HBOT

Question 1

Hyperbaric Oxygen Therapy

Answer 1

• historically used for divers
• now for tx of musculoskeletal, neuro, and other disease states
  ex: compartment syndromes, sprains, strains, large hematomas, crush injuries, severe burns, systemic infection, CVA, TBI
• delivered in chambers or superficially

Question 2

Hyperbaric Oxygen Therapy

Answer 2

• historically used for divers
• now for tx of musculoskeletal, neuro, and other disease states
  ex: compartment syndromes, sprains, strains, large hematomas, crush injuries, severe burns, systemic infection, CVA, TBI
• delivered in chambers or superficially

Question 3

How HBOT works

Answer 3

• overload body with oxygen to prevent ischemia from secondary trauma and provide assistance to healing process
• exposed to environment that is 2-3 times atmospheric absolute (ATA)
  
  • 1 ATA = air/water pressure at sea level
  • each 33ft immersion = 1 ATA increase
    ex: if 33ft immersion at sea level = 2 ATA
• patient breaks air that is 95-100% oxygen (21% in normal air)
  
  • norm: 5mL oxygen consumed/100mL blood
  • in HBOT: 6.6mL O consumed/100mL blood
  • at 3 ATA = enough O2 to sustain life without hemoglobin
• high oxygen content => vasoconstriction
  - -> decreasing blood flow by at least 20%
  - -> diffusion gradient of oxygen to the tissue even with decreased blood flow
  - -> may be most beneficial for poorly vascularized areas (achilles, RC)
• increases PMN and fibroblastic activity
• most beneficial immediately after an injury
• sometimes used to prevent DOMS
• more research needed

Question 4

Indication for HBOT

Answer 4

• inflammatory conditions
• sprains
• strains
• DOMS
• muscle soreness
• wounds
• tendon lacerations
• compartment syndromes
• crush injuries

Question 5

Contraindications for HBOT

Answer 5

• middle or inner ear infection
• pregnancy
• tympanic membrane rupture
• sinusitis
• asthma
• high fever
• seizure disorders
• optic neuritis
• pneumothorax

Question 6

How HBOT works

Answer 6

• overload body with oxygen to prevent ischemia from secondary trauma and provide assistance to healing process
• exposed to environment that is 2-3 times atmospheric absolute (ATA)
  
  • 1 ATA = air/water pressure at sea level
  • each 33ft immersion = 1 ATA increase
    ex: if 33ft immersion at sea level = 2 ATA
• patient breaks air that is 95-100% oxygen (21% in normal air)
  
  • norm: 5mL oxygen consumed/100mL blood
  • in HBOT: 6.6mL O consumed/100mL blood
  • at 3 ATA = enough O2 to sustain life without hemoglobin
• high oxygen content => vasoconstriction
  - -> decreasing blood flow by at least 20%
  - -> diffusion gradient of oxygen to the tissue even with decreased blood flow
  - -> may be most beneficial for poorly vascularized areas (achilles, RC)
• increases PMN and fibroblastic activity
• most beneficial immediately after an injury
• sometimes used to prevent DOMS
• more research needed

Question 7

Indication for HBOT

Answer 7

• inflammatory conditions
• sprains
• strains
• DOMS
• muscle soreness
• wounds
• tendon lacerations
• compartment syndromes
• crush injuries

Question 8

Contraindications for HBOT

Answer 8

• middle or inner ear infection
• pregnancy
• tympanic membrane rupture
• sinusitis
• asthma
• high fever
• seizure disorders
• optic neuritis
• pneumothorax