HOC Hyperbaric Oxygenation Therapy (HBOT)
Oxygen is a vital substance that allows our
cells to produce energy and sustain life. Without it, our
bodies can neither function efficiently nor maintain a state
of health. Oxygen typically accounts for about 21% of the air
we breathe, though this may be significantly reduced due to:
- high pollution (leading to
less breathable oxygen)
- stress (causing a constriction
of arterial oxygen flow)
- heart disease (which again
constricts the flow of oxygen)
Vascular diseases are on the rise, and it
has been shown that depleted tissue oxygenation, as well as
the depletion of other vital nutrients, plays a significant
role in this increase. In healthy individuals, red blood cells
are extremely efficient in performing their task of delivering
oxygen to the rest of the tissues in the body. However, as
health declines or as disease processes develop, certain
tissues in the body begin to become severely depleted of vital
oxygen. This can happen gradually, as in chronic disease, or
suddenly, as in a stroke or an incidence of near drowning.
HBOT is normal oxygen delivered under
pressure at higher concentrations for medical and prescriptive
purposes. "Hyperbaric" is any pressure greater than the
pressure at sea level (1.0 ATA). The greater the pressure, the
greater the dose of oxygen delivered. In addition to
pressurization, the percentage of oxygen is increased from
room air (21% oxygen) to a maximum of 100% oxygen.
The limiting factor of oxygenation at normal
pressures (1.0 ATA) is our own blood and tissue physiology. At
1.0 ATA (atmospheres absolute), the red blood cells are able
to carry only a limited amount of oxygen, which includes a
very small percentage (about 3%) dissolved into our blood
plasma. At higher pressures, oxygen is more readily dissolved
in all bodily fluids, including blood, plasma, lymphatic
fluid, cerebrospinal fluid, and interstitial fluid.
This increase in oxygenation helps to
reverse states of tissue oxygen depletion, known clinically as
hypoxia, which is often a leading cause of cellular damage
during disease states.
It is important to understand the difference
in physiology between healthy and injured tissues. Research
has demonstrated that oxygen administered to healthy patients
results in an action called vasoconstriction, meaning that
once their blood vessel walls and surrounding tissues have
been sufficiently saturated with oxygen, the vessels
themselves constrict to restrict the flow of blood to the
tissues. This is a natural protective mechanism of the body,
which aids in reducing the toxicity of too much oxygen to
healthy tissues. However, in damaged tissues, where oxygen
toxicity is less of a concern due to an already depleted state
of tissue oxygenation, the vessels remain open and dilated
until the hypoxic state is reversed. This phenomenon allows
the oxygen to be routed through the body via the pathways in
which it is most needed by the tissues.
At higher pressures (those approaching 3.0
ATA), oxygen's toxic properties are used to fight infections
and cause damage to susceptible cancer cells. These effects
occur in a therapeutic window between the level of oxygen that
is toxic to us as complex human organisms and the level that
is toxic to simpler organisms and single cells such as
bacteria and tumor cells. Research in this area has proven
quite promising and more research is currently underway.
The science of medicinal uses of
concentrated oxygen has been developing rapidly over the past
several years. HBOT provides a means to flush our bodies with
pure oxygen and undo some of the damage caused by breathing
poor quality air. Research has shown that at 1.5 ATA, many of
the regulatory hormones, neurotransmitters, and enzyme systems
operate in a balanced, optimized state. HBOT also produces
several long term health benefits, including enhanced growth
of new blood vessels (angiogenesis), optimization of the
immune system's ability to remove toxins and destroy bacteria,
increase the activity of fibroblasts (the cells responsible
for tissue repair) and enhanced metabolic activity in
previously inactive brain cells.
Oxygen under pressure (HBOT) is a
therapeutic dose of oxygen that is administered as a drug by a
licensed hyperbaric physician. The higher the dose of a drug
(in this case oxygen), the greater the risk for potential side
effects. In this case, the prescription dose of oxygen is
based upon 1) pressurization 2) time and 3) oxygen
concentration. Therefore, an increase in pressurization, time,
or oxygen concentration will all independently increase the
dose of oxygen. With short-term 100% oxygen delivery, the side
effects noticed at 2.0 ATA are relatively minimal compared to
the side effects at 3.0 ATA or higher. At clinical pressures
below 3.0 ATA, clinicians have demonstrated a significant
decrease in the incidence of initial onset oxygen toxicity.
Avoiding and minimizing such toxicity is possible by using
treatment pressures below 3.0 ATA, keeping treatments to 90
minutes or less, and by incorporating regular air (21% oxygen)
periods during HBOT.
Serious complications that have been
observed during HBOT sessions are damage to the ear (barotrauma),
brain (seizures), and lungs (pneumothorax). It must be noted
that these complications are an important issue when HBOT is
performed without medical supervision, and when very high
dosages are used.
HBOT Safety Standards
Scientific research has validated numerous
therapeutic benefits of oxygen administered between 1.0 ATA
and 3.0 ATA. HOC maintains session durations of typically less
than 2 hours and pressures of less than 2.5 ATA (most common
being 60 minutes at 1.5 ATA), causing minimal complications
and side effects. HOC physicians, who are trained in
Hyperbaric Oxygen Therapy, carefully monitor the chambers, and
trained attendants are on hand inside the chambers to prevent
any potential difficulties.
HOC physicians are carefully trained to
minimize the occurrence of these major complications:
1.) Barotrauma: Relatively
non-existent with pressurizations below 2 ATA. Approximately
5% of patients may experience some discomfort in their ears
while initially increasing pressure, similar to ascending or
descending in an airplane. Middle ear discomfort can be
alleviated by alerting one of our attendants who will alter
the pressure gradient. HOC physicians perform a screening
physical evaluation of the integrity of the ears before
treatments begin.
2.) Seizures: HBOT treatments have
been clinically refined to minimize any danger of transient
oxygen toxicity, which manifests primarily as temporary
seizure activity. While toxicity is a very rare occurrence in
the clinical treatment setting, safety protocols as well as
certified hyperbaric physicians serve to minimize the chance
of any potential discomfort. In addition, HOC physicians use
advances in nutritional medicine to reduce the risk of
seizures.
3.) Pneumothorax: HOC physicians take
extra precaution in reducing this risk by using extensive
screening processes and routinely monitoring symptoms. The
dosage of oxygen is then prescribed specifically to the
individual according to risk factors.
Treatment chambers utilizing
pressurized oxygen are currently in use in major hospitals for
the following emergency conditions:
- Air or gas embolism
- Carbon monoxide poisoning or
smoke inhalation
- Gas gangrene/Gangrene
- Crush injury and acute
traumatic ischemias
- Decompression sickness
- Enhanced healing of selected
problem wounds
- Blood loss anemia
- Necrotizing soft tissue
infections
- Refractory Osteomyelitis
- Osteoradionecrosis
- Compromised skin grafts
- Thermal burns
However, HBOT is
also being used worldwide for the treatment of over 130 other
medical conditions. HOC incorporates these scientifically
validated modalities, along with strict guidelines for safety
and cost-effectiveness, to deliver some of the most advanced
treatment protocols available.
The following are just as few of the many
therapeutic applications of HBOT supported by current clinical
research, though classed as "off-label" or investigational:
Brain/Nerve Damage
The brain is a large consumer of oxygen and
requires 500 - 600 ml O2/min (25% of total body
demand). Brain damage can occur when oxygen supply to the
brain is compromised. It only takes 6 seconds without oxygen
to disturb brain metabolism and only 2 minutes to cease brain
activity. When blood supply and oxygen become compromised,
local neurons (brain cells) die or become damaged in a pattern
consistent with the injury. In this immediate area where blood
and oxygen loss has occurred, the neurons quickly die. The
surrounding neurons (the penumbra) also react to the decreased
oxygen levels by shutting down to conserve energy in an
attempt to survive (dormancy period). This often results in an
exaggeration of the symptoms experienced by brain-damaged
patients. While no known treatments are yet able to
resuscitate dead neurons, HBOT serves to re-oxygenate the
dormant neurons in the penumbra and restore a portion of their
previous activity.
Specific Neurologic Conditions
- Stroke
- Cerebral Palsy
- Multiple Sclerosis
- Migraine
- Cerebral Edema
- Multi-infarct Dementia
- Spinal Cord Injury
- Traumatic Nerve Injury
- Brain Abscess
- Peripheral Neuropathy
- Radiation Myelitis
- Vegetative Coma
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