A few months ago, Rose, a friend and a diabetic, was prescribed HBO2 therapy to enhance a slow healing wound on the bottom of her foot. The open wound created more problems for her medical condition including limiting her ability to walk and increasing the possibility of infection. After several months of slow progress, her doctor said, “Your wound looks like it wants to heal. Perhaps we should help it.”
The help that her doctor referred to was four weeks of HBO2 therapy, 90 minutes each day. I was vaguely familiar with the term, HBO2 therapy, and knew that it has been used in medical treatments for years. I also knew that a few years ago, oxygen bar treatments were buzzing as the in-thing to do for the health conscious who could afford them. Many patrons extolled the virtues that the extra oxygen added to their circulatory system. Some sat in chambers and others inhaled it via mask to purge toxins from their system and gain clarity in their thinking.
According to Scottsdale Healthcare [Ref 1], the medical organization that Rose is associated with, HBO2 therapy is defined as a medical treatment that has been successfully used with certain medical conditions including chronic wounds. During HBO2 therapy, the patient breathes 100 percent oxygen at the same time his or her body is under increased atmospheric pressure. The increased pressure and oxygen concentration aids in healing, though treatment effects vary per patient.
Some of the positive attributes associated with HBO2 therapy treatment are:
- Advanced wound healing.
- Increased oxygen delivery to injured tissues.
- Improved infection control.
- Greater blood vessel formation.
- Preservation of damaged tissues.
- Elimination and reduced effects of toxic substances.
- Reduction or elimination of gas-bubble obstructions.
Given Rose’s diabetic condition, one or more of these attributes could certainly enhance the healing process and help close the wound on her foot quicker than just adding compression hosiery and bandages to her feet and legs.
It is important to note that the effects of HBO2 therapy result from an oxygen-enriched bloodstream, and not from the oxygen’s direct contact with wounds. This is why wound dressings are usually left in place during treatment. Scottsdale Healthcare’s Hyperbaric Medicine and Wound Management Center houses Arizona’s largest hospital-based hyperbaric oxygen chamber, which seats up to 12 patients, as well as a single-patient mono chamber. In the multi-person hyperbaric chamber, patients can watch television, a movie, listen to the radio, read or just rest.
I was allowed to go into the chamber with Rose prior to the beginning of the treatment cycle. It was like being in the cabin of an airplane prior to strapping everyone in, closing the door, and pushing back from the gate.
Short History: Although hyperbaric treatment has been around for a while, it’s only been the last 50 years that it has been used more widely for treatment of many medical conditions. The concept of this treatment is somewhere between 400 and 500 years old. However, the first pressurized room used to treat health problems was built by Henshaw, an Englishman, in 1662. Over a century later in 1788, compressed hyperbaric air was put to large scale use in a diving bell for underwater industrial repairs of an English bridge. A French iron shop in 1834 built the first hyperbaric tank under direction of a physician named Dr. Junod. A copper sphere five feet in diameter with the appropriate viewports and compressed air fittings were used successfully with many patients. Hyperbaric enthusiasm spread among the European countries during the next 40 years. Sick people came from America to try the new therapy. [Ref 2]
The first North American hyperbaric chamber was built in 1860. Research and various projects were noted in the first half of the 20th century, however, it has been in the last four decades that great strides have been made in HBO2 research and treatments.
How it works: “Normal” atmospheric pressure that we breathe at sea level exerts approximately 14.7 pounds per square inch (psi), or 760 millimeters of mercury (mmHg) on our bodies and on the surrounding air that we breathe. This is equivalent to one atmosphere absolute (one ATA).
Regular atmospheric air is approximately 79% nitrogen and 21% oxygen, resulting in an oxygen pressure of about 160 mmHg. Hemoglobin is the primary carrier of oxygen to the tissues under normal atmospheric pressure. Hemoglobin is approximately 97% saturated with oxygen and there is a smaller amount of oxygen dissolved in the plasma. Increasing the inspired oxygen alone, cannot improve delivery by hemoglobin, and breathing 100% oxygen at normal atmospheric pressure will only increase the amount of oxygen dissolved in the plasma by a small amount. The amount of oxygen dissolved in the plasma is referred to as the partial pressure of oxygen and is designated as pO2. [Ref 3]
The pO2 is reduced by a complicated transport system between the atmospheric pressure and the mitochondria in the cell that also determines the rate the oxygen is delivered to the tissues. The process or succession of diminishing pO2 is called the “Oxygen Cascade”. The oxygen cascade involves a successive decrease in the pO2 as blood flow leaves the lungs and progresses to the cellular level, such that capillary pO2 is less than 50 mmHg and even lower at the intracellular level.
The most important thing to remember here is that the objective of HBO2 therapy is to increase the pO2 obtained in the gas that is breathed in during treatment. During HBO2 therapy, the pressure is increased two or three times more than normal and you breathe 100 percent oxygen. Most patients are treated at two times the normal atmospheric pressure (two ATA).
The combination of high concentrations of oxygen (100 percent) and increased pressure cause large amounts of oxygen to be dissolved in your blood and other tissue fluids. There can be as much as 10 to 15 times the usual amount of oxygen dissolved in your blood, which gets more oxygen to the rest of your body. It is this increased oxygen that is delivered to injured tissues that enhances wound healing and also improves infection control. This is the help that Rose’s doctor was speaking of.
Veterinary Treatment: If HBO2 is good for humans, can it also work for animals? The answer is YES! It has proven useful in the treatment of acute injuries as well as the enhancement of healing chronic disorders in both small and large animals. It has been used as and adjunct therapy to other medications and procedures.
According to VHO2, the use of HBO2 as an exciting adjunctive therapy has provided veterinarians with another option to significantly improve animal medical care, and has been used in the treatment of multiple conditions in the past decade. VHO2 is a Lexington, Kentucky based manufacturer and global distributor of veterinary hyperbaric oxygen chambers for horses and companion animals (including dogs, cats, pigs and birds) and exotics (including turtles, alpacas, etc.). [Ref 3]
If searching for information on treatment for animals, you’ll find a variety of names including veterinary hyperbaric oxygen therapy (VHBOT), veterinary hyperbarics or even animal/veterinary oxygen therapy in some areas.
Rose’s foot wound is still stubborn, and has not completely healed, however, after four weeks of HBO2 therapy, it has improved significantly and is smaller in diameter than it was before treatment began. The tissue around the wound appears to be thicker, healthier, and has a nice pink color, and less liquid is produced from the wound area.
Rose is happy with her medical progress. Her doctor and I are happy that her wound is becoming smaller and closing up, and we hope her wound is happy, too.
- Hyperbaric Oxygen Therapy, http://www.shc.org/Medical+Services/Wound+Management/Hyperbaric+Oxygen+Therapy#n
- Southeast East Health, http://www.sehealth.org/wound-care/SoutheastHealth.aspx?nd=308
- VHBO2, http://www.vhbo2.com/equine/