Other Uses of Hyperbaric Oxygen Therapy
Hyperbaric Oxygen Therapy (HBOT) is formally approved for some conditions but is also commonly used with positive results for a larger range of conditions. Common uses prescribed by doctors based on standards of care and clinical experience, that are not formally approved, are known as ‘off-label’ uses. The pivotal studies needed to formally validate these common off-label uses does not easily attract research funding because there is no intellectual property or patent on Oxygen. Nonetheless, Hyperbaric Oxygen is old technology that is finding new uses that will increasingly become validated through observational clinical studies and patient registries followed by controlled clinical studies. However, individual patients may have results that differ and the challenge for all of medicine is to learn how to best individualize treatments.Hyperbaric oxygen has been in wide use and approved for many conditions in Russia and Europe, however, in the United States, we are only beginning to re-discover these uses.
Due to the accreditation process, hospital-based centers are restricted in that they can treat patients only for a condition that is formally approved. However, independent centers are not subject to hospital accreditation policies and restrictions. Conditions not formally approved can be treated under the authority of a medical professional after careful review of the case and full informed consent regarding available options and the risk vs benefit of each approach.
We voluntarily participate in external quality assurance programs and develop our own protocols for quality assurance and improvement, including the use of data systems that help validate clinical practices and conduct clinical research.
We also support non-profit foundations are developing protocols that can be used by ALL centers to allow the formal study and validation of all uses of hyperbaric oxygen therapy.
What kind of wounds can hyperbaric oxygen therapy treat?
Most wounds show substantial healing progress within two weeks of injury and will be completely healed within four weeks or less. Wound healing may take longer if the tissue surrounding the wound does not have enough blood supply to bring in the oxygen needed for healing. Delayed-healing wounds will very often respond to hyperbaric oxygen therapy. Brain injury is another non-healing wound, and thus, can benefit from hyperbaric oxygen therapy. The brain is unique, and so, helping to heal it or reduce symptoms with hyperbaric oxygen requires some special care and protocols. This is an active area of research with promising early results.
A common wound-healing problem is a diabetic leg ulcer. Diabetics often have thickened small blood vessel walls, called a microangiopathy, associated with impaired oxygen diffusion into tissue. Over time, particularly when blood sugar is not under excellent control, diabetics can develop injury to nerves in their legs called peripheral neuropathy, preventing them from feeling pain normally. Small soft-tissue injuries to the foot that would ordinarily be painful are easily overlooked until they become more severe.
Reduced oxygen supply, which may be enough to keep uninjured tissue healthy, may not be enough to supply the increased oxygen demand of wound healing and the diabetic wound frequently becomes chronic. HBOT works over time by stimulating new blood vessels to grow into the wound, improving oxygen delivery and promoting wound healing. HBOT has been proven to reduce the amputation rate in patients with diabetic ulcers.
FDA-Approved Uses in the U.S. Include
- Brain Injury
- Air or gas embolism
- Decompression sickness
- Carbon monoxide poisoning
- Intracranial abscess
- Tissue Repair
- Arterial insufficiency
- Radiation tissue damage
- Skin grafts and flaps
- Thermal burns
- Crush injuries, acute trauma
- Necrotizing soft tissue infections
- Exceptional blood loss anemia
- Gas gangrene
“Off-Label” Uses in the U.S. and Worldwide Include
- Concussion, TBI and brain injuries
- Post-operative healing
- Metabolic Syndrome
- Bell’s palsy
- Spinal cord injury
- Peripheral nerve damage
- Bone fractures
- Organ transplants
- Muscle injury
- Multiple Sclerosis
- Systemic shock
- Sickle-cell disease
- Rheumatic diseases