How HBOT Works to Treat Crush Injuries and Compartment Syndrome

Inside a hyperbaric chamber

With HBOT treatment, a patient receives 100 percent oxygen under increased atmospheric pressure. This form of treatment floods the body with oxygen which, in turn, floods the damaged areas with oxygen. This helps repair damaged tissue. HBOT also reduces edema in the area and helps control infection. It also stimulates blood vessel and collagen formation and reduces the free radicals in the body.

HBOT is an FDA approved treatment for both crush injuries and compartment syndrome. It is often used together with traditional treatment. In the case of crush injuries, HBOT increases the chance of a positive outcome following the injury. In compartment syndrome, HBOT slows progression and complications of the swelling before a fasciotomy is necessary, often reducing the need for surgery at all. The best time to start HBOT treatment is immediately after the injury in order to achieve the best results.

What are Crush Injuries?

Two cars involved in an accident

A crush injury occurs when an injury or accident puts force or pressure on a part of the body. This type of injury most often occurs when two heavy objects squeeze a part of the body between them. You often see crush injuries after a natural disaster, such as an earthquake. If an object, such as a bookcase, falls on top of a person, pinning them down, this can cause a crush injury. Common damage associated with a crush injury includes:

  • Bleeding
  • Bruising
  • Fracture
  • Laceration
  • Nerve Injury
  • Secondary Infection
  • Nerve and Tendon Injuries
  • Rhabdomyolysis
  • Compartment Syndrome

When a crush injury occurs, the longer the person remains under a crushed object, the greater the chance of complications. This includes tissue, muscle, capillary, and nerve damage. As the object puts pressure on the body, it disrupts the flow of blood, starving the area of oxygen. The longer the tissue is deprived of oxygen, the greater the risk of serious damage. If the oxygen deprivation to the muscle lasts too long, muscle tissue begins to die and releases myoglobin into the bloodstream. This results in a condition called Rhabdomyolysis. This myoglobin travels to the kidneys, where it damages kidney cells. This can lead to kidney damage or kidney failure. Other complications of crush injuries can include osteomyelitis, nonunion of the fracture, failed flap, and amputations. Hyperbaric oxygen, or HBOT, floods the crush injury area with increased levels of oxygen, helping cells and tissue repair and heal.

What is Compartment Syndrome?

buildings damaged from an earthquake

Your body is broken down into different compartments. These compartments consist of muscles, nerves, and blood vessels separated into sections by the fascia. The fascia is a tight tissue that keeps each compartment confined. The fascia does not expand. If an injury to a compartment causes swelling, the increased pressure pushes on the muscle, nerves, and blood vessels. When the swelling and blood pressure gets too high, it restricts blood flow into the compartment and can result in permanent damage. If the pressure is not released, it can result in complete tissue death. When complete tissue death occurs in a limb, amputation is often the only option.

Compartment syndrome most often occurs in the lower leg or forearm, though it can also occur in the hands, feet, thighs, buttocks, and upper arm. Symptoms include:

  • Loss of sensation, numbness, tingling in the affected limb
  • Decreased color in the skin
  • Pain that will not go away
  • Noticeable swelling in the affected area
  • Tightness in the affected muscle
  • The area is tender to the touch
  • Inability to move the affected limb

Traditional Treatments for Crush Injuries and Compartment Syndrome

Crush injuries and compartment syndrome are medical emergencies. In crush injuries, care and treatment must begin before you even remove the item causing the injury. Depending on the length of time an area remains in a crushed state, removal of the object can result in immediate complications. Due to the lack of oxygen and blood flow, tissue cells in the crushed area begin to die. As they do this, they release toxins into the crushed area. Therefore, when you remove the item and blood flow resumes, these toxic substances travel throughout the body. If left untreated, a patient can experience rhabdomyolysis, kidney failure, cardiac arrhythmias or cardiac arrest due to increased potassium, respiratory damage, or liver damage.

In cases of compartment syndrome, the immediate course of action is to surgically cut open the fascia. This relieves pressure from the swelling and this surgery is called a fasciotomy. Once doctors release the swelling, the incision is repaired. In some cases, the incision must remain open to keep the pressure down. In this case, a skin graft is often necessary. Hyperbaric oxygen, or HBOT, can help reduce compartment syndrome swelling and complications before a fasciotomy. In many cases, it reduces enough to avoid a fasciotomy.

With this in mind, if you would like more information on hyperbaric oxygen, HBOT and its benefits for crush injuries or compartment syndrome, visit HERE and fill out our request form or call our office to set up an initial consultation.