Hyperbaric Oxygen Therapy

HBOT  has been shown to benefit people with many conditions, from mild to severe. These include: Autism, ADD/ADHD, Asthma, Allergies, Bells Palsy, Brain Injury, Stroke, Cerebral Palsy, Chronic Fatigue, Diabetic Wounds, Crohns Disease, Fibromyalgia, Hypoxia, Joint Pain, Lupus, Lyme Disease, MS, many skin conditions, sports injuries and frequent air travel. HBOT is impressive in its ability to speed recovery from surgery and to prepare for it, and to heighten an athletes ability to train and perform at peak levels – & recover quickly! HBOT is also of value in the field of Age Management because lack of oxygen and inflammation are major causes of rapid aging.  Once these are reversed, aging slows and vitality increases.

Here are some common questions asked about HBO and Hyperbaric Oxygen Therapy:

What is Hyperbaric Oxygen Therapy (HBOT)?

Oxygen is the essential nutrient.  It’s needed to nourish healthy tissue, aid the repair of damaged tissue and support the production of new tissue. Tissue damaged by disease or injury requires increased amounts of oxygen to provide the additional energy necessary to sustain the healing process. Hyperbaric Oxygen Therapy (HBOT), a non-invasive therapy, is the means by which this extra oxygen can be provided.

The patient breathes 96% to 100% oxygen whilst in a chamber pressurized to greater than normal atmospheric pressure. HBOT is a well founded and accepted technology, and assists in the treatment of many difficult, persistent, costly and otherwise hopeless health problems.

Evidence from more than 10,000 medical research and clinical papers published in the past 30 years has confirmed that Hyperbaric Oxygen Therapy (HBOT) is effective in the following basic ways:

  • Decreases swelling and inflammation
  • Promotes the growth of new blood vessels
  • Improves oxygen delivery to the tissues even in the presence of reduced blood flow
  • Reduces pain associated with ischemia
  • Accelerates the healing rate
  • Helps the body discard toxins and metabolic wastes
  • Increases the body’s ability to fight infection

 

What is the historical basis for HBOT?

Studies into HBOT began in the 1930’s with the purpose of treating decompression sickness and reducing decompression times in diving. In the 1950’s and 60’s, other studies focused on the use of oxygen in aviation and space exploration. Unfortunately, the knowledge gained was generally confined to those physicians and scientists involved in the support of subsea or space activities. This restriction contributed to the confusion regarding the use of HBOT for clinical management of patients within the general population.

Throughout this period, a large volume of confirmed data was built up through controlled animal and human studies. In addition, clinical data was gathered from various activities in medical establishments throughout the world. However, progress was hampered by a lack of equipment equal to the standards of patient care demanded by modern medicine.

Despite these difficulties, research and the use of HBOT in purely clinical applications have continued quietly and professionally in various parts of the world. In this environment the firm physiological basis supporting its use – for a growing number of medical conditions – has been emphatically established.

 

 

What is modern Hyperbaric Oxygen Therapy?

Clinical HBOT had its foundation in the 1950’s with the work carried out by Boerema, Brummelkamp and others at the University of Amsterdam. This was complimented by the pioneering work of Lllingworth and others in Glasgow, Scotland.

The further development of HBOT has largely taken place in the United States, USSR, China and Japan. Lower key activities also took place in many other parts of the world.

In the United States, the steady expansion of HBOT was a result of the activities of members of the Undersea and Hyperbaric Medical Society (UHMS). Formed in 1967 by physicians and scientists involved in supporting man’s undersea work, the UHMS recognized the need to bring order and guidance to this important branch of medicine. Consequently, in October 1975, they brought together 50 leading hyperbaric specialists from various parts of the world. This meeting culminated in the publication, in 1978, of a state of the art list of accepted conditions and the identification of promising research areas. Now regularly updated, this list provides a guide to physicians on current indications. Parallel activities in Japan and elsewhere have led to the publication of similar lists of accepted indications. Both the CIS (Russia) and China have highly developed programs covering the research and clinical use of HBOT which include a much broader range of indications than those generally accepted in the West.

Today, because of the clinically proven benefits and cost management of an increasing number of indications, the use of HBOT is growing continuously and gaining wider acceptance.

HBOT is finding its proper place as an important part of the armory available to modern medicine in the constant battle against the effects of disease, injury and rising costs.

How does it work?

HBOT elevates oxygen delivery to the tissue.

The only way that oxygen delivery to the tissues can be increased is by elevating the partial pressure of oxygen in the breathing gas. A normal level of oxygen in arterial blood cannot ensure that the tissue oxygen levels are correct. Many diseases are associated with ischemia and poor oxygen delivery because of tissue edema. HBOT can restore normal tissue oxygen levels. The volume of oxygen delivered to normal tissue, is the sum of the amount carried on totally saturated haemoglobin plus the amount in physical solution in plasma. When breathing 96% oxygen, this is approximately 2 vol% in physical solution for each atmosphere (760 mmHg) of pressure. Oxygen content at any given point in tissue is a factor of its distance from functioning capillaries, the oxygen requirement of that tissue and the oxygen-carrying fluids in the capillary.

Hyperbaric Oxygen Therapy works by elevating the plasma oxygen level in proportion to the partial pressure of inspired oxygen (Henry’s Law). Thus at 1.4 ATA (4.5 psi), the amount of oxygen dissolved in plasma is increased to approximately 2.8 vol% even though the level of oxygen carried by hemoglobin remains the same.

HBO is a vasoconstrictor thus it reduces Edema.

In all HBOT treatments, raised arterial PO2 (oxygen partial pressure) causes vaso- constriction, reducing blood flow and edema whilst paradoxically improving oxygen delivery to the tissue.

HBO promotes Neo-vascularization (new blood vessels).

In compromised and ischemic wounds, impairment of the microcirculation causes hypoxia (loss of oxygen). In hypoxic areas the oxygen partial pressure could be as low as a few mmHg. Some fibroblasts (cells in connective tissue that produce collagen) can survive, though inactive, at this low PO2 level. However, when the PO2 is elevated, by means of HBOT, fibroblasts divide, producing collagen and promoting neo-vascularization.

HBO enhances the killing power of Leukocytes.

Leukocytes (white cells) when deprived of oxygen exhibit diminished activity and are unable to kill the organisms they normally ingest. Their activity and killing ability are greatly enhanced when blood and plasma oxygen levels are elevated with HBOT.

HBO kills anaerobic bacteria (bacteria that use fermentation to survive).

It has been clinically demonstrated that HBO has a role in combating certain infections such as gas gangrene by acting directly against anaerobic bacteria.  Because of this anti-anaerobic bacterial aspect, HBOT is also effective against Candida yeasts and other similar infestations.

What can HBOT do?

HBOT is an indicated therapy in a large and increasing number of recognized conditions. It is, however, important to differentiate between HBOT as a primary and adjunctive therapy. In modern medicine, HBOT is accepted as the primary therapy in only a few conditions: Decompression sickness, gas embolism, gas gangrene and acute anoxia for example in carbon monoxide poisoning. In the other indications, it does not replace existing forms of treatment but is an adjunctive therapy. One of the most widespread clinical applications for HBOT is that of wound healing. Current practice reserves the HBOT for lesions which are failing to respond to normal management techniques and is generally considered unnecessary – but effective – in managing simple, well perfused wounds. Hypoxic and/or ischemic wounds such as stasis ulcers, diabetic wounds, grafts and flaps, radiation necrosis, necrotising soft tissue infections and refractory osteomyelitis have all been shown to respond well to HBOT. Indolent wounds, persisting despite long term surgical and medical protocols, have been completely resolved when HBOT was regularly applied.

Used pre and post-surgically, HBOT has proven effective in establishing a vascular granulation base for grafting. Via neo-vascularization it promotes a clearly defined demar- cation line of viable tissue, thus maximizing limb salvage in prospective amputees and faster healing times and decreased incidence of infection, inflammation and scarring in elective surgical procedures.

For thermal burns, comparative analyses of HBOT – Non HBOT treated patients indicate that significant increases in survivor rates and reductions in hospitalization times are achieved with HBOT. The value of HBOT in dealing with Carbon Monoxide and Cyanide intoxication is well established, with evidence supporting its efficacy in mitigating the effects of subacute and chronic sequelae that follow exposure.

HBOT is a cost effective means of dealing with difficult or persistent clinical problems by reducing direct hospitalization costs, permitting greater utilization of outpatient facilities and minimizing the degree of infection, disfigurement or disability.

What are the current “accepted” indications?

HBOT is an indicated therapy in a large and increasing number of recognized conditions. These accepted acute and adjunctive indications include:

Acute Indications

  • Acute Smoke Inhalation
  • Air or Gas Embolism
  • Carbon Monoxide Poisoning
  • Cyanide Poisoning
  • Osteomyelitis (Refractory)
  • Selected Refractory Anaerobic Infections (Actinomycosis)
  • Decompression Sickness
  • Exceptional Blood Loss (Anemia)
  • Gas Gangrene
  • Ileus
  • Osteoradionecrosis

Indications for Adjunctive Therapy

  • Anaerobic or Mixed Anaerobic Infections
  • Arterial Insufficiency Ulcers
  • Burns (Thermal)
  • Cerebral Edema
  • Chronic Osteomyelitis
  • Skin Grafts or Flaps (Compromised)
  • Soft Tissue Radiation Necrosis
  • Venous Stasis Ulcers
  • Wound Healing
  • Decubitus Ulcers
  • Diabetic Ulcers and Lesions
  • Necrotising Soft Tissue Infections
  • Non-Union of Fractures
  • Peripheral Vascular Disorder

 

 

Note: Current research and investigative indications that are consistently positive are not included in the above list.  They include:  PTSD, Traumatic Brain Injury (Concussion) ADD/ADHD, Lyme Disease, Chronic Dermatitis, Multiple Sclerosis, Fibromyalgia, Mycosis, Crush Syndrome, Stroke, Diabetes, Cardiac Disease, Autism, Sepsis, Muscular Sprains and Strains, Fatigue, Sports Recovery and Sports Performance Enhancement

 

* The above lists of indications for the use of Hyperbaric Oxygen Therapy has been compiled from the following sources:

  • British Medical Association, Undersea and Hyperbaric Medical Society, Japanese Society of Hyperbaric Medicine, USSR Ministry of Health Decree No. 977, Chinese Society of Hyperbaric Medicine, Italian Society of Undersea and Hyperbaric Medicine, Harch Hyperbarics Media – Dr. Paul Harch, M.D.

 

“The public doesn’t know what they don’t know. It’s simple.  The reality of this is that pressure (plus) oxygen heals. It heals wounds on your foot. It will heal a scrape on your knee – when you put hydrogen peroxide on it, and it will heal your brain.  And, that is the single message that needs to get out there: It’s that (hyperbaric) oxygen, profusing [sic] the body and all of its tissue with oxygen, heals.”  Pierre Gremillion

Hyperbaric Oxygen Therapy (HBOT) - Exactly how does it work?

Hyperbaric chambers, used in Hyperbaric Oxygen Therapy (HBOT),are any number of enclosures, which can be pressurized to allow a person inside to experience higher atmospheric pressures than the normal environmental pressures.  For example, a treatment at an elevation of 12,000 feet above sea level using a 4.41 psi (1.3 ATA) can simulate a decent of ~5,843 feet down, to 6,157 feet above sea level.

At higher elevations, the barometric pressure is lower.  This decrease of pressure also decreases the oxygenation of blood, and is known as anoxia—where molecules of oxygen exert less pressure on the walls of the alveoli (Dalton’s Law). Hyperbaric Oxygen Therapy (HBOT) follows this law – in reverse.

Hyperbaria = Increased atmospheric pressure as a means of increasing oxygen uptake without an enriched oxygen source Hyperoxia   = Increased total oxygen content

Hyperbaria is based on the concept of the relationship of gas pressure and uptake in liquids (blood, plasma and tissues).  Henry’s Law states that “a gas is dissolved by a liquid in direct proportion to its partial pressure.”  For example, at sea level, atmospheric pressure is 760 mm Hg, the oxygen concentration is 21% and the body’s oxygen content or partial pressure, pO2, in blood and plasma is ~ 40 mm Hg.

Red blood cells have a limitation as to how much oxygen can bind with hemoglobin, while the plasma portion of the blood typically has only about a 3% oxygen concentration.

By placing someone in a 3 psi pressure hyperbaric environment, the increase in atmospheric pressure at sea level goes from 760 mm Hg to 915 mm Hg.  This increase in gas pressure, increases the partial pressure of the oxygen gas and thus forces more oxygen to be dissolved in the plasma.  This saturation of oxygen in the blood, due to the Hyperbaric Oxygen Therapy or HBOT, allows the extra oxygen to be diffused or transported to the surrounding body tissues.  Thus, oxygen transport by plasma is significantly increased under Hyperbaric Therapy (HBOT).  At three atmospheres pressure, enough oxygen can be dissolved in the plasma to support the oxygen demands of the body at rest in the absence of hemoglobin!  [ie – you can go without breathing for several minutes or more.]

Hyperbaric Oxygen Therapy (HBOT) is designed to boost the supply of oxygen to ischemic (oxygen lacking) tissue or to diseased tissue that responds to increased oxygen levels.  Increasing the volume of oxygen dissolved in the blood plasma, that is brought about by hyperbaric therapy (HBOT), produces five basic effects:

  • Reduction of volume of gas bubbles in the blood
  • Vasoconstriction, which reduces edema and secondary hypoxia
  • Restoration of aerobic metabolism to ischemic tissue
  • Detoxification of poisoned tissues
  • Enhanced phagocytosis (to remove bacteria, visrus and fungus)

Henry’s Law: Henry’s law states that for a gas-liquid interface the amount of the gas that dissolves in the liquid is proportional to its partial pressure.  So Henry’s law helps to predict how much gas will be dissolved in the liquid.  The actual amount also depends on the solubility of the gas as well as its partial pressure.  At 4.5 psi (used in our HBOT chambers) at sea level, the pressure drives the very soluble oxygen into solution within the plasma.

Dalton’s Law:  John Dalton observed that the total pressure of a gas mixture was the sum of the pressures of each of the gases if they were to exist on their own.

More and more evidence of the benefits of HBOT

Sports

• Enhanced recovery between intense raining sessions • Improved stamina, endurance and speed • Maintenance of fitness level during injury periods • Greater depth and more control of breathing • Pre-acclimatization to altitude and reduced risk of altitude sickness

Life

• Increased overall energy levels and motivation • Improved quality and duration of sleep and assistance with sleep disorders • Reduced stress levels • Increased mental ability • Reduced fatigue and faster recovery from work done

Wellness

• Boosted immune response • Improved lung function • Improvement in the ease of breathing in mild to moderated Asthma • Reduced blood pressure and hypertension • Increased metabolism and permanent weight loss

Benefits of HBOT pre-and post- surgery

Hyperbaric Oxygen Therapy (HBOT) Helps Patients Heal Quickly An unavoidable part of any surgical procedure is trauma to the body. Tissue and cartilage subjected to the surgeon’s scalpel suffer damage to blood vessels that carry vital oxygen to the surgical site. Swelling and edema (accumulation of excess fluid in connective tissue) are the body’s natural reaction to trauma, and they too can impede the delivery of oxygen to damaged tissues. HBOT speeds healing by delivering oxygen to cells that might otherwise be deprived of this vital element. Patients who undergo HBOT before and after a surgical procedure heal up to 80 percent more quickly than those who do not use oxygen therapy. They also have greatly reduced scarring because the body has all the oxygen it needs to more efficiently repair the surgical site; and greatly reduced occurrence of post-surgical, bacterial infection.  Most bacteria are anaerobic, that is they cannot live in a high oxygen environment.

How Hyperbaric Oxygen Therapy Helps the Body Heal While breathing 96% pure oxygen via a small mask, the pressurized environment of the hyperbaric chamber allows up to a tenfold increase in the oxygen level of blood plasma. Hyper-oxygenated plasma and red blood cells travel to compromised tissues bringing all the oxygen they need to heal and regen- erate. This oxygen saturation also greatly increases the natural ability of blood cells to modify their shape and decrease clumping – allowing them to be more “single file” and easily pass through restricted blood vessels to deliver healing oxygen into the surgical site and the entire body. Recovery can then be faster and more complete.

Oxygen Therapy and the Immune System Hyperbaric Oxygen Therapy also helps the body heal by giving the immune system a boost. Any type of chronic or extreme stress depresses the immune system, which increases the chance of infection and dysfunction. When the cells responsible for protecting the body against infection (white cells, Killer T-cells, ect.) encounter bacteria and viruses, they require additional oxygen to fight off and kill the harmful agents – as most of these are anaerobic organisms. If the immune cells do not have sufficient oxygen to carry prevail in this encounter, these harmful agents can quickly challenge or overwhelm the system. HBOT provides the immune system and its infection-fighting cells all the oxygen necessary to operate at maximum efficiency.

More on Preparing for Surgery Hyperbaric Oxygen Therapy prior to surgery also increases the body’s ability to respond to the trauma of surgery and destroy the infection-causing agents that can quickly proliferate in a wound. Smokers planning any surgery are advised to quit at least four weeks prior to their procedure because toxins present in cigarettes impede the healing process. HBOT before surgery floods the body with oxygen to help eliminate carbon monoxide and other harmful gases introduced by tobacco smoke. Pre-surgical HBOT, by increasing oxygen delivery, speeds healing times, and reduces infection. If you are planning a surgical procedure of any kind, we urge you to consider Hyperbaric Oxygen Therapy. This outstanding treatment enhances your body’s ability to prepare you to tolerate surgery and recover quickly.

At my Long Life Sciences Clinic in Los Gatos, California, HBOT is so comfortable that most of our patients describe it as “soothing.” Once you’ve entered one of our roomy hyperbaric chambers, you will be able to read, listen to CDs, watch a movie on your iPad, or simply relax and perhaps even slip into a restful nap. You may begin to feel better after only one treatment (many patients report a lift in clarity and mood), and your body will have all the oxygen it needs to repair itself and recover more quickly.

Call me today to learn more about the benefits of having mild Hyperbaric Oxygen Therapy as part of your surgical procedure. Once your evaluation indicates that you are a safe candidate for HBOT, I will gladly provide the necessary prescription for you to continue here or elsewhere. Either way, we look forward to serving you and assisting your doctor’s efforts to allow your procedure to have the best possible outcome. *(The term “mild” when referring to this type of HBOT is incorporated to denote the use of pressures less than two atmospheres (14 psi) and oxygen fed to the patient, not to the chamber, at less than 100% pure. It has recently been discovered that pressures between 4 and 7 psi and oxygen at 95 – 96% are quite effective in providing the conditions necessary for oxygen to make the transition from a gas to a solution in a dose that is physiologically beneficial and completely non-toxic – even for the most severe cases such as stroke, heart attack, brain injury and diabetic wounds. For less severe and/or chronic cases, mild HBOT is the actually the most preferred, more cost-effective and more easily accessible method than the alternative: High-pressure, 100% oxygen HBOT used in some hospitals and specialized clinics.)

Former NFL player finds hope with HBOT

NFL Football Player with Multiple Concussions Retired NFL player finds hope for his brain via HBOT Feb 4, 2010 by Melanie D.G. Kaplan

George Visger was a defensive lineman in the NFL. He said his dream was to play for five years and then retire and build a homestead in Alaska. Things didn’t turn out the way he expected. Today Visger is 51. He is a wildlife biologist in Northern California and has spent the better part of the last 28 years suffering from brain damage, the result of numerous concussions. Visger played for the University of Colorado in the 1977 Orange Bowl, and many hard hits later, he finished his NFL career with the San Francisco 49ers, playing with the 1981 team that won the franchise’s first Super Bowl. In one of his earlier emails to me, Visger wrote, “The human body was not meant to play football. My Orange Bowl and Super Bowl rings are not worth what my family goes through dealing with my short term memory issues, anger management issues and lack of judgment.” We talked on the phone last week.

You started Hyperbaric Oxygen Therapy (HBOT) last week. Have you noticed a difference? “Within three treatments I was feeling really different. I’m a lot less tense, and my memory is better. Just remembering your call today -that wouldn’t have happened before. A few months ago I also, started taking some Dr. Barry Sears food supplements – industrial grade Omega 3 and concentrated fruit and vegetable juices, and I think that is helping too.”

Describe the experience in the oxygen chamber.  “They have you climb into a pressurized tube and crank up the oxygen level 10 times the normal level [note:  It’s actually only 96%], and for brain injuries, 1.5 times the normal atmospheric pressure [at sea level, 1.5 ata = 7.35 psi & 1.3 ata = 4.41 psi]. So they lock me in there and let me bake for an hour. It super-charges your blood with oxygen, which helps restore metabolic activity to the damaged areas of my brain and helps speed up the healing process. When they crank up the pressure, your ears start popping, but otherwise you don’t feel anything. They originally told me 40 treatments, but now they said with my damage they want me to do 80.”

How do you feel about concussions and football getting so much media coverage recently?  “It’s about time. I’ve been fighting this fight for 28 years. Things have to change. Someone needs to be held accountable. Sure, you play football and you know there are risks; all we’re asking for is to be taken care of.”

How is your daily life affected?  “I live out of notebooks. I have to take notes on all my phone calls and appointments. I’m taking notes now. I can’t tell you by the end of the day what I worked on in the morning. I’ve lived like that for years. When I was finishing my biology degree, I’d have to write in my notebook where I parked my truck. Yet I’m involved in three different businesses and give motivational talks. I also have insomnia and anger management issues. My [three] kids are afraid of me. They don’t know which dad’s going to come home today, whether he’ll be sweet or lose his temper.”

When was your first concussion?  “I started playing football when I was 11. My two loves were biology and playing football. I made a goal when I playedPop Warner football. I was scrawny and skinny, but I was motivated. I was eating a dozen raw eggs a day, and I built myself up. I was knocked totally unconscious in a tackling drill and hospitalized when I was 13. I had a number of concussions through high school and college. And my second year with the 49ers–this was the first Super Bowl team and I was just coming off a knee surgery—I started developing pounding headaches, temporary loss of vision and projectile vomiting.”

What was your experience with the team doctor at the 49ers?  “He said I had high blood pressure. I was 22, so I said, “OK.” My brain was hemorrhaging on me, and I was on high blood pressure meds. I’d developed hydrocephalus [in which excess fluid accumulates in and around the brain]. It wasn’t much after that I was having emergency brain surgery to put a shunt in my head. I’m in intensive care for 14 days. This was September 1981. I had the next two surgeries the following May, four months after [the team] won the Super Bowl.

How many brain surgeries have you had now?  “I’m on my ninth brain surgery and sixth anti-seizure medication. The shunt—I’ve had some last 10 hours and this one has lasted 16 years. When it goes, I start getting killer headaches. I went to see Dr. [Daniel] Amen, who does free one-day evaluations for retired NFL players. I went for three days. He said it’s amazing I’m functioning. I have huge holes on the SPECT scan of my right frontal cortex He said I’m the 67th NFL player who had come through the clinic. He said, “You’re showing early signs of the stuff that’s killing guys in their 40s and 50s.”

Will you watch the Super Bowl?  “I didn’t watch a football game for six or seven years. Now I watch, but I could care less who wins. I’m so cognizant of the hits, and the only thing going through my minds is, “What is that doing to his brain? What’s it doing to his body?” Fifteen years from now their bodies are going to be trashed.”

HBOT for brain injuries, PTSD and concussions

Preliminary Data in LSU IRB #7051 TBI/PTSD HBOT Pilot Trial: Hyperbaric Oxygen Therapy (HBOT) in Chronic Traumatic Brain Injury (TBI)/Post-Concussion Syndrome (PCS) and TBI/Post-Traumatic Stress Disorder (PTSD)-Pilot Trial

Paul G. Harch 1, Susan R. Andrews1, Edward Fogarty 2, Juliette Lucarini 1, Claire Aubrey 1, Paul K. Staab 1, Keith W. Van Meter1 1 Louisiana State University School of Medicine, United States, 2 University of North Dakota School of Medicine, United States

The preliminary data from the LSU IRB #7051 TBI/PTSD HBOT Pilot Trial of Hyperbaric oxygen therapy in blast-induced chronic traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) represents the first organized body of information that suggests a significant treatment effect on the conditions that present the greatest challenge to the integrity of our armed forces. The Rand Report of 1/2008 indicated that X% of our military that have served in Iraq and Afghanistan have been injured or affected by TBI or PTSD. Traditional treatment is protracted counseling and unapproved use of psychoactive drugs that have significant side effects such as increased suicide rates. Epidemic suicide rates in veterans are consistent with the use of such medications. In this seminal report at the 8th World Congress on Brain Injury Harch and colleagues from LSU School of Medicine, New Orleans demonstrated significant improvements in cognition, symptoms, and quality of life in 15 U.S. veterans with TBI and PTSD an average 3 years after their injury.

The physicians and researchers showed that with 4 weeks of treatment using a low dose of hyperbaric oxygen therapy, a treatment used for nearly 100 years in divers and 50 years for wounds, they were able to treat these wounds in the brains of injured U.S. servicemen. Specifically, the veterans achieved improvements in memory, concentration, executive function, and quality of life, and a reduction in headaches, concussion symptoms, depression, and anxiety. The average veteran experienced an increase in IQ of 15 points, a nearly 35 percentile increase. Other cognitive changes averaged 25 percentile point increases while quality of life measures, concussion symptoms, depression and anxiety indices, and the veterans’ estimates of their cognitive, physical, and emotional improvements improved by 30-90%. Surprisingly, the veterans showed a 30% reduction in PTSD symptoms. While the study did not include a control group, the magnitude of the improvement measured was striking and never before reported in the medical literature. Moreover, the data was supported by functional imaging data and very similar to a previous study by Harch where HBOT improved memory and blood vessel density in an animal model of traumatic brain injury. Equally importantly, in both the case reports and the LSU pilot study there were no significant side effects to the treatment. The scientific report at the International Brain Injury Association’s 8th World Congress reaffirmed earlier published peer-reviewed case reports of Harch and USAF Col. Jim Wright on brain injured U.S. servicemen.

The implication of this preliminary study is that U.S. veterans and others with the similar conditions can safely begin treatment with this established modality – HBOT – by physician direction, privately or (for veterans) under a national program approved by Western Institutional Review Board. This program, the National Brain Injury Recovery and Rehabilitation Project (N-BIRR) will incorporate the latest statistical design methodology that is favored by the FDA, the Bayesian Method, to accumulate further scientific proof of HBOT treatment for these two diagnoses. The program will consist of delivery of the same Harch HBOT protocol in one or two blocks; there will be no placebo group. The researchers hope to see this larger trial confirm the exciting preliminary results of the LSU pilot trial and the case reports.

HBOT for diabetic patients

Effects of hyperbaric oxygen treatment on oxidative stress parameters in diabetic patients.

F Gürdöl, M Cimşit, Y Oner-Iyidogan, S Körpinar, S Yalçinkaya, H Koçak

Department of Biochemistry, Istanbul Faculty of Medicine, Çapa, Istanbul, Turkey. figur@istanbul.edu.tr.

Exposure to hyperbaric oxygen leads to increases in the amount of reactive oxygen species (ROS) that are derived from a variety of sources. After the discovery that ROS can function as signaling molecules, the idea of ROS being hazardous to biological tissues has been challenged. The aim of this study was to examine the changes in oxidative stress parameters in diabetics undergoing hyperbaric oxygen therapy (HBOT) due to foot ulcers. Twenty patients who received HBOT for diabetic foot ulcers were included in the study. Blood samples were taken before HBOT and 30 min after the exit from the chamber, on the day of the first and 15th HBO sessions, and used for the determinations of malondialdehyde (MDA), 8-isoprostane and advanced oxidation protein products (AOPPs). Statistical evaluations were made by the two-way ANOVA. 8-Isoprostane and AOPP levels did not alter significantly after the first HBO therapy, while both were increased on the fifteenth day (p<0.05). MDA was significantly increased only after the first HBOT, and remained unchanged on the fifteenth day. Plasma AOPP levels lowered significantly after fifteen consecutive HBOT. Decreased AOPP levels suggest that increased oxygenation of tissues due to HBO therapy may activate some endogenous factors that prevent hazardous effects of the disease itself.

HBOT may help reduce stroke damage

Oxygen Therapy May Help Minimize Damage from Strokes adapted from a report by the Wake Forest University School of Medicine 13-May-98

Library: MED

Description: A small-scale study suggests that hyperbaric oxygen therapy may hasten recovery from stroke and save millions or even billions of dollars annually in health care costs, a medical researcher says. The study also indicates that the new approach could give doctors a vital fourth hour to intervene after the onset of stroke. Current approaches are limited to about three hours.

Dr. Richard Neubauer, the director of the Ocean Hyperbaric Center, says that in a study involving 32 victims of acute stroke (within four hours of onset), 25 percent of those receiving hyperbaric oxygen therapy were discharged from the hospital within 24 hours. In comparison, none of the 16 stroke victims receiving standard treatment was discharged in less than 5 days and all but two were hospitalized 10 days or longer.

Neubauer presented the results of his study today at a meeting of the Space and Underwater Research Group of the World Federation of Neurology. The meeting is being coordinated by the Stroke Research Center of the Wake Forest University Baptist Medical Center. But Dr. Stephen Thom, the president of the Undersea and Hyperbaric Medical Society, cautions that medial researchers still do not have a clear understanding of why hyperbaric oxygen therapy works and that more studies are needed to validate these results.

There is also disagreement within the medical community over whether hyperbaric oxygen therapy should be considered a treatment in itself or simply a tool to extend the time for using other treatments, said Dr. George Howard, professor of public health sciences and neurology at the Wake Forest University Baptist Medical Center.

Doctors hope that one result of their meeting this week will be a trial to further investigate hyperbaric oxygen therapy, said Howard, who is on the planning committee for the trial. This could be either a large-scale pilot study, or a clinical trial involving 30 to 50 medical centers.

“The task is to see if we can come up with a consensus as to what the next step is,” said Howard.

Stroke is the third leading cause of death in the United States and the leading cause of disability. It happens when a blood vessel serving the brain hemorrhages, or is blocked by a blood clot, impairing the flow of oxygen to that part of the brain. Each year roughly 600,000 Americans suffer a stroke, according to the American Heart Association. In 1994, almost 155,000 people died from stroke.

Hyperbaric oxygen therapy can revive dormant brain cells that have ceased functioning after a stroke, Neubauer said. Hyperbaric oxygen therapy placing patients in a whole-body chamber in which atmospheric pressure can be raised to two or more times normal level and breath pure oxygen

The key, he said, is to combine this therapy with a diagnostic test called single photon emission computerized tomography, or SPECT, scanning. SPECT scanning is used mostly by cardiologists, Neubauer said, but with the appropriate software it can be used to determine if a stroke victim has viable dormant brain cells that survived the stroke. These cells, surrounding the brain cells killed by the clot, are getting enough oxygen to survive but not enough to function properly.

By putting these victims in a hyperbaric chamber breathing 96% pure oxygen at 1.5 times the normal atmospheric pressure, far more oxygen is dissolved into the blood plasma and other bodily fluids, including the central nervous system fluid.

“You are giving free molecular oxygen immediately available for metabolic use” to the impaired cells, Neubauer said. “Hyperbaric oxygen therapy with SPECT scanning may at times predict which patients are going to recover,” Neubauer said. “Thus, patients may be treated at home with all modalities of physical therapy and continued hyperbaric oxygen.”

This could have far reaching economic consequences, he said. “If we can take one day off the hospital stay, one week off the nursing home and one week off the physical therapy, the savings are in the billions.”

Currently the only treatment for acute stroke victims is to inject clot-busting drugs within three hours. But this is used in only about 5 percent of all stroke victims, Neubauer said, because the drugs cannot be given to victims with hemorrhages, with hypertension, or who may not tolerate the side effects of the drugs. Hyperbaric oxygen therapy has none of these limitations, and can be effective up to four hours for help with immediate vessel integrity and up to several months to help mediate the inflammation and oxidative damage of brain cells caused by reperfusion injury.

An extra hour represents a significant improvement, given the time it can take for a family to recognize that a stroke is occurring, get the patient to a major medical center from an outlying area, and to wait while brain images are made to determine if the stroke is caused by a brain hemorrhage or a blood clot.

Theoretically, Neubauer said, the combination of hyperbaric oxygen therapy with clot-busting drugs could extend the window for intervention to up to six hours.

Neubauer said he hopes a large-scale clinical trial will attract the attention of hospitals and health-maintenance organizations, which are being financially squeezed into finding more cost-effective ways to deliver care. “The thing that will save it is its cost effectiveness.”

Chamber price list

Large:  The Vitaeris (Giver of Life) – $18,900 including frame, mattress and compressor

Medium:  The Respiro (The Breather) – $12,000 including, frame, mattress and compressor

Small:  The Solace (The Peaceful) – $7,200 including, frame, mattress and compressor

Oxygen concentrator:  $1,500 including 6 masks

Rental prices vary, based upon period of rental and chamber size.  There is a three month minimum.  First month’s rent in advance + deposit.