Over the course of its development, Hyperbaric Oxygen Therapy (HBOT) has gone from the fringes of medicine and science to the front lines of emergency care.
This treatment has become such a valuable tool in acute care environments, it is increasingly considered an essential, not unlike x-ray cameras or MRI machines.
Although HBOT is often utilized for longer-term therapies and as part of a rehabilitative journey, it also has a several life-saving applications.
HBOT is generally used in one of two ways: as a primary therapy, in which HBOT is the first treatment applied, and adjunct therapy, in which HBOT is either a secondary treatment or else is used to enhance other primary therapies. In either case, it is a critical element of acute care plans that can mean the difference between life and death, or even avoiding amputation.
Probably the best-known application of HBOT as a primary therapy is in the treatment of embolisms. An embolism is essentially a buildup of gas in the bloodstream that forms a clot. Even the most aquaphobic among us are likely familiar with the bends, in which pressure changes brought on by diving cause a nitrogen buildup in the blood, which can result in an embolism. However, many other gases from a variety of other sources can also lead to this condition.
While other types of blood clots often call for surgery, HBOT has proven itself as For arterial embolisms, HOBT is both the primary therapy, and the most effective treatment currently known. It works so well in part because the hyperbaric oxygen tank creates a pressure-controlled environment around patients, allowing the body to reabsorb concentrated gasses in the body, or else causing such bubbles to shrink and circulate safely again.
Outside of scuba diving, one of the most common causes of an air or gas embolism is actually surgery, and other invasive medical procedures. Any time a part of the body is breached--by surgery, or even intravenously--embolism becomes a possible, though far from probable, risk. This means embolisms are possible in virtually any clinical specialty, and can quickly escalate into a serious case of morbidity or even death.
For this reason, the presence of hyperbaric oxygen tanks in a clinical setting can actually help manage the risks of other treatments by providing an emergency response option to control gas embolisms.
The Blood-Boosting Effect
Along with the pressure-controlled environment, of course, HBOT involves creating an oxygen-rich atmosphere around patients, creating optimal conditions for cellular function, especially healing and tissue repair. The circulation of blood, after all, is meant to carry oxygen to where it is needed in the body. Oxygen-immersion can enhance this natural function, especially in cases where the blood supply has been suddenly cut off or interrupted, a condition broadly known as ischemia.
Ischemia can afflict any part of the body--limbs, organs, the brain, and especially the heart--but the key to treatment in every case centers on restoring proper circulation and oxygenation. Once patients suffering acute attacks are stabilized, HBOT in ischemic emergencies can provide the kind of acute tissue resuscitation needed to avoid loss of limb and life.
Similarly, when patients have suffered from carbon monoxide poisoning (which starves tissue of oxygen) or crush injuries (anything from bruises to more extreme damage to circulatory tissue that limits oxygen flow), diabetic injury, or any other condition in which tissue is at risk of becoming necrotic, HBOT is often the first, best way to preserve injured tissue once patients have been stabilized.
In the same vein--so to speak--are patients suffering from anemia. Anemia, a shortage of hemoglobin and red blood cells, can result from acute blood loss (injury), as well as from natural or even hereditary conditions. In both cases, HBOT can make up for the body’s deficiencies of oxygenated blood, without the need for transfusions or other more invasive treatments.
The same features that make HBOT an effective primary treatment in so many cases have led to its inclusion as an adjunct to other comprehensive treatment plans. For example, burn victims will typically need a combination of antibiotics (to prevent infection), and in extreme cases, skin grafts (to cover the worst parts of the injury). HBOT can both enhance the efficacy of these treatments, and even bring them back from the brink of failure.
The same goes for other severe or open wounds that aren’t healing properly or quickly enough. Just as with anemia or crush injuries, this kind of bodily trauma can interrupt the flow of blood to the area, making it difficult for the body to heal itself. While the primary goal in such injuries is to stop bleeding and prevent infection, HBOT as an adjunct can help promote the body’s natural healing process, giving wounds the oxygen they need to repair tissue, return normal circulation, and otherwise recover.
This is why HBOT is often recommended for patients who have already received treatment, but are struggling through the healing process. The body’s immune system may be overextended fighting infection, metabolizing medication, and trying to heal tissue. HBOT can provide a boost that helps the body’s cellular functions keep up with the demands, ensuring that improvement continues and maximizing the chances for a full recovery.
Naturopathy and Prevention
The area of medicine in which HBOT is enjoying the greatest boost in popularity is the naturopathic sector. As the practitioners of naturopathic medicine will explain, the whole field is dedicated to adjunct therapies--supplementary treatment and processes that maximize the body’s natural abilities, as well as providing a secondary element of care alongside--or even in order to prevent the need for--standard and emergency clinical care.
The same general principles apply here as well, although in naturopathic settings there is not always a preexisting condition or injury to indicate the need for HBOT. Instead, naturopathic doctors will recommend patients for the treatment in order to promote general health, enhance natural cellular function, and ensure tissue health to better prevent disease, rather than just to promote recovery. The idea, in part, is to keep the body in optimal condition to prevent things like diabetic injury, anemia, or embolisms that could escalate and require hospitalization.
Adjunct treatments have been a key element of the advancement of development of HBOT. The different regulatory environment of naturopathic medicine enables such providers to pioneer different applications and gather data to demonstrate the full efficacy of the therapy.
Veterinarians also practice under a much less restrictive regulatory protocol, freeing them to use HBOT to its full potential in animal care and rehabilitation. Veterinarians have come to rely on HBOT as both a primary and an adjunct therapy. In particular, treating snake bites often entails the use of antivenom to stabilize the affected animal, then HBOT to prevent tissue at the site of the bite from deteriorating.
Whether HBOT is the primary therapy or an adjunct, its applications are well-established in medicine, and more practitioners along the continuum of care are taking advantage of its healing and rehabilitative powers. In fact, the primary criticism in many medical journals is not whether or not HBOT works for these cases, but whether or not patients and providers have sufficient access to hyperbaric oxygen tanks.
Although their list of applications and body clinical evidence is constantly growing, they have not yet become a ubiquitous feature of medical clinics. In the same way that MRI machines and X-Ray equipment are common but not universal--depending on the size, location, and public or private status of the clinic--so too are hyperbaric oxygen tanks sometimes stuck on the wish list of doctors and administrators.
Fortunately, in recent years their value has been recognized by insurers as well as policy makers, enabling more caregivers and patients alike the opportunity to access and benefit from hyperbaric oxygen therapy.