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What is Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy (HBOT) is a therapeutic technique designed to enhance the oxygen levels delivered to the body’s cells. This process involves spending time in a hyperbaric chamber while breathing highly concentrated oxygen at pressures greater than normal atmospheric levels (above 1 atmosphere).

HBOT can be incorporated into an integrated healthcare approach to complement other treatments or utilised as a standalone therapy to support a range of health conditions. By increasing oxygen availability in the body, HBOT aims to optimise cellular function and promote the body’s natural healing processes.

This therapy is widely recognised internationally for its potential to assist in various health and wellness contexts. A typical HBOT session involves exposure to a pressure of 1.4 ATA, tailored to meet individual needs and goals.

Additional Benefits of HBOT:

  • Tissue Repair and Wound Healing: HBOT has been used to support recovery from non-healing wounds, particularly in diabetic patients or those recovering from surgery or injury.
  • Immune System Support: By improving oxygen delivery, HBOT may support the body’s defence mechanisms and reduce inflammation.
  • Cognitive Function: Emerging research suggests that HBOT may benefit cognitive recovery in cases of traumatic brain injuries or age-related cognitive decline.
  • Performance and Recovery: Athletes and active individuals may use HBOT to enhance recovery after intense physical exertion or injury.

How HBOT Works:
Under increased atmospheric pressure, the lungs can absorb significantly more oxygen than they would under normal conditions. This oxygen is then dissolved into the bloodstream and delivered more efficiently to tissues, promoting:

  • Improved blood flow to damaged areas.
  • Enhanced production of collagen and new blood vessels.
  • Reduction of swelling and inflammation.

Hyperbaric chambers are designed with patient comfort in mind, and the process is non-invasive and generally well-tolerated.

Safety and Considerations:
HBOT is generally safe when administered under professional supervision. However, it may not be suitable for everyone. A comprehensive assessment by a qualified healthcare provider is essential to determine if HBOT is appropriate for your specific needs.

How Many Sessions?

The number of sessions is largely driven by the reason you are using the chamber; everyone has different needs and goals, all of which we will assess before your first session. HBOT is a cumulative therapy, so the benefits are seen over time, as the blood oxygen saturation builds. Most people using the chamber start with 10 or 20 sessions, the first 5 of which should ideally be completed over a 7 day period however this is not essential

Worried about feeling claustrophobic?

Our state-of-the-art Hyperbaric Oxygen Chamber is large enough to fit 2 people. Some people look at the chamber and are worried that they might feel too enclosed; however, when completely inflated, there is enough room to sit up without touching the roof of the chamber.

10 Primary Benefits of HBOT

  • Enhanced Oxygen Delivery: Immediate increase in freely available oxygen for tissue utilisation.
  • New Blood Vessel Formation: Encourages angiogenesis, fostering the growth of new blood vessels.
  • Boosted Immune Function: Improves the activity of white blood cells, including neutrophils and macrophages.
  • Nerve Regeneration Support: Promotes healing factors such as VegF, BDNF, and HIF1 for nerve repair.
  • Accelerated Wound Healing: Increases capacity for healing through enhanced production of PDGF, VegF, collagen, and improved circulation.
  • Stem Cell Activation: Stimulates up to an 8-fold increase in mesenchymal and central nervous system stem cells.
  • Reduced Swelling: Vasoconstriction helps minimise oedema and swelling in damaged tissues.
  • Improved Mitochondrial Health: Enhances the size, shape, and number of mitochondria, supporting energy production.
  • Anti-Inflammatory Effects: Decreases inflammatory cytokines while increasing anti-inflammatory cytokines.
  • Microbial Balance: Aids in balancing the microbiome by reducing anaerobic pathogens and increasing beneficial aerobic probiotics.

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Uses for Hyperbaric Oxygen Therapy

While HBOT is widely utilised in other countries for various conditions, any additional uses observed internationally are not recognised or endorsed by the TGA for practice in Australia.

Australia

In Australia, the Therapeutic Goods Administration (TGA) has approved HBOT for a more limited set of conditions:

  • Decompression sickness
  • Certain non-healing wounds, such as diabetic ulcers
  • Carbon monoxide poisoning
Japan

Japan’s approved HBOT conditions reflect the country’s progressive approach to integrating HBOT for a variety of medical contexts. These indications include:

  • Decompression sickness
  • Air or gas embolism
  • Carbon monoxide poisoning
  • Gas gangrene
  • Crush injury and compartment syndrome
  • Acute traumatic ischemia
  • Thermal burns
  • Necrotizing soft tissue infections
  • Radiation tissue damage
  • Compromised skin grafts and flaps
  • Chronic refractory osteomyelitis
  • Intracranial abscess
  • Acute peripheral arterial insufficiency
  • Acute severe anemia
  • Sudden sensorineural hearing loss
  • Retinal artery occlusion
  • Severe brain injury
  • Cerebral palsy (adjunctive therapy)
  • Autism spectrum disorder (exploratory use)
  • Multiple sclerosis (supportive therapy)
New Zealand

In New Zealand, Hyperbaric Oxygen Therapy (HBOT) is utilized to treat a variety of medical conditions. The Christchurch Hyperbaric Medicine Unit, based at Christchurch Hospital, provides HBOT for the following conditions:

  • Air or Gas Embolism: Treatment for gas bubbles in the bloodstream that can obstruct blood flow.
  • Decompression Sickness: Also known as “the bends,” a condition affecting divers who ascend too quickly.
  • Carbon Monoxide Poisoning: Therapy to eliminate carbon monoxide from the body and restore oxygen levels.
  • Gas Gangrene: A severe bacterial infection producing gas within tissues.
  • Necrotising Soft Tissue Infections: Rapidly spreading infections that destroy soft tissues.
  • Crush Injury, Compartment Syndrome, and Other Acute Traumatic Ischemias: Conditions resulting from severe trauma leading to restricted blood flow.
  • Thermal Burns: Treatment to enhance healing in burn injuries.
  • Intracranial Abscess: Management of pus-filled swellings in the brain.
  • Compromised Skin Grafts and Flaps: Support for healing in skin grafts or flaps that are not healing adequately.
  • Delayed Radiation Injury (Soft Tissue and Bony Necrosis): Treatment for tissue damage resulting from radiation therapy.
  • Enhancement of Healing in Selected Problem Wounds: Therapy to promote healing in wounds that are not responding to standard treatments.
  • Refractory Osteomyelitis: Management of persistent bone infections unresponsive to standard therapies.
  • Retinal Artery Occlusion: Treatment for sudden vision loss due to blockage of the retinal artery.

These applications align with international standards and reflect New Zealand’s commitment to utilising HBOT for conditions with substantial clinical evidence supporting its efficacy.

USA

In the United States, the Food and Drug Administration (FDA) has approved HBOT for 14 specific conditions where enhanced oxygen absorption is vital for healing and recovery. These conditions include:

  • Decompression sickness
  • Carbon monoxide poisoning
  • Air or gas embolism
  • Chronic non-healing wounds (e.g., diabetic foot ulcers)
  • Necrotising soft tissue infections
  • Radiation tissue damage (e.g., osteoradionecrosis)
  • Thermal burns
  • Compromised skin grafts and flaps
  • Crush injuries and other acute traumatic ischemias
  • Severe anemia
  • Intracranial abscess
  • Central retinal artery occlusion
  • Acute peripheral arterial insufficiency
  • Acute cyanide poisoning
China

Chinese medical practice incorporates HBOT for a range of both acute and chronic conditions, including:

Emergency Conditions:

  • Acute carbon monoxide poisoning
  • Gas gangrene, tetanus, and other infections
  • Decompression sickness
  • Air embolism
  • Post-cardiopulmonary resuscitation syndrome
  • Shock
  • Brain edema
  • Pulmonary edema
  • Crush syndrome
  • Post-skin transplantation of limbs (fingers, toes)
  • Drug and chemical poisoning
  • Acute ischemic anoxic encephalopathy

Non-Emergency Conditions:

  • Toxic encephalopathy
  • Sudden deafness
  • Ischemic cerebrovascular diseases (e.g., cerebral arteriosclerosis, transient ischemic attack, cerebral thrombosis, cerebral infarction)
  • Craniocerebral injury (e.g., concussion, cerebral contusion, intracranial hematoma removal surgery, brain stem injury)
  • Cerebral hemorrhage recovery
  • Poor healing fractures
  • Central serous retinal inflammation
  • Vegetative state
  • Plateau adaptation insufficiency syndrome
  • Peripheral nerve injury
  • Intracranial benign tumor surgery
  • Periodontal disease
  • Viral encephalitis
  • Facial paralysis
  • Osteomyelitis
  • Aseptic osteonecrosis
  • Cerebral palsy
  • Fetal developmental delays
  • Diabetes and diabetic foot
  • Coronary atherosclerotic heart disease (e.g., angina and myocardial infarction)
  • Rapid arrhythmia (e.g., atrial fibrillation, premature beat, tachycardia)
  • Myocarditis
  • Peripheral vascular diseases (e.g., vasculitis, Raynaud’s phenomenon, deep vein thrombosis)
Germany

In Germany, Hyperbaric Oxygen Therapy (HBOT) is approved for several medical conditions, primarily focusing on those with substantial clinical evidence supporting its efficacy. The recognized indications include:

  • Decompression Sickness: Treatment for divers experiencing decompression illness due to rapid ascent.
  • Air or Gas Embolism: Management of gas bubbles in the bloodstream, often resulting from surgical procedures or trauma.
  • Carbon Monoxide Poisoning: Therapy for individuals exposed to carbon monoxide, enhancing the elimination of the toxin.
  • Clostridial Myonecrosis (Gas Gangrene): Treatment of severe bacterial infections that produce gas within tissues.
  • Necrotizing Soft Tissue Infections: Management of rapidly spreading infections that destroy soft tissues.
  • Chronic Refractory Osteomyelitis: Treatment of persistent bone infections unresponsive to standard therapies.
  • Radiation-Induced Tissue Damage: Management of tissue injuries resulting from radiation therapy, such as osteoradionecrosis.
  • Compromised Skin Grafts and Flaps: Support for healing in skin grafts or flaps that are not healing adequately.

These indications align with the European Committee for Hyperbaric Medicine (ECHM) consensus, which provides guidelines on HBOT applications across Europe.

Below is a growing list of studies supporting the use of HBOT.

This list is not exhaustive, and will continue to grow as we add more information.

Viral & Bacterial Infections

There is sufficient evidence to suggest that HBOT offers valuable advantages, either alone or as an adjunct treatment, for patients with infectious diseases. HBOT promotes the healing of infections by three main mechanisms including direct bacteriostatic or bactericidal effects, enhancement of the immune systems antimicrobial effects, and additive or synergistic effects with certain antimicrobial agents.[2]

Anemia

The mechanisms of action of HBO, including increased systemic plasma oxygenation, can alleviate signs and symptoms of anaemia regardless of its aetiology. HBO administration can greatly enhance the plasma arterial oxygen content, leading to clinical improvement in patients with anaemia who cannot receive blood transfusion.[4]

Sports Injuries & Recovery

The healing of a sports injury has its natural recovery, and follows a fairly constant pattern irrespective of the underlying cause. Three phases have been identified in this process: the inflammatory phase, the proliferative phase and the remodelling phase. Oxygen has an important role in each of these phases[8].

HBO treatment has been reported to reduce post-injury swelling in animals, and in humans; swelling was also mitigated, but to a lesser extent. Positive results have also been reported regarding tissue remodelling after injury, with injuries involving bones, muscles and ligaments showing improved recovery. Furthermore, HBO treatment has effectively increased recovery from fatigue. This was clearly seen at the Nagano Winter Olympics, where sports players experiencing fatigue were successfully treated, enabling the players to continue performing in the games[7].

Fibromyalgia

There is growing evidence that HBOT is a non-invasive way to treat chronic pain diseases with long-lasting efficacy and minor adverse effects.HBOT improves muscle oxygenation in FM, which can reduce the tissue lactate concentration and help maintain ATP levels, thus possibly preventing tissue damage in ischaemic tissue. It raises the oxygen concentration in all tissues far above physiological levels to cause hyperoxia, which breaks the hypoxic-pain cycle in patients with FM. [3]

Rheumatoid Arthritis

Hyperbaric oxygen therapy is effective for joint pain in patients with RA based on data from multiple, validated clinical measures [5]. Findings suggest that HBO2 therapy may be useful as an adjunctive or alternative treatment to disease-modifying drugs for rheumatoid arthritis [6].

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Immune Function

ROS (Reactive Oxygen Species) are important mediators in several pathways, modulating proliferation, survival, apoptosis, and immune response. During HBOT, the whole body compensates to accommodate the increased oxygen stimulus and the higher amount of ROS with a number of adaptive mechanisms. A vasoconstriction response helps modulating the amount of oxygen delivered to the brain and tissues, while endogenous antioxidant defense systems are enhanced to counterbalance the induced oxidative stress. Results seem to suggest that HBOT induces a similar response in protective mechanisms against ROS.

Furthermore, HBO resulted in increased Hemoglobin levels and contributed to immunomodulation [9].

References

  1. Kenneth P. Stoller. All the right moves: the need for the timely use of hyperbaric oxygen therapy for treating TBI/CTE/PTSD,2015 May 28. DOI: 10.1186/s13618-015-0028-0
  2. Mohammad Yousef Memar , Mina Yekani , Naser Alizadeh , Hossein Bannazadeh Baghi. Hyperbaric oxygen therapy: Antimicrobial mechanisms and clinical application for infections, 2019 Jan. DOI: 10.1016/j.biopha.2018.10.142
  3. Jiuhong You,Cheng Huang. Efficacy and safety of hyperbaric oxygen therapy for fibromyalgia: a systematic review and meta-analysis, 2013 Mar. DOI: 10.1136/bmjopen-2022-062322
  4. Kelly Johnson-Arbor, Richard Verstraete. Use of hyperbaric oxygenation as an adjunctive treatment for severe pernicious anaemia in a bloodless medicine patient, 2021 Apr. DOI: 10.1136/bcr-2020-240619
  5. Michelle T Sit, Thomas W Schmidt , Lance D Edmond , Jason A Kelly , Karen M Sky, Jennifer A Thornton , Antoinette M McNeary-Garvin , Stephen R Thom , John B Slade.
    The Effects of Hyperbaric Oxygen on Rheumatoid Arthritis: A Pilot Study, 2021 Dec. DOI: 10.1097/RHU.0000000000001540 
  6. Adam Dulberger , John B Slade , Jennifer A Thornton , Antoinette McNeary-Garvin , Jason A Kelly , Lance Edmonds. The effects of hyperbaric oxygen on MRI findings in rheumatoid arthritis: A pilot study, 2023 First Quarter. DOI: 10.22462/01.01.2023.19 
  7. Yoshimasa Ishii, Masataka Deie, Nobuo Adachi, Yuji Yasunaga, Patrick Sharman, Yutaka Miyanaga, Mitsuo Ochi. Hyperbaric oxygen as an adjuvant for athletes, 2012 Sep. DOI: 10.2165/00007256-200535090-00001 
  8. Pedro Barata, Mariana Cervaens, Rita Resende, Óscar Camacho, and Frankim Marques. Hyperbaric Oxygen Effects on Sports Injuries, 2011 Apr. DOI: 10.1177/1759720X11399172
  9. Gerardo Bosco, Matteo Paganini, Tommaso Antonio Giacon, Alberto Oppio, Alessandra Vezzoli, Cinzia Dellanoce, Tatiana Moro, Antonio Paoli, Federica Zanotti, Barbara Zavan, Costantino Balestra, and Simona Mrakic-Sposta. Oxidative Stress and Inflammation, MicroRNA, and Hemoglobin Variations after Administration of Oxygen at Different Pressures and Concentrations: A Randomized Trial, 1991 Nov. DOI: 10.3390/ijerph18189755