What is Hyperbaric Oxygen Therapy (HBOT)?

Hyperbaric Oxygen Therapy (HBOT) involves breathing 100% oxygen inside a specialized chamber pressurized to levels greater than atmospheric pressure. At sea level, the air we breathe contains 21% oxygen and 79% nitrogen. In an HBOT chamber, pressure levels can reach the equivalent of being 66 feet under seawater. This increased pressure, combined with pure oxygen, allows oxygen to dissolve into the blood plasma and diffuse into all tissues and body fluids. Under these conditions, oxygen delivery to tissues can increase by 15 to 20 times compared to normal levels.

How Does HBOT Work?

Oxygen is absorbed into the bloodstream via the lungs and carried throughout the body by the circulatory system. The increased pressure creates a strong oxygenation gradient between oxygen-saturated blood and hypoxic (low-oxygen) tissues. This process allows oxygen to reach areas with limited or no blood flow.

Oxygen-saturated plasma can move into areas such as:

• Tissue spaces
• Interstitial fluids
• Cerebrospinal fluid

The required pressure starts at 1.4 ATA (atmospheres absolute). HBOT chambers are designed and built to rigorous safety standards, similar to submarines.

Benefits of Increased Oxygen Availability

The potential benefits of HBOT arise from enhanced oxygen delivery, including:

• Improved oxygen supply to injured or hypoxic tissues
• Stimulation of new blood vessel formation (angiogenesis)
• Promotion of wound healing
• Enhanced immune function to support infection control
• Regeneration of damaged tissues
• Reduction of toxic effects from harmful substances
• Relief of gas obstructions, such as nitrogen bubbles in decompression sickness
• Improved blood flow through rebound arterial dilation following HBOT, which may enhance organ function
• Inhibits production of proinflammatory cytokines therefore playing a role in reducing inflammation

Approved Indications for HBOT

As of 2019, the Undersea & Hyperbaric Medical Society (UHMS) recognizes HBOT for the following conditions:

1. Air or Gas Embolism
2. Carbon Monoxide Poisoning
3. Gas Gangrene
4. Crush Injury, Compartment Syndrome, and Acute Traumatic Injuries
5. Decompression Sickness
6. Wound Healing (e.g., diabetic ulcers)
7. Severe Anemia
8. Intracranial Abscess
9. Necrotizing Infections (flesh-eating disease)
10. Osteomyelitis (bone infections)
11. Delayed Radiation Injury (e.g., radiation burns)
12. Compromised Grafts and Flaps
13. Acute Thermal Burn Injury (e.g., fire or electrical burns)
14. Idiopathic Sudden Sensorineural Hearing Loss* (*approved October 8, 2011, by the UHMS Board of Directors)

Potential Complications of HBOT

While HBOT is generally safe, potential complications include:

Barotrauma:

• Ear or sinus trauma
• Tympanic membrane rupture
• Alveolar over-distension and pneumothorax
• Gas embolism

Oxygen Toxicity:

• Central Nervous System (CNS) reactions
• Pulmonary toxicity

Other Risks:

• Fire 
• Sudden decompression
• Reversible visual changes
• Claustrophobia

Treatment Pressure, Duration, and Protocols

Oxygen under pressure is considered a drug. Like any medication, its “dose”—pressure, duration, and frequency—must be adjusted based on the condition and severity of each patient’s case.

• Duration: Sessions typically last 90 to 120 minutes.
• Dosing protocols (pressure, duration, and number of treatments) are determined on a case-by-case basis by our naturopathic doctors

Example Protocols:

1. Decompression Sickness (The Bends):
   • Treatment duration: 4 hours and 35 minutes
   • Pressure: Starts at 2.8 ATA, then gradually reduces to 2.0 ATA.
   • Typically, one treatment is sufficient.

1. Carbon Monoxide Poisoning:

• Treated using the Weaver Hyperbaric Protocol
• Pressure: 2.4 ATA for three sessions within 24 hours.

Patient Safety and Monitoring

At The Nardella Clinic, HBOT is conducted in Perry Baromedical monoplace chambers, which are annually inspected by the manufacturer to ensure safety and performance. Our naturopathic doctors carefully determine treatment protocols and monitor progress to ensure safe, effective therapy. Patients are educated on both the potential benefits and risks of HBOT to make informed decisions about their care.

Health Canada Compliance Notice

Health Canada regulates the approved use of HBOT for 13 specific medical conditions. While HBOT is recognized for the 14 conditions outlined by the Undersea & Hyperbaric Medical Society, any additional uses must be assessed through a comprehensive consultation with our qualified naturopathic doctors. Patients are encouraged to discuss their health concerns and explore whether HBOT is appropriate for their care.