Hyperbaric Bags
Hyperbaric Bags
Hyperbaric medicine, also known as hyperbaric oxygen therapy (HBOT), is the medical use of oxygen at a level higher than atmospheric pressure.
Therapeutic principles
Several therapeutic principles are made use of in HBOT:
The increased overall pressure is of therapeutic value when HBOT is used in the treatment of decompression sickness and air embolism.
For many other conditions, the therapeutic principle of HBOT lies in a drastically increased partial pressure of oxygen in the tissues of the body. The oxygen partial pressures achievable under HBOT are much higher than those under breathing pure oxygen at normobaric conditions (i.e. at normal atmospheric pressure).
A related effect is the increased oxygen transport capacity of the blood. Under atmospheric pressure, oxygen transport is limited by the oxygen binding capacity of hemoglobin in red blood cells and very little oxygen is transported by blood plasma. Because the hemoglobin of the red blood cells is almost saturated with oxygen under atmospheric pressure, this route of transport cannot be exploited any further. Oxygen transport by plasma, however is significantly increased under HBOT.
Uses
In the United States, the Undersea and Hyperbaric Medical Society, known as UHMS, approves for reimbursement diagnoses for application of HBOT in hospitals. The following indications are approved uses of hyperbaric oxygen therapy as defined by the UHMS Hyperbaric Oxygen Therapy Committee.[1]
Air or gas embolism
Carbon monoxide poisoning
Carbon Monoxide Poisoning Complicated by Cyanide Poisoning
Clostridal Myositis and Myonecrosis(Gas gangrene)
Crush Injury, Compartment syndrome, and other Acute Traumatic Ischemias
Decompression sickness
Enhancement of Healing in Selected Problem Wounds
Exceptional Blood Loss
Intracranial Abscess
Necrotizing Soft Tissue Infections(Necrotizing fasciitis)
Osteomyelitis(Refractory)
Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
Skin Grafts & Flaps (Compromised)
Thermal Burns
Other reported applications include:
Diabetically derived illness, such as diabetic foot, diabetic retinopathy, diabetic nephropathy
Epidural abscesses
Certain kind of hearing loss
Radiation-induced hemorrhagic cystitis
Inflammatory bowel disease
HBOT is controversial and health policy regarding its uses is politically charged. Both sides of the controversy on the effectiveness of HBOT is available in the form of Cochrane Library reviews.
Home Treatment
There are portable HBOT chambers, which are used for home treatment. These are usually referred to as "mild chambers", which is a reference to the lower pressure of soft-sided chambers. Those commercially available in the USA go up to 4 PSI (1.27 ATA 8.92 FSW). There are new FDA approved chambers out that go to the full 1.3 ATA which is 4.4 PSI (see those pictures in this article). International portable chambers can go to 7.35 psi (1.5 ATA 16.38 FSW) or higher. These chambers are operated with oxygen concentrators (typically 85-95% oxygen) or with 100% oxygen as the breathing gas. Physiologically, the human body cannot tell the difference between 80% and 100% Oxygen. (The difference is clinically insignificant and with less risk using an oxygen concentrator.)[citation needed] Total concentration of oxygen in the chamber should not exceed 25% as this can increase the risk of fire. 10 lpm of oxygen input into a mild chamber equals about 24-25% oxygen depending on the size of the chamber. The oxygen concentrator used for HBOT should include an on-board oxygen purity monitor and should have at least 15 psi outflow pressure. An audible alarm will sound if the purity ever drops below 80%. A standard concentrator used by respiratory patients is not recommended due to low total output and poor delivery pressures.
These chambers are often used in a clinical settings, but are also used in homes. Mild hyperbaric chambers use standard 120 volt outlets and can also be configured for 220 volt use. Ranging in size from 21" up to 40" in diameter these chambers measure between 84" to 120" in length. New vertical chambers are coming on the market which are up to 5' in diameter allowing for treatments sitting up or standing instead of lying down.
The soft chambers are only approved by the FDA for the treatment of altitude sickness, but are commonly used for other "off-label" purposes. Although research into mild chambers is young, one double-blind controlled trial showed improvement in 80% of the treatment group of children with Autism
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