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Other common name(s):
hyperbaric medicine, hyperbarics, HBOT, HBO2
Scientific/medical name(s):
none
DESCRIPTION
Hyperbaric oxygen therapy (HBOT) involves the breathing of
pure oxygen while in a sealed chamber that has been pressurized at 1.5
to 3 times normal atmospheric pressure.
OVERVIEW
Research has shown HBOT is effective when used in addition to
conventional treatment for the prevention and treatment of
osteoradionecrosis (delayed bone damage caused by radiation therapy).
There is also some evidence suggesting HBOT may be helpful as an
additional treatment for soft tissue injury caused by radiation. There
is no evidence that HBOT cures cancer. The US Food and Drug
Administration (FDA) has approved HBOT to treat decompression sickness,
gangrene, brain abscess, air bubbles in the blood, and injuries in
which tissues are not getting enough oxygen.
How is it promoted for use?
HBOT is used in conventional treatment for decompression
sickness and severe carbon monoxide poisoning. Decompression sickness,
commonly known as "the bends," is an extremely painful and potentially
dangerous condition that strikes scuba divers who surface too quickly
and, occasionally, miners and tunnel builders who come up too rapidly.
It can also affect fighter pilots who climb very quickly.
Claims about the alternative use of HBOT include that it
destroys disease-causing microorganisms, cures cancer, alleviates
chronic fatigue syndrome, and decreases allergy symptoms. A few
supporters also claim that HBOT helps patients with AIDS, arthritis,
sports injuries, multiple sclerosis, autism, stroke, cerebral palsy,
senility, cirrhosis, Lyme disease, and gastrointestinal ulcers.
Available scientific evidence does not support these claims. Because of
that, the FDA has sent a warning letter to at least one manufacturer
about promoting HBOT for unproven uses. The FDA considers oxygen to be
a drug which must be prescribed by a physician or licensed health care
provider to help treat illnesses or health conditions.
What does it involve?
HBOT can be done in single-person chambers or chambers which
can hold more than a dozen people at a time. A single-person chamber
(monoplace) consists of a clear plastic tube about seven feet long. The
patient lies on a padded table that slides into the tube. The chamber
is gradually pressurized with pure oxygen. Patients are asked to relax
and breathe normally during treatment. Chamber pressures typically rise
to 2.5 times normal atmospheric pressure. Patients may experience ear
popping or mild discomfort, which usually disappears if the pressure is
lowered a bit. At the end of the session, which can last from 30
minutes to 2 hours, technicians slowly depressurize the chamber.
After an HBOT session, patients often feel light headed and
tired. Monoplace chambers cost less to operate than multiplace chambers
and are relatively portable. Most health insurance policies cover
medically approved uses of HBOT. Recently, Medicare and Medicaid have
begun to cover them as well.
What is the history behind it?
In the early 1900s, Orville Cunningham noticed that people
with some heart diseases did better if they lived closer to sea level
rather than at high altitudes. He successfully treated a colleague with
influenza who was near death due to lung restriction, and later
developed a hyperbaric chamber. After his attempts to use HBOT to treat
a host of other conditions failed, the method was abandoned and his
chamber was scrapped.
HBOT chambers were developed by the military in the 1940s to
treat deep-sea divers who suffered from decompression sickness. In the
1950s, HBOT was first used during heart and lung surgery. In the 1960s,
HBOT was used for carbon monoxide poisoning, and has since been studied
and used for a number of health-related applications. It has been the
subject of a great deal of controversy because of the lack of
scientific proof to support many of the other uses for which it is
suggested.
What is the evidence?
There is strong scientific evidence showing HBOT is an
effective treatment for decompression sickness, arterial gas embolism
(bubbles of air in the blood vessels), and severe carbon monoxide
poisoning. It may also be useful as an additional method for the
prevention and treatment of osteoradionecrosis (bone damage caused by
radiation therapy), clostridial myonecrosis (a life-threatening
bacterial infection that invades the muscle), and for helping skin
graft and flap healing. Other evidence suggests HBOT may be helpful for
less severe carbon monoxide poisoning, and for radiation-induced
soft-tissue injury; anemia due to severe blood loss (when transfusions
are not an option); or crushing injuries, poor wound healing, and
osteomyelitis that doesn't respond to standard treatment (chronic bone
inflammation). There is
conflicting evidence about whether HBOT is helpful in treating burns
and fast-spreading infections of the skin and underlying tissues.
The lack of randomized clinical studies makes it hard to
judge the value of HBOT for many of its claims. Available scientific
evidence does not support claims that HBOT stops the growth of cancer
cells, destroys germs,
improves allergy symptoms, or helps patients who have chronic fatigue
syndrome, arthritis, multiple sclerosis, autism, stroke, cerebral
palsy, senility, cirrhosis, or gastrointestinal ulcers.
Carefully controlled scientific studies are going on to find
out whether HBOT may be helpful for lymphedema (swelling in arms or
legs after surgery, which can happen after mastectomy), diabetic
ulcers, cluster headaches, heart attacks, and other conditions.
Are there any possible problems
or complications?
HBOT is a relatively safe method for approved medical
treatments. Complications can be reduced if pressures within the
hyperbaric chamber remain below 3 times normal atmospheric pressure and
sessions last no longer than two hours.
Milder problems associated with HBOT include claustrophobia
(in monoplace chambers), fatigue, and headache. More serious
complications include myopia (short sightedness) that can last for
weeks or months, sinus damage, ruptured middle ear, and lung damage. A
complication called oxygen toxicity can result in seizures, fluid in
the lungs, and even respiratory failure. Patients at high risk of
oxygen toxicity may be given “air breaks” during which they breathe
room air rather than oxygen for short periods during treatment. People
with severe congestive heart failure may have their symptoms worsened
by HBOT. Patients with certain types of lung disease may be at higher
risk of collapsed lung during HBOT. Pregnant women should be treated
with HBOT only in serious situations where there are no other options.
Hyperbaric oxygen chambers can also be a fire hazard: fires or
explosions in hyperbaric chambers have caused about 80 deaths
worldwide.
Additional Resources
More Information From Your
American Cancer Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be ordered
from our toll-free number (1-800-ACS-2345).
References
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Note: This information may not
cover all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Revised: 05/23/2007
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