Hyperbaric Oxygen (HBO) Therapy

Hyperbaric oxygen therapy is a medical treatment used to manage a limited but diverse number of illnesses and diseases. It is the primary treatment in some cases but is commonly employed in conjunction with other medical care and surgical procedures.

How does hyperbaric oxygen therapy work and what can it treat?

This form of treatment uses a hyperbaric (high-pressure) chamber to produce very high levels of oxygen in the blood and tissues of the body.

These levels of oxygen, not achievable without a chamber, result in several direct and delayed healing effects.

Key immediate effects include:

  • Support of critically damaged tissues, such as extremity crushing injuries
  • Support of poorly oxygenated skin flap and skin graft procedures
  • Elimination of toxic carbon monoxide
  • Resolution of gas bubbles in divers suffering decompression sickness

Most commonly, hyperbaric oxygen therapy is employed for its ability to generate healing responses over time. Patients who would benefit from this process are those who have lower extremity ulcers and wounds that have failed to heal despite standard care. Some of these cases will likely benefit from the addition of hyperbaric oxygen therapy if a lack of oxygen supply at the wound or ulcer can be demonstrated. An important part of the evaluation of patients by the hyperbaric medicine team is a simple noninvasive test to see if oxygen levels are in need of improvement.

Another important category of patients who will benefit from this enhanced healing capability are those who have been treated with radiation therapy for cancer. Many months to several years later, a small percentage of patients will develop bone and soft tissue wounds at their site of previous radiation. These wounds can be readily visible on the skin surface or found deep within the body’s various organs by specialized assessment techniques.

Hyperbaric oxygen therapy has evolved to become an important standard of care for these late radiation complications.

What conditions may lead to a referral for hyperbaric oxygen therapy?*

  • Acute carbon monoxide poisoning
  • Cerebral arterial gas embolism
  • Chronic osteomyelitis
  • Clostridial myonecrosis
  • Crush injury; compartment syndrome
  • Compromised skin grafts and skin flaps
  • Decompression sickness
  • Enhancement of healing
  • Exceptional blood loss anemiaIntracranial abscess
  • Late radiation tissue injury
  • Necrotizing soft tissue infections
  • Sudden sensorineural hearing loss
  • Thermal burns

*Undersea and Hyperbaric Medical Society, 2013

How are patients referred?

Patients are referred for hyperbaric medicine evaluation and treatment recommendations by either their primary or specialty physicians.

In those with an urgent need to undergo hyperbaric oxygen therapy, including patients requiring advanced monitoring and other critical care support, Sentara Leigh Hospital is open 24 hours a day, seven days a week. For the more stable patients, all Sentara hyperbaric facilities are equally suitable and readily available.

How are treatments administered?

Patients will typically spend two hours inside the clear pressurized hyperbaric chamber once daily, five days weekly, for wound healing problems. Depending upon several factors, the treatment course will range from between 20 and 40 treatments. Some more urgent conditions may resolve with a single treatment. During each treatment patients are constantly monitored by a physician and nurse team. Patients typically watch TV, listen to music or nap.

What do treatments feel like?

Hyperbaric oxygen therapy is a comfortable and generally well-tolerated procedure. Patients will experience a sensation of fullness in their ears during the several minutes of chamber pressurization. This sensation is largely identical to that experienced while flying in an airplane or driving down a mountain, as the eardrums respond to changes in pressure. Patients are taught how to effectively manage these changes. There may be a very slight warming sensation as the treatment begins and a corresponding cooling towards its end. Every effort is made to ensure patient comfort.