Hyperbaric Oxygen Therapy (HBOT) is a technique we have been doing for almost 27 years at McDonagh Medical Center. It is a technique in which we place a patient in a sealed chamber (see picture of a chamber to the right) and increase the pressure to a level that is up to twice the normal atmospheric pressurre. The net effect of this is that we can drive or force oxygen into the liquid part of the blood called the plasma and since this liquid can go farther into an artery and cells than a red blood cell (which usually carries 98% of the bodys oxygen) can go. We can deliver oxygen to once unreached tissues and save them from dying wile we are waiting for the circulation to be restored.The use of hyperbaric systems in the treatment of disease is not new to the field of medicine. The British physician Henshaw is said to have been the first to use compressed air in a specially equipped room called a domicilium about the year 1664. His facilities were crude and his results are unknown. He believed that his contraption promoted good health by improving digestion and respiration. During the next two centuries, a variety of experiments were conducted by English, French, and Dutch workers using various types of diving apparatus. One important development during this early period was the discovery of oxygen by the English chemist Joseph Priestly in 1771. The early physiological studies of Paul Bert (1833-1886) on the barometric pressure effects on animals and man gave considerable impetus towards establishing a scientific basis for clinical HBO. Although numerous investigators were involved in one aspect or the other of what might be loosely termed hyperbaric medicine, one of the most serious clinical studies was conducted by the French physician J. A. Fontaine in 1879 at which time he constructed an operating room which provided hyperbaric conditions. The hyperbaric chamber was a mobile unit, placed on wheels, and used a manually operated compressor. During this period hyperbaric chambers met with a great deal of enthusiasm in Europe, and then gradually the interest waned. The reasons for this demise of hyperbaric medicine are still not clearly understood.
About the time that hyperbaric medicine in Europe was on the decline, interest in this new area of medicine started to catch on in the United States. The first hyperbaric chamber for therapeutic use on the North American continent was built and used in 1860 in Oshawa, Canada. The first chamber in the United States was in Rochester, New York, in 1891. Noteworthy in the early American scene was the work of Dr. Orval J Cunningham, who was probably one of the foremost of the American investigators. With the financial backing of Henry H. Timken of roller bearing fame, Dr. Cunningham constructed the largest hyperbaric chamber ever built, a steel sphere, 64 foot in diameter, containing 36 rooms, and with the usual amenities of a hotel. As a result of the depression, opposition by the American Medical Association, and a series of other unfortunate circumstances, Dr. Cunningham’s project was ultimately scrapped. The history of hyperbaric medicine over the years has been an up and down affair; but after World War II with an intensification in diving medicine and other submarine activities, hyperbaric medicine has achieved respectability and the scientific stature which it deserves. A recent upsurge in hyperbaric oxygen therapy followed the work of the Dutch surgeon I. Boerema and his associates who in 1956 began using it in cardiac surgery. Serious interest in the broad therapeutic applications of hyperbaric oxygen therapy started in the United States about 1961.
In September 1961, the First International Congress on the clinical application of hyperbaric oxygen was held in Amsterdam. The Second International Conference on HBO was held in Glasgow in September 1964. In general, this meeting concentrated on the basic physiological mechanisms of HBO. The Third International Congress was held at Duke University at Durham, North Carolina, in November 1965. The Fourth International Congress was held in Sapporo, Japan, in September 1969. The Fifth Congress was held in Vancouver, B. C. in 1973. The Sixth Congress was held at the University of Aberdeen, Scotland, in August 1977. The next International Congress was held in Moscow in 1981. These Congresses presented an extensive series of investigative reports dealing with basic physiology, oxygen toxicity, animal experiments, and a broad spectrum of therapeutic applications of HBO to human disease, viz.: actinomycosis, air embolism, burns, carbon monoxide poisoning, cerebral vascular impairment, crush injuries, cyanide poisoning, drowning or asphyxia, electrocution, gas gangrene, gastric ulcer, head injuries, intestinal obstruction, myocardial infarction osteomyelitis , peripheral vascular disease, pulmonary insufficiency, senility due to cerebral insufficiency, sickle cell anemia crises, skin grafts, skin ulcers, smoke inhalation, stroke, and in certain other disorders where oxygen impairment is a causative factor.
Unfortunately hyperbaric chambers are quite costly to construct and to operate, and limited in their distribution. Hyperbaric chambers are presently maintained by the U. S. Navy, U. S. Air Force, U. S. Army, NASA, Veterans Administration, and a number of universities and larger medical centers. Most of the hyperbaric oxygen units are involved in clinical investigational studies or are used for special purposes and are frequently not available to the general public.
