| Over the past 40 years hyperbaric oxygen therapy | | | | |
| conducted in personal hyperbaric chambers has been | | | | Personal Hyperbaric Chambers Are Mainly Of Two |
| recommended and used in a wide variety of medical | | | | Types: Monoplace Hyperbaric Chamber And Multiplace |
| conditions, often without adequate scientific validation | | | | Hyperbaric Chamber: |
| of efficacy or safety. Consequently a high degree of | | | | Comparison of monoplace and multiplace hyperbaric |
| medical scepticism has developed regarding its use. | | | | oxygen chambers Monoplace Personal Hyperbaric |
| The Undersea and Hyperbaric Medical Society | | | | Chamber |
| approves use of personal hyperbaric chambersfor | | | | - Claustrophobic environment; limited access to patient |
| hyperbaric oxygen therapy for a few conditions for | | | | - Whole chamber contains hyperbaric oxygen, |
| which there is thought to be reasonable scientific | | | | increasing fire risk |
| evidence or well validated clinical experience. In these | | | | - Lower cost |
| conditions early referral is essential. | | | | - Portable |
| | | | | |
| Some of the therapeutic uses of hyperbaric oxygen | | | | Multiplace Personal Hyperbaric Chamber |
| given in personal hyperbaric chambers: Based on | | | | |
| Suggestive scientific evidence: | | | | - More room; assistant can enter to deal with acute |
| Adjunctive treatment | | | | problems such aspneumothorax |
| | | | | - Hyperbaric oxygen via tight fitting mask—chamber |
| 1. Refractory osteomyelitis | | | | gascan be air (reduced fire risk) |
| 2. Radiation induced injury | | | | - Risk of cross infection when used for ulcers etc |
| 3. Acute traumatic ischaemic injury | | | | |
| 4. Prolonged failure of wound healing | | | | Often early treatment in personal hyperbaric chamber |
| 5. Exceptional anaemia from blood loss | | | | is essential for maximum benefit. This poses |
| | | | | appreciable practical problems as severely ill patients |
| Hyperbaric oxygen therapy given in personal | | | | may have to be transported long distances and may |
| hyperbaric chambers has been shown ineffective in | | | | require intensive medical support, including mechanical |
| diseases such as multiple sclerosis and dementia, but it | | | | ventilation, between treatment sessions. It is important |
| continues to be used despite the risks of the | | | | to discuss the potential benefits and risks for each |
| treatment. For conditions where its use remains | | | | patient with the regional hyperbaric oxygen facilities. |
| unproved—for example, rheumatoid arthritis, cirrhosis, | | | | |
| and gastroduodenal ulcer— personal hyperbaric | | | | Multi- occupancy personal hyperbaric chambers are |
| chamber providing hyperbaric oxygen should be used | | | | required for critically ill patients who require an |
| only in the context of well controlled clinical trials. | | | | attendant within the chamber and are usually used for |
| | | | | acute problems. Monoplace chambers can be used to |
| Cellular and biochemical benefits of hyperbaric oxygen | | | | treat patients with chronic medical conditions. |
| treatment in a personal hyperbaric chamber: | | | | Hyperbaric oxygen is inhaled through masks, tight fitting |
| 1. Promotes angiogenesis and wound healing | | | | hoods, or endotracheal tubes. |
| 2. Kills certain anaerobes | | | | Inside the chambers pressure is usually increased to |
| 3. Prevents growth of species such as Pseudomonas | | | | about 250-280 kPa, equivalent to a depth of 15-18m of |
| 4. Prevents production of clostridial alpha toxin | | | | water. The duration of treatment varies from 45 to |
| 5. Restores neutrophil mediated bacterial killing in | | | | 300 min and patients may receive up to 40 sessions. |
| previously hypoxic tissues | | | | Appropriate monitoring is essential during treatment, |
| 6. Reduces leucocyte adhesion in reperfusion injury, | | | | and facilities for resuscitation and immediate |
| preventing release of proteases and free radicals | | | | mechanical ventilation should be available. |
| which cause vasoconstriction and cellular damage | | | | |