In hyperbaric oxygen therapy, a patient is placed in an enclosed clear acrylic chamber into which 100 percent oxygen flows at high atmospheric pressure. The increased pressure in the chamber causes the concentration of oxygen in the bloodstream to rise to 15 to 20 times the normal level. The high levels of oxygen promote the healing of damaged tissues, reduce swelling, reduce air bubble size and discourage bacterial growth.
Originally, hyperbaric therapy was used to treat scuba divers and tunnel workers suffering from decompression sickness. In recent years, however, this therapy has proven beneficial to patients with a variety of other conditions as well.
Mechanisms of Action
Hyperbaric oxygen therapy features several biological actions that promote healing: Hyperoxygenation increases the amount of oxygen in the blood, thus reducing nitrogen and carbon monoxide levels and supplying more oxygen to the tissues. Bubble reduction results from both a direct volume reduction under pressure and a counterdiffusion effect. Reduction in edema occurs because of an adrenergic-like vasoconstriction. The hyperoxygenation compensates for reduction in blood flow. Antimicrobial effect includes inhibition and inactivation of toxins; bacteriostasis; facilitation of white blood cell killing; and improved antibiotic transport. Neovascularization is promoted by enhanced angiogenesis and accelerated capillary formation. Tissue viability is maintained in marginal and ischemic regions.
Indications for Hyperbaric Treatment
Hyperbaric oxygen therapy is effective for treating the following conditions:
- Carbon monoxide poisoning
- Soft tissue radionecrosis
- Problem wounds
- Non-healing diabetic wounds (Wagner scale 3 or greater)
- Decompression sickness
- Compromised skin grafts or flaps
- Chronic refractory osteomyelitis
- Acute traumatic peripheral ischemia
- Anaerobic necrotizing infections
- Air/gas emboli
Hyperbaric Equipment and Standards
Providence Hyperbaric Medicine houses three hyperbaric chambers that can accommodate patients of all ages and conditions. These are the only chambers in the Oregon/southwest Washington region that can adapt to critical care patients with ventilators, intravenous fluid lines and invasive monitors. We adhere to national standards and practice guidelines in hyperbaric medicine, including treatment protocols of the Undersea & Hyperbaric Medical Society.
Comprehensive Team and Resources Physicians, registered nurses and registered respiratory therapists staff Providence Hyperbaric Medicine. Medical director William Spisak, M.D., is one of the Northwest’s leading experts in hyperbaric medicine and wound care. Because we are located within Providence Portland Medical Center, we have immediate access to comprehensive hospital resources, including a vascular lab, surgical consultants, infectious disease specialists, hospitalists and an ICU rapid response team. Providence Diabetes Education program is located nearby on the medical center campus.
Care and Consultation
Our staff provides individualized care for patients and monitors each one carefully. We provide feedback to referring and primary physicians, and make referrals to other disciplines as needed to achieve optimal outcomes for patients. Our physicians are available for consultation to help you determine whether a patient is a candidate for hyperbaric oxygen therapy.