From the Guidelines
A hyperbaric chamber is a specialized medical device that delivers oxygen therapy at higher than normal atmospheric pressure, primarily used to treat conditions like decompression sickness, carbon monoxide poisoning, non-healing wounds, and certain infections. The use of hyperbaric oxygen therapy has been proposed as a key mechanism for improving wound healing in diabetes-related foot ulcers with ischemia or hypoxia, as it increases the partial pressure of oxygen in hypoxic or ischemic tissues 1. During treatment, patients breathe 100% oxygen while inside a pressurized chamber, typically at 2-3 times normal atmospheric pressure, with sessions usually lasting 1-2 hours and may be required daily for several weeks depending on the condition being treated. The increased pressure allows oxygen to dissolve more effectively in the bloodstream, promoting healing by reducing inflammation, fighting infection, and stimulating the growth of new blood vessels. Some of the key points to consider when using hyperbaric oxygen therapy include:
- The evidence behind its use is conflicting, but the studies with the lowest risk of bias suggest that there may be some benefit for its use in improving wound healing 1.
- Hyperbaric oxygen therapy should only be administered under medical supervision as it requires careful monitoring and has specific contraindications including certain lung conditions, recent ear surgery, and some medications.
- The treatment is generally safe when properly administered by trained healthcare professionals, but side effects can include ear pain, temporary nearsightedness, and rarely, oxygen toxicity.
- The optimal dose and frequency of hyperbaric oxygen treatments for acute carbon monoxide poisoning remain unknown, and the protocol used and number of treatments administered are left to the discretion of the managing hyperbaric physician 1. It is essential to weigh the potential benefits and risks of hyperbaric oxygen therapy and consider the individual patient's condition and medical history before initiating treatment, as the evidence is not yet conclusive on its effectiveness for all conditions 1.
From the Research
Definition and Description of Hyperbaric Oxygen Chamber
- A hyperbaric oxygen chamber is a device used to deliver hyperbaric oxygen therapy (HBOT), which involves breathing concentrated oxygen at a pressure higher than 1 absolute atmosphere 2.
- The chamber can be either monoplace (for one person) or multiplace (for multiple people), and is used to achieve high-dose oxygen inhalation and diffusion therapy 2, 3.
- Hyperbaric oxygen therapy is typically administered in daily sessions lasting 90-120 minutes, at pressures between 2.0 and 2.5 absolute atmosphere, for a total of 30-40 sessions 2.
Uses and Applications of Hyperbaric Oxygen Chambers
- Hyperbaric oxygen chambers are used to treat various medical conditions, including diabetic foot ulcers 2, decompression illness 4, acute carbon monoxide poisoning 4, gas gangrene, necrotizing soft-tissue infection, and crush injury 4.
- Hyperbaric oxygen therapy also has an adjunctive role in managing severe anemia in patients where blood transfusion is not possible 5.
- Additionally, hyperbaric oxygen chambers can be used in intensive care units to provide life-saving treatment for critically ill patients 3, 6.
Safety and Operational Considerations
- Hyperbaric oxygen chambers must be specifically designed and equipped to allow for patient monitoring and treatment, and should be located in or near the intensive care unit 3.
- The chamber should be operated by a well-trained team of physicians, nurses, and technicians, and all devices used in the chamber must be evaluated and tested for safety 3.
- Hyperbaric oxygen therapy can cause physiological changes that may compromise the patient's state, and therefore requires careful risk-benefit assessment and monitoring 3, 6.