Hyperbaric oxygen therapy (HBO) is a medical treatment that allows patients to breathe 100% oxygen while lying comfortably inside a pressurized chamber. This oxygen saturation promotes the body's immune and healing responses to renew tissue and heal more rapidly. Increased oxygen therapy is extremely safe and produces no long-term side effects.

Deaconess Medical Center currently offers hyperbaric oxygen therapy treatments to patients with the following approved conditions for which the therapy has been proven effective:

• Radiation Injury
• Soft Tissue Radiation Necrosis
• Osteoradionecrosis
• Hemorrhagic Radiation Cystitis
• Compromised Skin Grafts or Flaps
• Chronic Non-Healing Wounds
• Refractory Osteomyelitis

EMERGENCY INDICATIONS:

• Carbon Monoxide Poisoning
• Decompression Illness
• Gas Gangrene
• Acute Gas Embolism

The Deaconess Regional Hyperbaric Center and Comprehensive Wound Center is on the first floor of Deaconess Medical Center. The center is open from 7 a.m. to 6:30 p.m., Monday through Friday, and can be reached by calling 473-7005. A patient must be referred to the center by his or her doctor.

Deaconess Medical Center’s Hyperbaric Center is under the direction of a doctor trained in hyperbaric medicine. Its staff includes registered nurses who specialize in hyperbaric medicine and wound care.

Hyperbaric oxygen therapy is oxygen, pure and simple.
The air we normally breathe contains 21 percent oxygen, 78 percent nitrogen, and 1 percent carbon dioxide and all other gases. Within a hyperbaric chamber patients breathe 100 percent oxygen that is at one or two times normal air pressure. This process dramatically increases the number of oxygen molecules entering the bloodstream, by up to 2000 percent. This allows oxygen to reach bone and tissue that is normally not accessible to oxygen-carrying red blood cells.

This “hyperbaric” (or high pressure) dose of oxygen offers distinct therapeutic benefits and can be used to treat a variety of illnesses. It may be the primary treatment for some disorders, but it’s often combined with antibiotics and surgery.

Hyperbaric therapy also enhances the function of white blood cells, which fight infection.

Hyperbaric therapy also causes the formation of new capillaries, which are tiny, thin-walled blood vessels. Such formations effectively increase blood flow to a patient’s hands and feet.

Hyperbaric therapy is approved by the American Medical Association and the Food and Drug Administration for the treatment of many conditions including burns, diabetic ulcers and carbon monoxide poisoning, to name a few.

Air or Gas Embolism: Similar to the bends, air or gas bubbles enter arteries or veins causing reduced blood flow, which results in less oxygen being delivered throughout the body.
Carbon Monoxide Poisoning: Carbon monoxide (CO) is a colorless, odorless gas. It is a byproduct of combustion. Carbon monoxide binds to red blood cells, blocking delivery of oxygen to the body. Hyperbaric therapy accelerates the clearance of carbon monoxide from the body, restoring oxygen delivery and preventing or reducing damage to the central nervous system and blood vessels.
Gas Gangrene: This bacterial infection destroys soft tissues, releases toxins into the bloodstream and hinders the body's defense mechanisms. These bacteria prefer low-oxygen conditions. High doses of oxygen through hyperbaric therapy keep the bacteria and its toxin production in check.
Crush Injuries: Injuries from motor vehicle accidents, falls and gunshots frequently have complications. Hyperbaric treatments reduce swelling, improve healing and help fight infection.
Problem Wounds: Wounds may not heal because of low oxygen levels and poor circulation. Foot ulcers in diabetics are one such problem. By increasing oxygen levels within the wound tissues, hyperbaric therapy promotes healing.
Anemia/Blood Loss: In cases where a patient can't accept a blood transfusion for medical or religious reasons, sufficient oxygen delivery (via red blood cells) might be compromised. Hyperbaric treatment increases the oxygen content of existing red blood cells.
Intracranial Abscess: A sinus infection or bone infection of the skull may form an abscess within the skull or brain. Antibiotics may be ineffective and white blood cells require a minimum oxygen level to kill bacteria. Hyperbaric treatment provides oxygen for white blood cells and inhibits bacteria that need low oxygen levels to grow.
Soft Tissue Infections: These are serious infections -- in which tissue is dying -- that may be complicated by conditions such as diabetes or vascular disease. While primary treatments are removing the infected tissue and administering antibiotics, hyperbaric oxygen may inhibit bacteria from growing and enhance the ability of white blood cells to kill bacteria.
Bone Infections: Osteomyelitis, infection of the bone that does not respond to standard treatment, may benefit from hyperbaric oxygen. It inhibits bacterial growth, increases the killing power of white blood cells and enhances the effects of some antibiotics.
Radiation Therapy Complications: Chronic complications of radiation therapy used to treat cancer may result from scarring and narrowing of the blood vessels. Hyperbaric treatment allows more oxygen to reach these damaged areas and helps prevent tissue from dying for lack of blood and oxygen flow. It is most often used in the head and neck areas.
Skin Grafts: The success of transferred skin grafts or flaps (which might include skin, deeper tissue, muscle and bone) is largely dependent on sufficient oxygen supply to the affected area. Hyperbaric treatment can be used to saturate the area with oxygen before and after grafting.
Burns: Hyperbaric therapy is sometimes used to treat burns on the hands, face or groin area, or for deep second-degree and third-degree burns that cover more than 20% of the patient's body. Hyperbaric oxygen reduces swelling, limits progression of the burn injury (which continues 3-4 days after the initial injury) and may diminish lung damage from inhalation of heat and smoke.

You will lie comfortably in the hyperbaric oxygen chamber for approximately 90 minutes. Our care team technicians watch the chamber during treatment and can talk to you through a two-way communication system. A physician is also present in the hyperbaric unit at all times during treatment.

The first thing patients notice is that the chamber is noisy. The temperature in the chamber rises during compression. This is quite normal.

Generally, you’ll feel no differently than if you were lying in your own bed. The chamber is large enough for you to sit up comfortably. You can listen to music, watch TV or nap throughout the therapy. Patients will be supplied with drinking water in a plastic bottle to take into the chamber.

During certain parts of the treatment, you may experience a sensation of fullness in your ears – similar to when you’re flying in an airplane or driving down a mountain – as your eardrums respond to pressure changes. Prior to treatment, you will be taught several easy methods to avoid ear discomfort. If there are any problems, the technicians can slow the rate the chamber is pressurized to make clearing the ears easier.

It is best to go to the restroom before going into the chamber, as the restroom is not easily available. If this causes you concern, please speak to the care team staff.

The benefits of hyperbaric oxygen therapy result from oxygen-enriched blood and not from the oxygen’s direct contact with wounds. This is why wound dressings are usually left in place during treatment.

The number of treatments
The number of treatments you receive depends on your individual needs. Wound healing cases may require 20 to 30 treatments for maximum benefit. Your team at the Comprehensive Wound Center will discuss your treatment course with you in detail before therapy begins. The exact number of treatments will be determined by your response to hyperbaric oxygen therapy. Outpatients are normally treated once a day, five or six days a week.

Aftereffects are minimal
Hyperbaric oxygen therapy usually has no aftereffects. Some patients report a “crackling” in their ears between treatments. This can be relieved the same way ears are cleared of pressure changes during treatment. (If the “crackling” continues, report this to the staff.) Some patients may experience lightheadedness for several minutes after treatment, but this will soon pass, allowing resumption of normal daily activities. On rare occasions, patients may develop temporary changes in eyesight. In these cases, any altered vision usually returns to pretreatment levels within six to eight weeks after treatment ends. Like all medical treatments, hyperbaric oxygen therapy presents some risks, but these are quite rare and will be discussed with you before you consent to therapy.

No smoking
This applies to cigarettes, cigars, pipes, and snuff. The chemicals and gases produced by smoking constrict blood vessels, and limit the delivery of blood and oxygen to the body's tissues.

List all medications
It is very important that you provide a complete list of all medications, both prescribed and non-prescription, you are taking to the care team. Since some medications change the body's response to oxygen, the care team will discuss your individual medications with you prior to therapy. If your medication changes during a course of treatment, please tell the staff so they can change your medical record.

Delay for illness
Patients with cold or flu symptoms (like fever, cough, sore throat, nausea, vomiting, headache, diarrhea or generalized body aches) should immediately notify a hyperbaric staff member. These symptoms may require a temporary delay in your treatment schedule.

Clothing is provided for treatment
A 100 percent cotton gown or hospital scrubs will be provide for you to wear during treatment. Wear only the clothing provided by the hyperbaric staff. Non-cotton garments may cause static electricity. Lockers are provided for your clothing and other items. Please do not bring valuable items to the hyperbaric facility.

What to leave at home
Do not wear plastic accessories, petroleum or alcohol-based lotions, perfume or oils. Leave all flammable materials at home. Jewelry, metallic items, reading materials, hair spray, make-up and hearing aids are prohibited inside the chamber. Remove dentures, partial plates, and hearing aids. You may also be asked to remove contact lenses. Glasses are permitted in the chamber.