Physicians often use Hyperbaric Oxygen Therapy, or HBOT, alongside traditional surgical or medical treatment plans. The increased levels of oxygen that HBOT delivers to the body aids in healing, reduces the risk of infection, helps stimulate the growth of new tissue and blood vessels, reduces inflammation, and many other benefits. Hyperbaric oxygen therapy enhances the healing process through many different mechanisms.
Hyperoxygenation is the administration of higher than normal concentrations of oxygen. HBOT delivers this increased oxygen and gives immediate support to tissues with compromised blood flow. The increased pressure experienced inside the chamber creates a 10- to 15-fold increase in the plasma oxygen concentration. For instance, this increases the arterial oxygen values anywhere from 30 mm Hg to 2,000 mm Hg. This allows oxygen to spread outside of the blood capillaries by as much as four-fold. By using hyperbaric oxygen, physicians can buy time for their patients by keeping tissue viable and begin healing until corrective measures, such as surgery, can occur.
Surgery, radiation, severe trauma, ulcers, bacterial infections or other injuries and diseases can damage or destroy parts of the circulatory system and the tissues their blood supply support. To rebuild healthy new capillaries, the body must form new fibroblast cells that produce collagen and other fibers. This process of forming new blood vessels is neovascularization. HBOT treatments accelerate this process. Once the new capillaries and vessels form, blood flow to the damaged areas resume.
Hyperoxia refers to a high oxygen supply. The increased amount of oxygen delivered to the body during HBOT treatments helps to kill bacteria such as strep, staph or clostridium perfringens that cause gas gangrene. The increased oxygen levels stimulate the body’s immune system to function at a higher level and better fight off foreign organisms.
Direct pressure is the application of force onto something, such as compression on a wound. HBOT works by forcing increased oxygen levels into the body’s cells. Boyle’s Law states that at a constant temperature, the volume and the pressure of a gas are inversely proportional. This means that a gas compresses proportionately to the amount of pressure that’s exerted on it. For more than a century, hyperbaric medicine has used this concept to treat decompression sickness, or “the bends”, in scuba divers. Decompression sickness causes gas bubbles to form in the body and, if not treated, can lead to joint pain, paralysis, and even death. The increased pressure in hyperbaric chambers compresses the gas bubbles in the body, reducing their size and removing the nitrogen inside them.
Hypoxia-Induced Vasoconstriction and Compartment Syndrome
Compartment syndrome is a painful disorder that happens when the pressure within the skeletal muscle compartments build to unsafe levels. This pressure can reduce blood flow, which then prevents oxygen and nutrients from reaching the muscle and nerve cells. Acute compartment syndrome is a medical emergency caused by a severe injury where normal tissue function is damaged. This leads to increased tissue pressure, decreased capillary flow, hypoxia (Abnormally low oxygen levels) in the tissues and eventually tissue cell death.
The treatment of choice for acute compartment syndrome is immediate decompression. Typically, this is in the form of surgical intervention. Surgeons cut the facia (the thin sheath of fibrous tissue enclosing the muscle or organ) to relieve pressure. HBOT often supplements surgery and, in some cases, can be used as an alternative to surgery. HBOT reduces the swelling of the blood vessels and allows blood to flow more freely. This allows the body to deliver increased oxygen and nutrients while removing cellular debris.
Healing Reperfusion Injury
Reperfusion injury (often called ischemia-reperfusion injury (IRI) or reoxygenation injury) refers to tissue damage that occurs when the blood supply returns to the tissue after a period of inadequate blood supply or lack of oxygen. For example, when a leg has been crushed under a wall after an earthquake. One hypothesis is that a series of events inside the damaged cells triggers the release of harmful free radicals. These free radicals cause irreversible damage to the tissue, causing blood vessels to restrict and blood flow to stop. HBOT increases the oxygen levels in the blood which in turn encourages the body’s free radical scavengers to hunt them down and promote healing.
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