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Information for Health Professionals Modern Hyperbaric Oxygen (HBO) treatment involves the patient breathing pressurised, pure oxygen through a clear hood or a mask while seated in the equally pressurised normal air atmosphere of the hyperbaric chamber. The effect of breathing 100% oxygen at increased pressure is to significantly increase the amount of dissolved oxygen in plasma resulting in a 10-15 fold increase in available oxygen. This produces a four-fold increase in the diffusing distance of oxygen from functioning capillaries. The arterial oxygen values are between 1,500 and 2000 mmHg. Both the pure oxygen and the normal air are at the same pressure - between 2.0 and 2.4 atmospheres for standard treatments. The normal air in the HBO chamber reduces safety risks and means attendant staff can be present at all times. HBO treatment shows significant improvements in healing in a number of conditions and can reduce morbidity dramatically. For example, the risk of amputation for patients with chronic ulcers can be reduced by about half and Intercranial abscess mortality rates dropped from 20% to 2% of patients treated with HBO.
The effects of increased plasma oxygen include: enhanced fibroblast function, improved formation of collagen and capillary angiogenesis in areas of sluggish neovascularization (e.g. late radiation damaged tissue, refractory osteomyelitis and chronic ulcerations in soft tissue). HBO has also demonstrated antimicrobial activity by several mechanisms.
People normally associate hyperbaric medicine with the treatment of divers with decompression illness (DCI) or The Bends. However this constitutes a very small part of our overall patient numbers. Besides DCI, there are a number of other illnesses that benefit from the administration of hyperbaric oxygen. Every 3 years the Undersea and Hyperbaric Medical Society, the scientific "watch-dog" for the discipline based in the USA, convenes a committee that reviews the evidence supporting the use of hyperbaric oxygen in a range of diseases. They publish a list of "established indications", that is, those diseases or conditions for which there is adequate evidence from proper clinical trials to justify the use of hyperbaric oxygen. The last such review was conducted in 2003. The current list of UHMS endorsed indications is as follows: Covered by Medicare and/or various medical insurers:
Not covered by Medicare but covered by one or more medical insurers: In general these are the only conditions treated at the WCHM although there are a few other conditions that are endorsed by the Australia and New Zealand Hyperbaric Medical Group (ANZHMG) that are sometimes treated. Examples of such illnesses include, sudden hearing loss and Retinal Arterial Occlusion. A note about UNESTABLISHED indications for hyperbaric oxygen: Unfortunately there are a few unscrupulous operators of hyperbaric units (mainly but not exclusively overseas) who will treat a wide variety of conditions and/or diseases for which there is little or no data to support the use of hyperbaric oxygen.
Giving false hope to desperate people and charging money for unproven therapy is unethical and this type of practice only draws the discipline into disrepute. Common examples of diseases treated that fall into this unestablished category include cerebral palsy in children, multiple sclerosis, motor neuron disease and sports injuries.
Unless part of an ethically approved study, The Wesley Centre for Hyperbaric Medicine DOES NOT treat unestablished indications. Health Professionals: In the interest of educating fellow health professionals on the indications and use of Hyperbaric Oxygen Therapy, both Dr Bob Long and Kate Smith - CSN are available to attend education programs at institutions and community based programs. Dr. Long often attends Grand Rounds at major teaching hospitals as an invited guest speaker. |
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