blue flower blooming representing medical oxygen

Chapter 2

The Importance of Pressure and Medical Oxygen in HBOT

The Physics of Pressure in HBOT

Pressure is a cornerstone of HBOT, differentiating it from simply breathing oxygen at normal atmospheric conditions. Here’s why pressure matters:

Increased Gas Solubility: According to Henry’s Law, the amount of gas dissolved in a liquid is directly proportional to the pressure of the gas above the liquid. In HBOT, the increased pressure forces more oxygen to dissolve into the blood plasma and other body fluids.
Reduced Gas Volume: Boyle’s Law states that as pressure increases, the volume of a gas decreases. This principle helps in treating conditions like decompression sickness by reducing the size of gas bubbles in the body.
Enhanced Tissue Penetration: The increased pressure allows oxygen to penetrate deeper into tissues, reaching areas that might be oxygen-deprived due to poor circulation or injury.
Cellular Response: Pressure itself can trigger cellular responses that contribute to healing, such as the up-regulation of growth factors and anti-inflammatory processes.

Pressure

How Increased Pressure Enhances Oxygen Absorption

Importance of Pressure

The combination of pressure and oxygen creates a powerful therapeutic effect:

Hyperoxia: At normal atmospheric pressure, nearly all oxygen in the blood is bound to hemoglobin. Under hyperbaric conditions, the plasma can carry 10-15 times more dissolved oxygen.
Increased Diffusion: The higher pressure gradient between the blood and tissues enhances oxygen diffusion, allowing it to reach oxygen-starved areas more effectively.
Overcoming Diffusion Barriers: In some injuries or conditions, swelling or damaged blood vessels can create barriers to oxygen diffusion. The increased pressure helps oxygen overcome these barriers.
Extended Oxygen Availability: The increased amount of dissolved oxygen in the plasma remains available to tissues for some time after the HBOT session, prolonging the therapeutic effects.

The Critical Role of Pressure
in Safety and Efficacy

Controlled pressure is a fundamental aspect of HBOT that requires careful management to ensure safety and effectiveness:

Precise Control: HBOT chambers must maintain precise pressure levels, typically 1.5 to 3 times normal atmospheric pressure. This precise control is crucial in delivering the therapeutic benefits of HBOT while minimizing risks associated with rapid pressure changes.
Gradual Changes: Pressure changes must be gradual to allow patients to equalize and prevent barotrauma. This careful management of pressure transitions is key in reducing the risk of ear, sinus, and lung injuries associated with pressure changes.
Monitoring: Constant monitoring of chamber pressure is essential for patient safety and treatment efficacy. Advanced monitoring systems allow for real-time adjustments and rapid response to any pressure-related issues, further enhancing safety.
Individualized Protocols: Pressure protocols are often tailored to individual patient needs and conditions, ensuring the safest and most effective treatment possible.

Understanding the role of pressure helps patients appreciate the importance of following all instructions during treatment, particularly those related to equalization techniques and reporting any discomfort.

The Significance of Using Medical-Grade Oxygen

Not all oxygen is created equal. Medical-grade oxygen is crucial for HBOT for several reasons:

Purity: Medical oxygen is typically 99.5% pure or higher, ensuring that patients receive the maximum possible oxygen concentration.
Safety: Medical oxygen undergoes strict quality control to ensure it’s free from contaminants that could be harmful when inhaled at high pressures.
Consistency: The use of medical-grade oxygen ensures consistent treatment outcomes across sessions and between different patients.
Regulatory Compliance: In most jurisdictions, the use of medical-grade oxygen is required for therapeutic applications like HBOT.

Medical Grade Oxygen

The Importance of Medical-Grade Oxygen in Risk Mitigation

HBOT relies on the use of 100% medical-grade oxygen, which is crucial for both safety and effectiveness:

Purity: Medical oxygen must meet strict purity standards (typically 99.5% or higher) to prevent contamination and ensure optimal therapeutic effects. This purity is essential in minimizing the risk of adverse reactions and ensuring consistent treatment outcomes.
Regulation: Medical oxygen is regulated as a drug by agencies like the FDA, ensuring consistent quality and safety. This regulation helps maintain stringent quality control measures, reducing the risk of impurities or inconsistencies that could compromise patient safety.
Delivery Systems: Specialized delivery systems are used to maintain the purity and pressure of the oxygen throughout the treatment. These systems are designed with multiple safety features to prevent oxygen leaks or contamination, further reducing risks associated with oxygen administration.

The use of medical-grade oxygen is non-negotiable in HBOT, as it directly impacts treatment outcomes and patient safety. By ensuring the highest quality of oxygen, many potential risks associated with impurities or inconsistencies in gas composition are effectively mitigated.

The Synergistic Effects of Pressure and Pure Oxygen

The true power of HBOT lies in the combination of increased pressure and pure oxygen:

Exponential Increase in Oxygen Levels: While breathing 100% oxygen at normal pressure can increase blood oxygen content by about 7%, HBOT at 3 ATA can increase it by up to 1500%.
Enhanced Cellular Metabolism: The abundance of oxygen under pressure allows cells to produce more ATP, fueling various healing processes.
Stimulation of Growth Factors: The combination triggers the release of growth factors and stem cells, promoting tissue repair and regeneration.
Antimicrobial Effects: The high-pressure, oxygen-rich environment is hostile to many anaerobic bacteria, enhancing the body’s ability to fight certain infections.

Hbot chamber colour palette design, with blue yellow green

Conclusion

The interplay between increased atmospheric pressure and pure, medical-grade oxygen is what gives HBOT its unique therapeutic properties. By understanding these fundamental principles, we can better appreciate how HBOT works and why it’s effective for a wide range of medical conditions. In the next chapter, we’ll explore the specific benefits and applications of HBOT across various medical fields.

Back To Chapters

CONTACT

US

Tel: 2513 9992 | 2513 9993

A.M.L. 28A Shum Wan Road, Wong Chuk Hang, Hong Kong

VISIT

US

Monday - Friday 9:00 - 18:00

Sat - Sun Closed

(Unless emergency)

TELL

US

References

Thom, S. R. (2011). Hyperbaric oxygen: its mechanisms and efficacy. Plastic and Reconstructive Surgery, 127(Suppl 1), 131S-141S.
Gill, A. L., & Bell, C. N. (2004). Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM: An International Journal of Medicine, 97(7), 385-395.
Strauss, M. B., & Miller, S. S. (2012). The role of hyperbaric oxygen in crush injury, skeletal muscle-compartment syndrome, and other acute traumatic ischemias. Hyperbaric Medicine Practice, 3rd Edition Revised, Best Publishing Company, 1029-1048.
Weaver, L. K. (2009). Clinical practice. Carbon monoxide poisoning. New England Journal of Medicine, 360(12), 1217-1225.
Fife, C. E., Eckert, K. A., & Carter, M. J. (2016). An update on the appropriate role for hyperbaric oxygen: indications and evidence. Plastic and Reconstructive Surgery, 138(3S), 107S-116S.
Lin, K. C., Niu, K. C., Tsai, K. J., Kuo, J. R., Wang, L. C., Chio, C. C., & Chang, C. P. (2012). Attenuating inflammation but stimulating both angiogenesis and neurogenesis using hyperbaric oxygen in rats with traumatic brain injury. Journal of Trauma and Acute Care Surgery, 72(3), 650-659.
Mader, J. T., Brown, G. L., Guckian, J. C., Wells, C. H., & Reinarz, J. A. (1980). A mechanism for the amelioration by hyperbaric oxygen of experimental staphylococcal osteomyelitis in rabbits. Journal of Infectious Diseases, 142(6), 915-922.
Mathieu, D., Marroni, A., & Kot, J. (2017). Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving and Hyperbaric Medicine, 47(1), 24-32.
Nylander, G., Lewis, D., Nordström, H., & Larsson, J. (1985). Reduction of postischemic edema with hyperbaric oxygen. Plastic and Reconstructive Surgery, 76(4), 596-603.
Sukoff, M. H., & Ragatz, R. E. (1982). Hyperbaric oxygenation for the treatment of acute cerebral edema. Neurosurgery, 10(1), 29-38.
Benson, R. M., Minter, L. M., Osborne, B. A., & Granowitz, E. V. (2003). Hyperbaric oxygen inhibits stimulus-induced proinflammatory cytokine synthesis by human blood-derived monocyte-macrophages. Clinical and Experimental Immunology, 134(1), 57-62.
Thom, S. R. (2009). Oxidative stress is fundamental to hyperbaric oxygen therapy. Journal of Applied Physiology, 106(3), 988-995.