperbaric Oxygen Therapy is given in a cabin which is pressurized with compressed air. At a certain controlled pressure patients breathe 100% oxygen through a mask, hood or endotracheal tube. 4-6 patients can be treated at the same time.A staff nurse is present at all the times with patients inside the chamber while the treatment is monitored from a Control Panel outside the chamber.

Except for decompression sickness and arterial gas embolism, the typical treatments are approximately one and half hours long. Patients are generally treated once a day, but sometimes may require therapy twice a day.The hyperbaric doctor will determine your treatment schedule. Normal treatment days are Monday through Saturday, excluding holidays.You must be on time for your session since any delays affect the treatment of all patients. A late arrival may result in the cancellation of your treatment. If you are unable to attend your session because of an urgent problem, please call us.

The treatment is painless. At the beginning and end of your treatment, you may notice a feeling of fullness in your ears. This is much like the feeling when flying in an airplane or diving underwater. As your eardrums respond to the changing pressure, you may hear popping or crackling noises. The Paramedic / Nurse will teach you how to relieve this sensation by clearing your ears.Consent We cannot legally treat you without your written consent. You will be asked to sign a form consenting to treatments and photographs (of wounds).Following are the steps to the treatmentThe staff will assist you in entering the treatment chamber. You will be positioned at your seat. Now we are ready to pressurize the chamber, this is when you need to clear your ears. Compression takes about 10-15 minutes and you will have to clear your ears several times during this phase. Notify the inside attendant at the first sign of discomfort in your ears or sinuses so we can stop compression and help you. The Technician / Doctor will adjust the rate of compression to reduce the fullness in your ears. You will notice the air gets warm during compression. When our treatment pressure is attained, we will vent out the warm air and ventilate with fresh air for the whole time of the treatment. The chamber has an air conditioning system. Treatment normally ends after about 90 minutes. The inside observer will place your Oxygen mask / hood on and set the oxygen flow and exhaust dump hose to the proper settings. Hoods, neck rings and console panel are the responsibility of the inside observer and should not be operated by the patient. Neck rings must remain on until the end of the treatment. The staff will assist you in removing the neck rings. After your treatment is finished we slowly decompress the chamber. This takes another 10 – 15 minutes. Don’t try to clear your ears during the decompression phase. Your ears will clear automatically.

You may feel pain in your ears during pressurisationThe Valsalva ManoeuvreHold your nose closed and close your mouth. Lift the back of your tongue toward the roof of your mouth. Attempt to blow through your nose (short and sharp) while holding it shut. Other MethodsYou can try to yawn; swallow or drink sips of water. You will have to repeat this procedure several times during the pressurization phase of treatment If you have difficulty with your ears, notify an inside attendant immediately. Don’t wait until it hurts.

Analysis have shown that the addition of Hyperbaric Oxygen to conventional treatment results in significant cost savings due to lesser stay in hospital and shorter course of illness. The unit cost of treatment at Apollo hospital is the cost per patient per therapy in a sitting position. Each therapy lasts for 60 – 90 minutes. Patients who are in a lying position, have multi system ailments and are treated as emergency cases are charged additional amounts. Chronic conditions such as non-healing wounds and radiation wounds have to receive a large number of therapies and are offered discounts

Most Indications do not need admission to hospital. However, you may need admission for some procedures and if required by Insurance Company.

Diabetic foot ulcers are usually located on the sole of the foot or tip of toes. They are usually round with a red crater and make have thickened skin in wound edges.

Patients with diabetes commonly have damage to their nerves and poor blood supply which impairs wound healing. A diabetic foot ulcer, if not treated adequately may even lead to amputation.

Most of the diabetic foot ulcers, when treated by a trained healthcare professional following standards of care protocols, such as offloading and advanced dressings, should heal in 6-12 weeks.

Bedsores are caused by a combination of pressure and friction on the affected part. So, removing pressure from the area, and protecting the ulcer with a dressing will help in healing.

Depending on the depth and stage of the wound, most of the bedsores can be safely treated at home using standard wound care protocols.

Venous ulcers are usually located on the lower part of legs and are irregular in shape, shallow and with a red base.

Venous leg ulcers should heal in 8-12 weeks when treated with graduated compression therapy by a trained healthcare professional.