Patched Up!: Hyperbaric Oxygen Therapy Unraveled

By Dr. Lance Davis, Medical Director, Roper Hospital Undersea and Hyperbaric Medicine

The small but medically important field of Hyperbaric Oxygen Therapy (HBO) remains a source of interest and confusion. HBO is the use of pressurized oxygen to heal a very specific list of injuries or conditions. The length and number of treatments depends on the condition and its severity. 

When properly administered, HBO can be a remarkably effective component of a treatment plan for some patients. However, like all therapeutics and medical procedures, it does come with some risks and precautions.

For example, governing bodies have approved HBO for a small list of emergency and chronic (longer term) conditions and medical studies have demonstrated positive outcomes for those patients. Emergency conditions include many associated with scuba diving such as decompression sickness (the bends) and gas embolisms (air bubbles in the circulation). Other emergencies qualifying for HBO treatment include Carbon Monoxide poisoning, necrotizing fasciitis (flesh eating infections), gangrene and surgical flaps and grafts that are at risk.

Chronic conditions benefiting from HBO can include radiation damage from cancer treatment, severe diabetic wounds of the lower extremities, and resistant bone infections.

HBO has not been shown to be helpful for conditions such as autism, cerebral palsy, strokes, infertility or fibromyalgia. Beware of claims on the internet or in some outpatient settings that state otherwise.

Concerns about HBO

Although most HBO is delivered safely with a very low rate of serious complications, a high-pressure oxygen chamber does bring certain risks into play. That is why it is important to work with your doctor to locate an HBO center that is certified by The Undersea and Hyperbaric Medical Society (UHMS) which is an international, non-profit organization. The Roper St. Francis Hyperbaric & Underseas Medicine (HBO) department is certified by the UHMS, with distinction, and is also regulated under the direction of an experienced doctor.  The medical staff is trained to recognize proper indications for the use of HBO, and to treat patients safely and appropriately.

There are hyperbaric facilities that have different levels of oversight and accreditation. Some are outpatient facilities with limited oversight, while others serve as fully accredited, hospital-based departments which are on call for emergency and chronic cases.

Many people have seen the news reports about two HBO accidents that contained explosions and fires. Both occurred in Florida and both were in non-accredited facilities with minimal third-party oversight. To date there have been no serious safety hazards in any HBO facilities accredited by the UHMS. We welcome any questions you may have about this form of treatment.

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