Hyperbaric Oxygen Chambers: The Confirmed Advantages and Doable Dangers
Written by: Gerda Endemann, PhD
Printed on: September 1, 2022
The utility of hyperbaric oxygen remedy (HBOT) has superior method past decompression sickness (when scuba divers come to the floor too quickly). Services are arising world wide, they usually’re getting used to deal with a variety of complaints, from surgical procedures that gained’t heal to fuzzy mind. You sit or lie in a pressurized chamber inhaling pure oxygen, and the excessive strain and excessive oxygen focus power additional oxygen into the physique. This oxygen helps cells thrive and develop so tissues can restore themselves.
There’s good proof that HBOT helps heal tissues broken by most cancers radiation therapies, burns, and infections, and it may well assist cut back the necessity for foot and leg amputations in diabetics. A physician will make a referral for these and other FDA-cleared conditions, together with extreme anemia and sudden imaginative and prescient or listening to loss. HBOT can be cleared by the FDA for the preservation of pores and skin grafts, together with these finished for gender-affirming surgical procedure. Insurance coverage corporations together with Medicare will doubtless pay for all FDA-cleared therapies.
However what about different situations that persons are going to HBOT services for, like cognitive assist and persistent Lyme illness? And what concerning the zip-up chambers for house use? Is the expense and time value it? Medical HBOT is pricey until your medical insurance covers it, to say nothing of being caught in a claustrophobia-inducing chamber for hours every single day along with your ears feeling the strain and with out your cellphone for distraction. (Electronics are included in an extended record of issues that can’t be introduced contained in the chambers.)
Hyperbaric Chambers: What It’s Like Inside
The remedy expertise varies amongst services. The John Muir Medical Center in Walnut Creek, California, is an accredited facility that gives non-public chambers made from clear plastic so you possibly can watch TV. You lie down on a gurney and slide in and oxygen is pumped in at a excessive strain. Different accredited services, together with Legacy Emanuel Medical Center in Portland and UCLA Hyperbaric Medicine, have multioccupancy chambers which you can rise up and transfer round in. You’ll be able to learn a ebook. They’re pressurized with air, and one hundred pc oxygen is delivered by tight-fitting masks or hoods. I spoke with Enoch Huang, MD, medical director of the hyperbaric drugs and wound care clinic at Legacy Emanuel, about these choices. “Some individuals discover the single-person chamber extra claustrophobic since you are bodily in a smaller house,” Huang says. “However different individuals discover it much less claustrophobic since you don’t have something so near your face.”
In a medical HBOT chamber, the strain is 2 to 3 occasions atmospheric strain at sea degree. To place this in perspective, two atmospheres of strain is what you’d expertise 33 ft deep within the ocean, and also you’d should go down 66 ft to see what three atmospheres looks like. Doable unwanted side effects embrace ear and sinus ache, a ruptured eardrum, and non permanent imaginative and prescient adjustments. Huang instructed me that you simply’re getting about 10 occasions extra oxygen than normal when inhaling pure oxygen at two atmospheres of strain.
Examine this to the zip-up baggage you should purchase for private use that pressurize to just one.3 occasions atmospheric strain with common air. In accordance with Huang, these have been meant for the remedy of altitude illness, not for the various situations persons are utilizing them for now. “Some individuals will take a bottle of oxygen into this delicate chamber and breathe pure oxygen from the bottle, which isn’t protected,” Huang says. “Oxygen is very flammable, and people can be badly burned on account of utilizing it in an unsafe method.” Huang notes that there are proponents of this type of chamber to deal with autism, Lyme illness, a number of sclerosis, and cerebral palsy, however that it’s controversial due to the dearth of confirmed outcomes. Some sufferers determine to take issues additional and construct their very own hyperbaric chambers, which is clearly dangerous. He added, “I bought a name about an individual in Texas who constructed his personal hyperbaric chamber. It exploded and he had two collapsed lungs.”
Gaining Entry to Hyperbaric Chambers
Individuals are constructing their very own chambers and going to services not related to hospitals as a result of with out one of many FDA- or Medicare-cleared situations, these are the one methods they can entry HBOT.
I believed I’d name a number of services across the San Francisco Bay Space to see what they stated about advantages for the extra controversial indications. I puzzled how their remedy plans would examine to research-based regimens for authorized indications. Primarily based on medical analysis, remedy in an accredited facility sometimes entails 90 to 120 minutes every day, 5 days per week, for six weeks.
The services I spoke with confirmed that a physician’s prescription was required. If I didn’t have a prescription, I might see their doctor on employees ($250 to $450), who would decide a remedy plan for my numerous aches and pains. I’d begin off with a basic wellness routine of 90 minutes ($220 to $375 per session) a minimum of twice per week, for a complete of 40 periods. It’s not shocking that services provide plans that don’t require every day attendance, though it’s every day therapies which have been studied clinically.
Off-Label Makes use of of HBOT
To search out out extra about off-label makes use of of HBOT, I appeared into ongoing and revealed analysis and talked to practitioners. Spoiler alert: If it weren’t so costly and time-consuming, based mostly on this analysis I’d wish to strive hyperbaric myself, and I’d additionally encourage a number of mates with numerous points to take action.
In accordance with Ronald Gordon, MD, the CEO and founding father of 8th Element Hyperbaric Medicine, persons are anecdotally reporting advantages from HBOT for sure off-label makes use of that aren’t but supported by analysis. Primarily based on the mechanisms by which HBOT works, he isn’t stunned by this. “If swelling is a giant a part of what’s occurring, or there are muscle, ligament, or tendon strains or tears, then the reply is completely, hyperbaric would assist,” Gordon says. “Most, if not all, skilled athletic groups have their very own hyperbaric chambers.” Gordon explains that the explanation HBOT shouldn’t be used on a regular basis for this kind of damage is that it’s terribly costly.
The mind is a significant goal for off-label use of HBOT. Medical researchers are significantly contemplating HBOT for indications together with lengthy COVID, concussions, and impaired cognition, and proper now within the US, 20 clinical trials are recruiting topics. Already medical research have been revealed displaying the advantages of HBOT for restoration from strokes and brain injuries, even years after the injury. In veterans with treatment-resistant PTSD, HBOT has led to enhancements not solely in signs but additionally in mind construction and functioning.
How HBOT helps heal the mind shouldn’t be a thriller. Utilizing mind imaging, scientists have proven that HBOT results in an increase in cerebral blood flow and extra exercise in mind areas that have been dormant. Kate Daly, MD, medical director on the All Points North TMS and HBOT facilities, instructed me that after they’ve used hyperbaric oxygen for concussion and postconcussive syndrome sufferers—lots of whom even have PTSD and melancholy—some sufferers report sudden advantages. “Folks usually say that their sleep is considerably improved, and lots of additionally discover an enchancment of their temper and nervousness,” Daly says.
Alzheimer’s and a few causes of impaired cognition are related to diminished blood circulation to the mind. The ensuing low oxygen ranges within the mind may very well be contributing to impairment—offering a rationale for HBOT. There’s a little analysis suggesting that HBOT might assist wholesome cognition. In a single examine on individuals with Alzheimer’s illness, 40 minutes of HBOT for 20 days led to vital improvements in cognition lasting a minimum of a month, enhancements that weren’t seen in untreated management sufferers. And cognitive advantages have been proven in wholesome adults. In a single trial, three months of HBOT for wholesome individuals over age 64 resulted in improved scores for a number of measures of cognition, together with data processing. As is the case for many HBOT, remedy was intensive. Folks obtained 60 therapies at two atmospheres for 90 minutes, 5 days per week.
We don’t but know if less-intensive remedy regimens shall be useful, or if the advantages will outweigh the dangers beneath real-life situations in the long run. There may very well be oxygen toxicity with continued remedy for persistent situations, so longer and bigger research are wanted earlier than reaching conclusions. In accordance with Huang, one motive the massive research required by the FDA haven’t but been finished is that pharmaceutical corporations can’t earn a living from oxygen, so that they haven’t invested within the mandatory analysis.
There doesn’t look like revealed proof supporting the usage of HBOT to deal with most cancers, Lyme disease, or autism spectrum disorder. I discovered minimal proof in assist of its use for fibromyalgia or arthritis—just one medical examine every.
What I did discover is that HBOT is underutilized for one indication that has been accepted by the FDA, the Undersea and Hyperbaric Medical Society, and Medicare: maintaining pores and skin and tissue grafts alive. HBOT can be utilized to assist therapeutic of tissue grafts utilized in gender-affirming surgical procedure.
HBOT in Gender-Affirming Surgical procedure
Simply south of San Francisco, 8th Element Hyperbaric Medicine is devoted to supporting wholesome pores and skin and tissue grafts utilized in gender-affirming surgical procedure. These surgical procedures continuously fail when grafts die due to low blood circulation or an infection. From earlier expertise as founding father of Mobile Hyperbaric Centers in Cleveland, Gordon knew that HBOT was essential for maintaining grafts alive. Pores and skin grafts liable to tissue loss of life have lengthy been cleared for remedy with HBOT by the FDA and coated by insurance coverage. “As a practitioner, I used to be shocked that surgeons doing gender surgical procedure weren’t utilizing hyperbaric, that they have been accepting the extent of issues that that they had,” Gordon says. He based eighth Aspect to fill this hole. “Out of a pair hundred individuals who bought 5 therapies or extra, we haven’t had anyone who didn’t recuperate. We’ll be publishing these knowledge.”
Selecting an HBOT Facility
Should you determine to strive hyperbaric oxygen remedy, right here’s what Huang instructed me to search for. At a minimal, a physician could have accomplished a 40-hour course in hyperbaric drugs. The gold commonplace is board certification in hyperbaric drugs.
So far as services, the FDA would really like you to make use of one which’s accredited by the Undersea and Hyperbaric Medical Society. This affords assurance that the chambers are constructed in accordance with code, the power has the suitable protocols in place, and the physicians are correctly educated.
Bear in mind the Gray’s Anatomy episode the place a affected person lit a cigarette and his oxygen line exploded? Pure oxygen is harmful. There have been deadly fires and explosions in unaccredited services. And oxygen oxidizes. Given all of the analysis on the dangerous results of oxidation and the advantages of antioxidants, you’d suppose we’d wish to use pure oxygen solely when fairly sure of the long-term risk-to-benefit ratio.
Contraindications to Hyperbaric Oxygen
Jonathan Rotella, president and CEO of NexGen Hyperbaric, instructed me that most individuals are capable of tolerate the strain. If they will’t, it’s sometimes as a result of the affected person has a head chilly. Different causes individuals might not have the ability to equalize ear strain are ear surgical procedures and infections.
Extra contraindications embrace claustrophobia, pneumothorax, and use of medicines equivalent to disulfiram, doxorubicin, and bleomycin. Doable contraindications might embrace persistent obstructive pulmonary illness, epidural ache pumps, and eye surgical procedures. As well as, excessive fever or epilepsy might make oxygen toxicity extra doubtless.
The Value of HBOT
Whether or not or not HBOT is roofed by insurance coverage is very variable. A prescription for remedy for one of many FDA-cleared situations at a hospital facility is more likely to be coated. Remedy at a wellness middle for an off-label situation is much less of a certain factor. At NexGen Hyperbaric, which makes use of HBOT for all kinds of situations, each on- and off-label, Rotella says they’ve been profitable in getting business insurance coverage to pay for concussions and melancholy. The doctor who prescribes the remedy often has to speak to the physicians working for the insurance coverage corporations, telling them why they imagine this remedy will assist the affected person and citing medical journals and different sources. “We’ve got been profitable, however that’s not at all times the case,” Rotella says. “In some instances, sufferers should pay money.”
Associated Studying on goop
There are a number of approaches to assist get oxygen to the tissues that want it. Supporting good circulation of blood is essential. Within the physique, oxygen is carried by hemoglobin, which requires iron with a purpose to perform. Many women show symptoms of low iron and can benefit from a supplement. And an intensive wellness retreat will provide quite a lot of circulation-boosting practices, together with loads of indulgence.
This text is for informational functions solely. It’s not, neither is it meant to be, an alternative choice to skilled medical recommendation, prognosis, or remedy and will by no means be relied upon for particular medical recommendation. To the extent that this text options the recommendation of physicians or medical practitioners, the views expressed are the views of the cited knowledgeable and don’t essentially symbolize the views of goop.