Summary: Brief user guidance about Hyperbaric Oxygen therapy. Discusses rules and regulations, precautions, dosages, etc. for the actual user and attendants. See the HBO page for details on Hyperbaric Oxygen Therapy. Last updated September 25, 2011
What is HBO Therapy ?
We have heard that when a deep sea diver comes up too fast from great depths, then gasses dissolved into his blood under pressure start to bubble out of solution, causing air embolus, that causes severe pain and may even cause death. These divers are immediately placed inside a pressure chamber where air pressure is kept at deep sea level, and then released slowly to enable gasses to dissolve out harmlessly and out of lungs. These chambers are now being used therapeutically in Multiple Sclerosis, and now in cerebral Palsy.
By Definition, Hyperbaric Oxygen Therapy involves intermittent inhalation of 100% Oxygen under a pressure exceeding that of the atmosphere (Committee on Hyperbaric Medicine (1976 ); Undersea & Hyperbaric Medical Society , USA ).
How does HBO-work?
Loss of function to the brain is due both to tissue destruction
(irreversible) and to tissue swelling, which can be reversed. Humans use
only up to 20% of their brain capacity throughout their lives, and it has been
shown that dormant cells around the destroyed areas can be revived and taught to
take over the function of the dead cells.
An increased amount of oxygen is necessary to heal these capillaries. Under normal conditions there is a limit to the amount of oxygen that can be carried by the red blood cells to be delivered to the plasma for transference to the tissues (0.3 ml/dl). Moreover, the capillary damage prevents red blood cells getting through to the areas where oxygen is most needed.
However, giving oxygen under increased atmospheric pressure dramatically increases the oxygen carried in the blood plasma (4 to 6 ml/dl : representing a several fold increase). Increasing oxygen intake to the bloodstream actually causes the blood vessels to shrink, reducing the amount of edema and making the blood 'oxygen-rich'. Thus the net result of giving HBO therapy, by both increasing oxygen delivery and decreasing fluid outpouring, is that oxygen-rich plasma is able to run freely into constricted areas of capillary damage in the brain to promote healing.
Scans indicate that, during HBO therapy, capillary healing occurs, fluid leakage is reduced, swelling recedes and effective blood supply is thus restored to previously oxygen-restricted brain tissue.
With the help of exercise and therapeutic treatment, functional ability can begin to be restored, as newly revived brain cells are trained to take over the function of dead cells.
Physiological Changes Main effects of HBOT High pressure ensures greater solubility of gas (Oxygen) in fluid (water content of blood). This blood’s water, with enhanced oxygen in solution, ACTUALLY delivers the gas to cells. HBOT induces Reduced inflammation Reduced swelling New capillary growth from normal to ischemic zones Promotes healing of damaged but not dead areas. Additional Effects of HBOT Increased Fibroblast Proliferation Hehenberger, K. Wound Rep Regen, 1997; 5: 147-50 Increased Bone Mineral Density & Healing Ueng, SWN. J of Trauma; Injury , Infection & Critical Care, 1998; 44(4): 676-81 Angiogenesis Marx, RE. Am J Surg, 11/90; 160: 519-24 Manson, PN. Surg Forum, 1980; 31: 564-66 Epithelialization Uhl, E. Plast Reconstr Surg, 1994; 93: 835-41 Manson, PN. Surg Forum, 1980; 31: 564-66 Ischemic Tissue Oxygen Capacitance Siddiqui, A. Plast Reconstr Surg, 1997; 99: 148-55 Mobilization of Bone Marrow Stem Cells Thom, SR. Am J Physiol Heart Circ Physiol, 2006;290:1378-86. Enhanced Neuro-Plasticity to allow unused areas of brain to take over function of fully damaged areas, and also normalisation of Metabolic Apoptosis & DNA signaling P Harch, Neural Repair & Neuro Rehabilitation Conf. (NR2CON), Ind. Inst. of Technology; Delhi; Sept. 2007
Is it safe? What about the bends?
Generally, there is no danger involved.
Can the parent accompany the child into the chamber?
As long as the parent has the all clear from his/her doctor then this is fine. At the multiplace chamber used by the children of UDAAN, one parent always carries the child and is present throughout, though breathing ordinary air inside the chamber.
Are there any restrictions on who can take part in the therapy?
What equipment do we need?
Access to a Hyperbaric chamber and all the facilities that go with it. This
is the hard part. In India, there is a large chamber at Mumbai (Bombay)
belonging to the navy, and single patient small chambers at a few centers,
mostly belonging to the Armed forces. The first civilian large chamber capable
of taking in 8 sitting or two stretcher cases plus supervisory staff, has come
up at Apollo Hospital Delhi. Abroad, many centers are in operation in
US/UK/Europe, but very few elsewhere. The other main requirement is a 'Free-flow
Oxygen Hood' for your child to wear, and optional 'Screw-fit' adapters for the
hoses. Adult size hoods are easily available but infant size hoods are not
available that easily.
What can't be taken in?
What can be taken in?
How long does each session take?
It depends on whose regime is being followed. At some places, sessions are an
hour at 24 feet below sea level. Allow at least two hours in total. You will
need to get you child comfortable and load in all your toys and books. It also
takes some time to pressurize and de-pressurize the chamber. Once the therapy is
over you will also need to remove everything again.
How long does the entire cycle of treatment last for?
However, at UDAAN, we use a regimen of 40 days at a stretch, with Sundays off. We have been very satisfied with the tolerance, safety and efficacy so far.
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