Hyperbaric oxygen therapy (HBOT) has emerged as a remarkable medical treatment with the capacity to address various conditions associated with oxygen-starved tissues. This therapy involves exposing individuals to pure oxygen within a pressurized chamber, elevating the pressure to 2.5 times that of normal air pressure. While the full range of applications for HBOT continues to expand, it has already received FDA approval for 14 conditions, including severe gangrene, specific infections, burns, radiation injuries, and crush injuries. Two conditions that profoundly demonstrate HBOT’s lifesaving potential are carbon monoxide poisoning and decompression sickness.

Carbon Monoxide Poisoning: The Silent Threat

Carbon monoxide (CO) poisoning occurs due to exposure to a colorless, odorless gas known as carbon monoxide, commonly found in combustion fumes. Sources of CO include car exhaust, wood stoves, fuel-burning appliances, blocked fireplaces, non-electric heaters, malfunctioning gas appliances, and faulty heating exhaust systems in homes or garages.

Often referred to as a silent killer, carbon monoxide displaces the oxygen in the bloodstream when mixed with the air you breathe. For example, if a malfunctioning heater’s combustion system emits CO, it can be fatal to individuals while they sleep. CO poisoning primarily occurs in enclosed spaces such as homes, garages, vehicles, campers, trailers, or tents. Everyone is susceptible, but some individuals, including babies, pregnant women, and those with certain medical conditions, are more at risk.

The Treatment of CO Poisoning

CO poisoning constitutes a medical emergency characterized by symptoms such as headaches, nausea, dizziness, vomiting, weakness, chest pain, confusion, loss of consciousness, and, in severe cases, death. The immediate response should involve evacuating the area contaminated with CO and seeking medical attention. Medical professionals often administer pure oxygen via a face mask, the standard treatment for CO poisoning. This treatment typically lasts around four hours. If a patient has difficulty breathing unassisted, a breathing assistance machine may be used.

The Role of Hyperbaric Oxygen Therapy in CO Poisoning

While many CO poisoning cases can be successfully treated without HBOT, long-term damage can occur, affecting the central nervous and cardiovascular systems. Several studies have indicated that under specific conditions, HBOT can reduce the risk of brain and nerve damage. However, it’s essential to note that not all hospitals have hyperbaric chambers, potentially requiring patients to be transferred to facilities with this specialized equipment. Additionally, HBOT is generally more expensive than traditional oxygen therapy administered via a face mask.

Decompression Sickness: The Bends

Decompression sickness (DCS) is a rare condition that can afflict deep-sea divers, aviators, miners, astronauts, mountain climbers, and individuals working at extreme altitudes. DCS often occurs when individuals return rapidly to normal altitudes from high or low-pressure environments. This condition results from the formation of bubbles of nitrogen and other gases in the bloodstream and can lead to dangerous symptoms throughout the body. The most recognizable symptom is excruciating joint pain, often referred to as “the bends.” Additional symptoms may include headaches, dizziness, fatigue, ringing in the ears, visual problems, chest pain, shortness of breath, skin rash, itching, and malaise. In severe cases, individuals with DCS may experience numbness, paralysis, staggering, coughing up blood, and even collapse, with the potential for fatal outcomes.

Hyperbaric Oxygen Therapy as the Primary Treatment for DCS

Hyperbaric oxygen therapy stands as the primary treatment for decompression sickness. It immediately reduces the quantity of bubbles in the bloodstream, saturates tissues with oxygen, and mitigates dangerous swelling. Time is of the essence when it comes to treating DCS, as symptoms can be life-threatening. Even if symptoms seemingly resolve upon returning to normal altitudes, medical attention is crucial, and HBOT may be necessary to prevent long-term damage.

In hyperbaric oxygen therapy it is the oxygen in dissolved in the blood that is so important. At 1.5 atmospheres of pure oxygen for instance, we have seven times the oxygen dissolved in our blood that we are breathing air at sea level, it is dissolved oxygen that is the primary response for the healing effects of HBOT.

Conclusion

Hyperbaric oxygen therapy has revolutionized the treatment of conditions like carbon monoxide poisoning and decompression sickness. In the case of CO poisoning, where immediate intervention is essential, HBOT can help mitigate the risk of severe brain and nerve damage. For individuals afflicted by the bends, HBOT is the primary treatment that swiftly reduces bubble formation and supports tissue healing.

Source

Hopkins, J. Hyperbaric Therapy for CO Poisoning and Decompression Sickness. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/hyperbaric-therapy-for-co-poisoning-and-decompression-sickness