Abstract Hyperbaric Oxygen Therapy
Abstract
Hyperbaric oxygen therapy (HBOT) involves the inhalation of 100%
oxygen inside a chamber pressurized above sea-level atmospheric
pressure. HBOT substantially increases the amount of oxygen dissolved
in all bodily fluids, including blood plasma, cerebrospinal fluid, and
lymph. Increased oxygen in these fluids provides oxygen directly to
underoxygenated (hypoxic) tissues, supplementing the usual transport
system by hemoglobin molecules in the blood.
As a result of extensive civilian and military medical research,
HBOT has become a standard, Medicare-reimbursable treatment in the
United States for fourteen medical conditions and classes of injury.
HBOT is the primary treatment for acute conditions including carbon
monoxide poisoning, air/gas embolism, and decompression sickness. HBOT
is an accepted adjunctive treatment for both acute and chronic
conditions, including crush injuries, radiation osteonecrosis, and poor
graft healing after severe burns.
Numerous medical studies show low-pressure HBOT to be an effective
treatment for many additional indications in which local or global
tissue hypoxia is present. Nevertheless, for non-medical reasons,
current standard medical practice in the United States does not include
the use of HBOT for these indications.
Among the most significant additional indications for which
low-pressure HBOT is beneficial is brain injury caused by respiratory
hypoxia or other brain insult, such as head trauma or stroke. These
brain injuries produce regions of chronically reduced blood flow
(hypoperfusion) in the brain, with consequent tissue hypoxia in these
regions. SPECT scans have conclusively demonstrated that some neurons
in these regions remain alive but are "idling" in a low metabolic state
which prevents normal function. SPECT scans taken before and after a
series of HBOT treatments have shown that HBOT can revive these idling
neurons in many cases, producing long term improvement in both brain
perfusion and clinical function.
SPECT scans have also shown regions of brain hypoperfusion in
several developmental disorders including Rett Syndrome (RS) and
cerebral palsy (CP). These disorders also share many symptomatic
parallels with hypoxic brain injuries. The primary regions of brain
hypoperfusion seen in RS are the frontal lobes and midbrain, regions
which control functions that are typically abnormal in RS. Given the
improvements in brain perfusion produced by HBOT in both hypoxic and
non-hypoxic brain injuries, HBOT may also be beneficial in treating the
brain hypoperfusion seen in RS, CP, and other developmental disorders.
Early trials of HBOT for CP have produced promising results, and formal
clinical trials are underway.
There is no evidence that low-pressure HBOT has any of the side
effects associated with high-pressure HBOT. Therefore, when an
appropriate low-pressure protocol is used, the risks of HBOT are minor
compared to the potential benefits.
For all these reasons, trials should be conducted to determine
whether low-pressure HBOT can improve the brain hypoperfusion and
functional abnormalities seen in RS. <back
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© 1999 CHARFOOS & CHRISTENSEN, P.C. Updated: January, 2011
