Ultimate Guide to Hyperbaric Oxygen Therapy

Introduction

Hyperbaric oxygen chambers are vessels in which patients breathe pure oxygen at pressures up to three times greater than normal atmospheric pressure.

Hyperbaric oxygen chambers were originally used to treat deep sea divers suffering from decompression illness, but have experienced a rise in popularity as the ongoing benefits of hyperbaric treatment continue to be discovered.

Although oxygen therapy may still be a novelty to many, the concept is certainly not new. Documentation shows that breathing hyperbaric oxygen as therapy has been around for nearly 350 years. It wasn’t until the mid-1800s that clinical use of hyperbaric oxygen therapy started. Decades later, the military successfully developed and tested hyperbaric chambers for purposes related to deep sea diving and aeronautics.

In a complex and sometimes crowded marketplace, however, it can be difficult to research and choose the right hyperbaric chamber for your needs.

Whether you're a medical professional looking to add to your facility, an individual looking for the right home hyperbaric chamber or just beginning your dive into hyperbaric research, RehabMart’s Ultimate Guide to Hyperbaric Oxygen Therapy wants to equip you with the knowledge to successfully navigate your journey.

Browse our guide below, and click through the pages listed to learn everything you need to know about this remarkable and versatile therapy!

Hyperbaric Oxygen Therapy (HBOT) 101

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy is a medical treatment that entails the use of oxygen at increased pressures for therapeutic purposes. The treatment is administered in hyperbaric chambers, and usually involves the circulation of pure oxygen. 

What is the difference between hyperbaric oxygen therapy (HBOT) and mild hyperbaric oxygen therapy (mHBOT)?

The difference is simple, and boils down to the level of oxygen in the pressurized chamber environment.

Mild hyperbaric oxygen therapy (mHBOT) generally involves a pressure protocol up to 1.3 ATA, or 4 psi. This pressure increase is mild, and is only slightly greater than what is experienced at sea level.

High-pressure hyperbaric oxygen therapy involves pressure above 1.5 ATA, and contains a substantially greater percentage of oxygen than ambient air. Users may achieve different levels of atmospheric pressure depending on the type of hyperbaric chamber utilized. Types of HBOT chambers include monoplace, multiplace and portable chambers, which we will discuss in the sections to come.

 

How does hyperbaric therapy work?

Hyperbaric technology involves increasing the air pressure inside of the hyperbaric chamber, enabling the body to absorb more oxygen per volume of compressed air.

Normally, the human body transports breathable oxygen through the bloodstream. Oxygen is carried in the hemoglobin of red blood cells. When an individual inhales pressurized air containing a higher concentration of oxygen, that oxygen is also driven into the body’s fluids, where it intensely saturates the tissues and organs.

This increased pressure can also send oxygen to the hard-to-reach places in the body, including areas of injury aggravated by damaged circulation. An example of this would be in the event of a stroke, where blood and oxygen are hindered from reaching important sections of the brain.

How often do most people receive HBOT treatment?

Frequency of usage varies, and is largely dependant on a doctor’s assessment of the user’s medical background and the user’s desired treatment outcome. Generally, many people report seeing results after completing a treatment plan of two sessions a day, five days a week.

At a minimum, individuals seeking effective hyperbaric oxygen therapy results should commit to three sessions per week.

After 40 sessions, it’s often wise to review progress and adjust session frequency as needed.

Read more about navigating hyperbaric therapy with your healthcare provider here.

Hyperbaric Chambers and What to Look For 

What is the difference between hard hyperbaric chambers and soft hyperbaric chambers?

Hard hyperbaric chambers (those traditionally used in HBOT) are typically made of steel, and most commonly found in a hospital or clinical environment. Soft chambers (mHBOT) are usually purchased by private individuals for their portability, compact size and ease of use.

Hard (or steel) chambers are often connected to an oxygen tank outside the clinic building that supplies the hyperbaric chamber with 100% pure oxygen. Due to their modified design, mild hyperbaric chambers will never reach 100% oxygen density and saturation. 

What pieces and parts are sold with hyperbaric chambers?

All of Rehabmart’s mild HBOT chambers are shipped with the internal wire frame, air compressors, and an internal mattress.

Essentially, the chamber will arrive with all required components necessary for full chamber operation.

Oxygen concentrators are sold separately, and require a prescription.

Is there a chamber available to accommodate larger adults?

This depends on the individual’s size and comfort preferences. The hyperbaric chambers available on Rehabmart.com come in a variety of internal diameters, so it is important to reference the size of the chamber you are considering for purchase.

How do I clean my hyperbaric chamber?

It is always best to consult the manufacturer’s recommendations; however, most chambers can be wiped down inside and out with a damp cloth. Cleaning works best with a mild hypoallergenic soap and water mixture.

Do not use bleach or harsh chemicals on the chamber bladder. Dry chamber after cleaning.

Any chamber covers may be laundered according to the manufacturer’s instructions.

What to Know about Oxygen and Air Pressure in Hyperbaric Chambers

Will a hyperbaric chamber always be filled with 100% pure oxygen?

Yes and no. Mild hyperbaric chambers (mHBOT) are inflated to their standard operating pressure using ambient air, at a pressure slightly greater than found at sea level.

Conversely, only medical grade hyperbaric oxygen chambers are pressurized with 100% pure oxygen. Medical grade HBOT chambers may only be operated by specially trained technicians working under the supervision of a physician.

Uses of Hyperbaric Oxygen Therapy

What conditions is hyperbaric oxygen therapy used to treat?

The following is a list for all FDA-approved uses of hyperbaric oxygen therapy:

  • Air embolism
  • Gas embolism
  • Acute traumatic ischemia
  • Burns
  • Carbon monoxide poisoning
  • Smoke inhalation
  • Diabetic foot ulcers
  • Exceptional blood loss
  • Decompression sickness
  • Gas gangrene
  • Necrotizing infections
  • Severe anemia
  • Skin grafts and flaps
  • Wound healing

Hyperbaric therapy is also frequently used for the following off-label uses, which has not been cleared by the FDA:

  • AIDS/HIV
  • Alzheimer's Disease
  • Asthma
  • Bell's Palsy
  • Brain Injury
  • Cerebral Palsy
  • Depression
  • Heart Disease
  • Hepatitis
  • Migraine
  • Multiple Sclerosis
  • Parkinson's Disease
  • Spinal Cord Injury
  • Sports Injury
  • Stroke 

What to Expect Your First Time in a Hyperbaric Chamber 

How long does an HBOT session last?

Users can expect the entire hyperbaric session to last around 90 minutes, although the first session may take longer.

Pressurizing and depressurizing the chamber takes about 15 minutes, and the chamber is steadily pressurized for approximately one hour during the treatment.

How does air inside the hyperbaric chamber stay fresh?

Air is filtered and ventilated continuously to minimize any “stuffiness” during the session.

Are hyperbaric chambers comfortable?

Quite. Hyperbaric chambers are well ventilated, and users are allowed to wrap themselves in a blanket if they become cold.

Most treatment centers will request that patients avoid wearing scented perfumes or deodorants prior to treatment, in addition to abstaining from smoking prior to the procedure. This is out of consideration for fellow clients, and to ensure the most comfortable experience for the patient.

What can I do to prepare for my first hyperbaric therapy session?

It is advisable to wear comfortable, loose clothing, as tight garments may contribute to a claustrophobic feeling.

Patients may also wish to bring some form of entertainment. Depending on the hospital or clinic, you may be allowed to bring a book, movie or portable game into the chamber with you, as sessions typically last beyond 60 minutes.

If bringing outside material into the chamber is not allowed, patients may have the option to watch some form of television on a device located just beyond the hyperbaric chamber.

Keep in mind that patients may experience mild discomfort in their ears, as one would during the ascending part of a commercial flight. Fatigue after your first few sessions is not uncommon, and should be temporary.

Related: 8 Ways to Prepare for your First Hyperbaric Therapy Session

Are hyperbaric chambers soundproof?

Most are not; however, the sound made by air compressors may help mask outside noise and translate as soothing white noise. 

Hyperbaric Oxygen Therapy Glossary of Terms

What does mHBOT stand for?

mHBOT stands for Mild Hyperbaric Oxygen Therapy. It is different from high-pressure hyperbaric oxygen therapy due to the lower level of both atmospheric pressure and oxygen delivered to the bloodstream.

What is a “dive”?

Hyperbaric oxygen therapy began as a treatment for the bends, also referred to as decompression sickness. This condition occurs when deep-sea divers ascend for the surface too quickly, not giving the now-pressurized gases trapped in tissues and joints adequate time to expand and safely re-enter the bloodstream.

At times, a hyperbaric treatment session is called a ‘dive’ in reference to this early use.

An oxygen concentrator: what is it, and how is it used?

An oxygen concentrator is a medical device supplying an oxygen-enriched gas stream to hyperbaric chambers. Breathability is achieved by concentrating the oxygen in a pressurized gas supply (typically ambient air), and feeding it into the hyperbaric chamber.

Monoplace Hyperbaric Chambers

Monoplace hyperbaric chambers were first introduced in the 1960s. Made of clear acrylic material and shaped as a cylinder, they were designed to accommodate only one patient.

During the hyperbaric treatment, the monoplace chamber is filled with 100% pure oxygen and atmospheric pressure is increased up to three times higher than ambient air. Transparent walls allow the clinical staff to monitor the patient closely during this process.

One primary disadvantage of a monoplace chambers is the patient being isolated and confined to a relatively small place. It may be a bit difficult to endure a two-hour treatment, especially if the patient is claustrophobic. 

Multiplace Hyperbaric Chambers

Though more expensive than monoplace chambers and requiring more hands to operate, multiplace chambers are a popular option for hospitals and medical centers. Monoplace chambers can hold up to 18 patients, and are used to treat conditions from slow-healing skin grafts and hypoxia to decompression illness and burns. In the chamber, patients may sit in a chair or recline.

In multiplace chambers, patients also breathe oxygen through a face mask, hood, or endotracheal tube.

Medical personnel monitor each patient’s signs and symptoms, and provide drugs and fluids if necessary. Users can enter or exit the chamber during the treatment through doorways, which can be independently pressurized to allow the transfer of patients and medical staff.

One of the biggest advantages of multiplace chambers is their allowance for extended treatment times. As a result of this design, these chambers are best suited for patients in convalescence, and need time to heal.

Portable Chambers

Portable hyperbaric chambers were first designed to be used as emergency treatments. While in transit to a medical facility, medical workers would place the patient - typically a person suffering from decompression sickness - into the portable chamber to get a head start on the treatment process.

Portable chambers are lightweight, inflatable, and operate via an oxygen concentrator.

One distinct difference between small, portable chambers and traditional HBOT is the lack of substantial atmospheric pressure. Generally ranging between 1.3 - 1.5 ATA, patients using portable chambers receive a much milder hyperbaric experience and a lower intake of oxygen when compared to a traditional hard-shell chamber. 

Is Hyperbaric Therapy Right for You?

Do I need a prescription for mHBOT or HBOT?

In order to experience a hyperbaric treatment in a clinical setting with medical-grade equipment, a prescription is necessary.

mHBOT therapy is typically done in-home, where the user administers treatment to themselves. Because hyperbaric oxygen chambers are a Class II medical device, they are moderated regulated by the FDA and require a prescription from a medical specialist for purchase.

While you should inform your doctor if you’re considering mHBOT as a treatment option for your child or loved one, many doctors not familiar with the therapy may initially express resistance to the program.

However, this trend is falling by the wayside as positive results continued to be reported.

Can mHBOT cure autism, cerebral palsy or other conditions?

As of January 2017, HBOT is not FDA-approved for treatment in cases of autism or cerebral palsy.

However, this doesn’t make HBOT unsafe, or unbeneficial. While results depend greatly on the individual case, in most reported instances, children with developmental disabilities undergoing mHBOT have developed skills and abilities previously considered beyond the scope of possibility.

At RehabMart, we see frequent cases in which the child’s and his/her caregiver’s lives are improved after undergoing mHBOT.

Do I need an oxygen concentrator for my hyperbaric chamber to work?

Your hyperbaric chamber will function properly without an accompanying oxygen concentrator, but the decision to enrich your oxygen intake while receiving hyperbaric oxygen therapy is one that should be made between you and your doctor.

If a user’s doctor prescribes an oxygen concentrator, the user can increase the oxygen density inside their home hyperbaric chamber.

If a patient receives hyperbaric oxygen therapy at a hospital or in a clinical environment, it is likely that the hyperbaric chamber will be pumped with air from an oxygen tank. This tank is typically stored outside the building and operates using 100% pure oxygen, pressurizing the chamber to a prescribed psi.

Mild hyperbaric chambers for home use pressurize and inflate with ambient air, which contains 21% oxygen (at sea level). The FDA has approved mild hyperbaric chambers for certain uses under the condition that they’re pressurized with ambient air.

While the amount of oxygen in a mild hyperbaric chamber will never reach 100%, users may purchase a prescribed oxygen concentrator to increase oxygen density within the chamber.

Why would a doctor prescribe an oxygen concentrator?

Research has shown positive results using mHBOT for many conditions when the individual is treated with additional oxygen delivered via an oxygen concentrator.

However, evidence suggests different protocols are necessary, depending on the psi and the model of oxygen concentrator.

I don’t need to use HBOT for treatment of any FDA-approved purposes. Can hyperbaric oxygen therapy help me with personal fitness and wellness goals?

Hyperbaric oxygen therapy is used by people from all walks of life, including professional athletes and mountain climbers, who find hyperbaric oxygenation helps with sports recovery, prevents muscle fatigue, and decreases the buildup of lactic acid.

Because the exposure to pure oxygen is widely beneficial in ways not limited to the treatment of sickness or injury, many people chose to purchase hyperbaric therapy chambers simply to add to their quality of life.

What are the most common uses for mild hyperbaric chambers (mHBOT)?

In children, the most common mHBOT uses include the following: developmental disorders (autism, cerebral palsy), anoxic brain injury, traumatic brain injury, and general autoimmune disorders.

mHBOT chambers are desirable for small children especially due to the flexibility it affords both the patient and the parent/caregiver. By having a mHBOT unit for in-home use, the family is able to ultilize treatment at their discretion, rather than schedule a session at a clinic or hospital.

Especially for families in which a child is living with a disability, this can greatly increase convenience and the amount of time the child is able to spend in the chamber environment overall. 

In adults, the most common mHBOT uses include oxidative stress, treatment of sports injuries, assistance in sports recovery (muscular fatigue and soreness), autoimmune disorders, stroke, nonhealing diabetic wounds, and peripheral vascular disease.

Safety, Side Effects and Risks of Hyperbaric Oxygen Therapy

Is hyperbaric oxygen therapy safe?

Yes! Very few safety complications have ever been reported.

Many visitors to hyperbaric centers report only mild topical discomfort, similar to the ear pressure you feel in an ascending or descending airplane. This kind of inner ear/sinus pressure can be minimized by altering the atmospheric pressure inside the chamber at a slower rate.

Discuss any concerns you might have with your treating physician or a hyperbaric technician.

Is hyperbaric therapy safe for the elderly?

Yes. Hyperbaric therapy can be very beneficial to individuals farther along in years, even contributing to reduced signs of aging.

New research indicates hyperbaric oxygenation slows apoptosis, or cell death - the leading component of visible aging.

Is HBOT/mHBOT painful?

No. HBOT/mHBOT is painless and noninvasive. As long as users can handle the air pressure change normally experienced on a commercial aircraft, they can tolerate HBOT.

Severely claustrophobic people may have some difficulty in a hyperbaric chamber, but a hyperbaric technician can teach techniques to relieve pressure and alleviate any discomfort.

Are there any long-term side effects of HBOT?

After long-term treatments, some patients report vision changes, but this is temporary. Visual acuity returns to normal within three to four months after ending HBOT treatment.

Is there any reason someone should not use a hyperbaric chamber?

Do not enter a hyperbaric chamber if you are under the influence of intoxicants, if you have ear canal problems or an ear infection, or if you are experiencing symptoms of a cold/influenza.

It is also a good idea to refrain from wearing strongly scented perfumes or other products, out of consideration for the next user and to maintain a neutral sensory environment. 

For Health Care Providers

Can I legally use an oxygen concentrator with a mild hyperbaric chamber?

Since oxygen is considered a drug by the FDA, oxygen must be prescribed by an MD, DO or DDS in the United States. Therefore, an oxygen concentrator should only be used when it is prescribed by a physician.

It is the patient’s responsibility to obtain a prescription and seek consultation for their in-home mild HBOT treatment protocol.

RehabMart is passionate about connecting patients and individuals with easy to understand information regarding the many benefits of Hyperbaric Therapy.

For continued reading on the many uses and benefits of HBOT, read our article 11 Ways Hyperbaric Oxygen Therapy Can Change Your Life, explore the leading brands of hyperbaric chambers with our Hyperbaric Chamber Brand List, or explore our transcribed video library here.

More Resources

9 Hyperbaric Oxygen Therapy Success Stories

What Does the FDA Say About Hyperbaric Oxygen Therapy?

8 Ways to Prepare for Your First Hyperbaric Oxygen Therapy (HBOT) Session

What is a Hyperbaric Chamber and What Does it Do?

Hyperbaric Chambers on Rehabmart.com

 

Mike Price, OT, CTO Rehabmart.com

Author:

Mike Price, OT, CTO Rehabmart.com

Co-Founder of Rehabmart and an Occupational Therapist since 1993. Mike has spent his professional career working in multiple areas of Occupational Therapy, including pediatrics, geriatrics, hand therapy, ergonomics and inpatient / outpatient rehabilitation. Mike enjoys writing articles that help people solve complex therapeutic problems and make better product choices.

If you liked this article, you might like these as well:

11 Ways Hyperbaric Oxygen Therapy Can Change Your Life

13 Interesting Facts About Hyperbaric Oxygen Therapy

8 Ways to Prepare for Your First Hyperbaric Oxygen Therapy Session

9 Hyperbaric Oxygen Therapy Success Stories

Everything You Need to Know If You're Considering Hyperbaric Oxygen Therapy (HBOT)

How Naturopathic Medicine Utilizes Hyperbaric Oxygen Therapy

Hyperbaric Chamber Brand List

Hyperbaric Oxygen Therapy FAQ

Hyperbaric Oxygen Therapy Video Library

Hyperbaric Oxygen Therapy: The Difference Between FDA Approval and FDA Non-Approval

Personal Testimonials: Sophia's Story (Hyperbaric Oxygen Therapy)

The Ultimate Guide to Hyperbaric Oxygen Therapy (HBOT)

Ultimate Guide to Hyperbaric Oxygen Therapy

What is a Hyperbaric Chamber and What Does it Do?

What the FDA Says about Hyperbaric Oxygen Therapy (HBOT)