Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is a
type of treatment used to speed up healing of carbon monoxide poisoning, gangrene, wounds
that won’t heal, and infections in which tissues are starved for oxygen.

If you have this therapy, you will
enter a special chamber to breathe in pure oxygen in air pressure levels 1.5 to 3 times
higher than average. The goal is to fill the blood with enough oxygen to repair tissues and
restore normal body function.

Facts about hyperbaric oxygen therapy

Hyperbaric oxygen therapy was first
used in the U.S. in the early 20th century.

The therapy was tried again in the
1940s when the U.S. Navy used it to treat deep-sea divers who had decompression
sickness. By the 1960s, the therapy was also used to treat carbon monoxide

Today, it’s still used to treat
sick scuba divers and people with carbon monoxide poisoning, including firefighters and
miners. It has also been approved for more than a dozen conditions ranging from burns to
bone disease, including:

  • Carbon monoxide poisoning

  • Cyanide poisoning

  • Crush injuries

  • Gas gangrene (a form of
    gangrene in which gas collects in tissues)

  • Decompression sickness

  • Acute or traumatic reduced
    blood flow in the arteries

  • Compromised skin grafts and

  • Infection in a bone
    (osteomyelitis) that doesn’t respond to other treatment

  • Delayed radiation injury

  • Flesh-eating disease
    (necrotizing soft tissue infection)

  • Air or gas bubble trapped in
    a blood vessel (air or gas embolism)

  • Chronic infection called

  • Diabetic wounds that are not
    healing properly

Medicare, Medicaid, and many
insurance companies generally cover hyperbaric oxygen therapy for these conditions, but
may not do so in every case. Check with your insurance plan to see if it is covered and
if you need pre-authorization before treatment.

Be aware that HBOT is not considered safe and effective for treating
certain conditions. These include: HIV/AIDs, brain injury, heart disease, stroke,
asthma, depression, spinal cord injury, and sports injuries.

How does HBOT work?

  • HBOT helps wound healing by
    bringing oxygen-rich plasma to tissue starved for oxygen.
    Wound injuries
    damage the body’s blood vessels, which release fluid that leaks into the tissues
    and causes swelling. This swelling deprives the damaged cells of oxygen, and
    tissue starts to die. HBOT reduces swelling while flooding the tissues with
    oxygen. The higher pressure in the chamber increases the amount of oxygen in the
    blood. HBOT aims to break the cycle of swelling, oxygen starvation, and tissue

  • HBOT prevents “reperfusion
    This is the severe tissue damage that happens when the blood
    supply returns to the tissues after they have been deprived of oxygen. When blood
    flow is interrupted by a crush injury, for instance, a series of events inside the
    damaged cells leads to the release of harmful oxygen radicals. These molecules can
    do damage to tissues that can’t be reversed. They cause the blood vessels to clamp
    up and stop blood flow. HBOT encourages the body’s oxygen radical scavengers to
    seek out the problem molecules and let healing continue.

  • HBOT helps block the action of harmful bacteria and strengthens the body’s immune system. HBOT can disable the toxins of certain bacteria. It also increases oxygen concentration in the tissues. This helps them resist infection. In addition, the therapy improves the ability of white blood cells to find and destroy invaders.

  • HBOT encourages the formation of
    new collagen and new skin cells.
    It does so by encouraging new blood vessel
    to grow. It also stimulates cells to produce certain substances, like vascular
    endothelial growth factor. These attract and stimulate endothelial cells needed
    for healing.

Types of hyperbaric oxygen chambers

Hyperbaric oxygen therapy uses 2 types of chambers:

  • Monoplace chamber. This is a
    chamber built for 1 person. It’s a long, plastic tube that looks like an MRI
    machine. The patient slips into the chamber. It’s slowly pressurized with 100%

  • Multiplace chamber. This
    chamber, or room, can fit 2 or more people at once. The treatment is largely the
    same. The difference is that people breathe pure oxygen through masks or

What happens during HBOT

Only a healthcare provider should
prescribe HBOT. A number of hospitals offer these chambers. People relax, sit, or lie
comfortably in these chambers and take deep breaths. Sessions can last from 45 minutes
up to 300 minutes, depending on the reason for the treatment.

Your ears may feel plugged as the
pressure is raised, like when you’re in an airplane or the mountains. Swallowing or
chewing gum will “pop” the ears back to normal.

Your blood carries the extra oxygen
throughout the body, infusing the injured tissues that need more oxygen so they can
start healing. When a session is done, you may feel lightheaded. Mild side effects
include claustrophobia, fatigue, and headaches. Always have someone drive you home after

Several sessions may be needed, so check beforehand to see whether your insurance company, Medicaid, or Medicare covers the cost.


Hyperbaric oxygen therapy is not
for everyone. It shouldn’t be used by people who have had a recent ear surgery or injury
, a cold or fever, or certain types of lung disease. 

The most common complication after
HBOT is trauma to the middle ear. Other possible complications are eye damage, lung
collapse, and sinus problems. In rare, severe cases, a person can get oxygen poisoning.
This can lead to seizures, fluid in the lungs, lung failure, or other problems.
Considering the possible risks and benefits, the decision to use hyperbaric oxygen
therapy must be carefully made after a discussion with your healthcare provider.