About Hyperbaric Oxygen Therapy
Our Clinic provides Edmonton with Hyperbaric Treatment
Less Edema - Receptors sense high oxygen levels from Hyperbaric Treatment, and cause blood vessels to constrict (vasocontriction) which reduces edema which is extremely important in injury.
HBO causes a 15-20% reduction in regional blood flow and edema, but oxygen content is still 10 to 15 times normal so the tissues still get dramatically more oxygen even though the blood flow is less.
Increased Collagen Production - The fibroblast is the cell responsible for soft tissue healing (forms collagen), Hyperbaric Oxygen Treatment dramatically increases Fibroblast proliferation.
Improved Immune Activity - Neutrophils which engulf and kill bacteria, do so with Oxygen generated radicals and Hyperbaric Treatment allows for the appropriate oxygen tension to do so (30-40mmHg).
Better Bone Repair - Hyperbaric Oxygen enhances osteoclastic activity (for resorption and remodeling of bone) and osteoblastic activity (whose function decreases in low oxygen tissues).
Antimicrobial - Hyperbaric Oxygen Therapy has a "static and cidal" effect on microorganisms especially anaerobic organisms such as clostridia, bacteroides, staph and strep.
Furthermore, HBO can promote active transport of some antibiotics into microorganisms & kills some fungi as well.
Stem Cell Release - Yes you read correctly! Hyperbaric Oxygen Therapy stimulates stem cells to produce and release growth factors.
Hyperbaric Oxygen also seems to mobilize stem cells from the bone marrow including blood vessel stem cells to areas of wounds.
Blood Vessel Generation - Oxygen under pressure from Hyperbaric Treatment also encourages new blood vessels to grow (angiogenesis) via production of Ang2 and VEGF (new blood vessels can often require 20-30 treatments to do so however).
Microcirculation effects: HBO improves the elasticity of the red blood cells and reduces platelet aggregation. This, combined with the ability of the plasma to carry dissolved oxygen to areas where RBCs cannot reach, has a beneficial effect on the oxygenation of many hypoxic tissues in various circulatory disorders.
UHMS Approved Hyperbaric Indications
1. Air or Gas Embolism
2a) Carbon Monoxide (CO) Poisoning
2b) CO Poisening Complicated By Cyanide Poisoning
3. Clostridial Myositis & Myonecrosis (Gas gangrene)
4. Crush Injury, Compartment Syndrome
5. Decompression sickness
6a) Arterial inefficiencies
6b) Arterial Inefficiencies
7. Severe Anemia
8. Intracranial Abscess
9. Necrotizing Soft Tissue Infections
10. Osteomyelitis (Refractory)
11.Delayed Radiation Injury (Soft Tissue & Bony Necrosis)
12. Compromised Grafts and Flaps
13. Acute Thermal Burn Injury
14. Idiopathic Sudden Sensorineural Hearing Loss
Researched Hyperbaric Areas:
Hyperbaric Therapy has been shown to be an amazing adjunct to the treatment of various infections.
Host defense mechanisms against infection are impaired by hypoxia and oxygen has synergistic effect with antibiotics especially in anaerobic infections.
The high levels of oxygen provided by Hyperbaric Oxygenation to the tissues are detrimental to organisms that thrive in the absence of oxygen.
Chronic wounds tend to have hypoxia due to the destruction of local vasculature, increased oxygen consumption by leukocytes and fibroblasts and chronic wounds tend to be colonized by bacteria
Hypoxia impairs the immune mechanism of the body, whereas Hyperbaric Treatment increases immune system generation free radicals which are toxic to microorganisms.
Most infectious data for Hyperbaric Treatment is related to bacteria, and fungi with less information on HBO and viral infections.
The use of Hyperbaric Oxygen Treatment for Lyme disease often cite the results of a 6-year Texas A&M University pilot program from the 1990s.
Subjects underwent up to 40 1-h HBOT sessions at a pressure of 2.36 ATA - Improvement or resolution of symptoms was observed in 37 of 38 subjects within 3 weeks post-treatment (Huang et al 2014).
We offer some limited Lyme Disease testing and treatment options at our Edmonton office.
In the double blinded study by Hammarlund and Sundberg, patients with chronic leg venous ulcers but without diabetes or large vessel arterial disease showed a 36% reduction in ulcer size at six weeks after a course of Hyperbaric Oxygen compared with a 3% reduction in the control group treated with hyperbaric air.
For most infections 100% oxygen is used up to 2.4 ATA for 1 h sessions, which can be given once a day or preferably twice a day.
The immune system is stimulated by oxygen pressures up to 2.5 ATA.
Hyperbaric Treatment is most commonly utilized for Stroke, Brain Injury and Concussion at our Edmonton office. In particular because there is a wealth of strong data to support its use in these conditions.
For most nervous system injury like Stroke, or Concussion the treatment pressures our Edmonton clinic uses is in the range is 1.5 - 2.0 ATA, and 60 minute sessions.
However data is emerging supporting the use of 90 minute sessions for Stroke Treatment.
In addition to Hyperbaric Treatment, we've seen the incorporation of IV Therapy to be beneficial in Stroke and Concussion Treatment at our Edmonton Clinic.
Hyperbaric Oxygen Treatment in 74 Stroke patients up to 3 years after the Stroke.
The authors stated "We found that the neurological functions and life quality of all patients in both groups were significantly improved following the HBOT sessions."
Hyperbaric Oxygen Treatment in 27 Stroke patients up to 4 years after the Stroke.
The Hyperbaric Treatment group showed significant improvements in numerous motor function tests and Stroke Impact Scale - superior benefits as compared to the control group.
Hyperbaric Oxygen Treatment in 56 Post Concussion Syndrome patients up to 6 years after the Brain Injury.
A significant improvement was observed in the treated group after HBOT in all cognitive measures: Information Processing Speed, Attention, Memory, and Executive Functions.
Hyperbaric Oxygen Treatment in 30 Post Concussion Syndrome patients at least 1 year after the injury.
Significant improvement was seen in neurological exam, symptoms, intelligence quotient, memory, measures of attention, dominant hand motor speed and dexterity, quality of life, general anxiety, PTSD and depression.
Ishii et al (2005) reported that the use of Hyperbaric Oxygen Treatment for muscular fatigue in Olympic Seven athletes who received Hyperbaric Therapy up to 40 minutes at 1.3 ATA with between two and six treatments per athlete.
It was found that all seven athletes had enhanced recovery rates from Hyperbaric Therapy.
Very commonly we see subacute musculoskeletal injury patients using Hyperbaric Treatment at our Edmonton office.
Hypoxia is also a common feature of the tumor microenvironment and a major cause of clinical radioresistance.
There is preliminary evidence that Hyperbaric Oxygen and ketogenic diets have a synergistic effect for cancer treatment (Poff 2013).
Hyperbaric Oxygen has been used with good results in the management of radionecrosis (the term used for radiation-induced tissue death): soft tissues radionecrosis as well as osteoradionecrosis (bone).
A Review of experiences with 124 patients has shown that HBO therapy led to significant improvement in 94 % of the cases (Slade and Cianci 1998 via Jain 2017).
HBO is not used in the early postradiation period as it may potentiate the effects of radiation.
Although not quite as common, we still see our fare share of Delayed Radiation Injury patients at our Edmonton clinic for Hyperbaric Treatment.
Unfortunately not many standard or alternative treatments exist for this but Hyperbaric Treatment has very strong data for a range of radiation damaged tissues.
The most common pain condition we use Hyperbaric Treatment for is Fibromyalgia management at our clinic.
Fibromyalgia - In a prospective, active control crossover trial of 60 female patients with FMS, HBOT administered in forty 90-min sessions, 5 days/week, using 100 % oxygen at 2 ATA led to significant improvement in both treated and crossover groups (Efrati et al. 2015).
Our Naturopathic Doctors are extremely experienced in Fibromyalgia treatment at our Edmonton clinic.
We frequently employ IV Therapy as some patients have extremely rapid improvements following IV Therapy.
Case Reports exist for the use of Hyperbaric Oxygen in IBD - Crohn's and Ulcerative Colitis.
Several cases of psoriasis have been reported to be successfully treated by HBO.
Anti-inflammatory effects of HBO on prostaglandin, nitric oxide, and cytokines involved in wound pathophysiology as well as the immunosuppressive effects of HBO contribute to the beneficial effect of HBO in these conditions (Dulai et al. 2014).
Our Edmonton office is experienced in Alternative management of Autoimmune conditions.
Risks of Hyperbaric Treatment:
Hyperbaric Oxygen Treatment is generally extremely safe, however there are a few common concerns that may arise
Visual Changes: After a large number of Hyperbaric Oxygen treatments some changes in vision may occur (myopia or nearsightedness).
These usually return to pretreatment vision levels in a 6 week to 6 month period.
Hyperbaric Oxygen Treatment may cause increased maturation of cataracts but does not cause cataracts.
Ear Discomfort: The increasing pressure during Hyperbaric pressurization can cause ear discomfort and you must to equalize the pressure by swallowing or yawning "cracking your ears."
Blood sugar changes: If you are diabetic we'll monitor your sugars pre and post dive.
With diabetics large decrease in blood glucose levels can occur from Hyperbaric treatment, blood glucose should be 5.5 before treatments.
Signs of oxygen toxicity are tingling in the fingers, nausea, dry cough, seizures and chest pain
Sinus squeeze: Second most common complication, usually during reduction of pressure "descent" - pain because sinus opening blocked by congestion, edema, blood, polyps.
We have not seen oxygen toxicity or visual changes occur from Hyperbaric Treatment at our Edmonton office. These principally are related to higher pressure procedures whereas the treatment of neurological injury (Stroke, Concussion etc) use moderate pressures.
Oxygen Toxicity: Oxygen toxicity can occur if a patient is overly sensitive to oxygen or is exposed to high pressure (>2.4 ATA) for prolonged periods - we have never seen any indication of oxygen toxicity in our patients.
Generally HBO therapy is safe and well tolerated by humans at 1.5–2 ATA.
Oxygen toxicity seizures are very rare - Diabetes, Hyperthyroidism and Fevers all increase risk.
If you have a history of seizures we will give you air breaks mid-ascent.
Generally speaking, the incidence of adverse effects with Hyperbaric Oxygen administration is extremely low when appropriate pressures and treatment durations are employed.
Preparing for Hyperbaric Treatment
Fire is the biggest safety risk because of the 100% oxygen used.
Do not to take anything into the Hyperbaric chamber.
No paper or books, metal objects, jewellery, watches, cellphones are allowed in the Hyperbaric Chamber.
Hearing aids, contact lenses and piercings are not allowed in the chamber either
Let us know about Implanted devices, pacemakers or AICDs - Automatic Implantable Cardioverter Defibrillator, or External insulin pump or continuous blood sugar monitor.
Gum is not permitted.
You will be asked to remove anything with oil in it including all cosmetics such as: lipstick, makeup, hair oil, cream, hair spray, nail polish, ointments, cologne or perfume, liniments and deodorant.
It's best to come to the clinic with none of these applied that day or removed prior to joining us at the clinic.
You will be given a 100% cotton gown to wear during the Hyperbaric Treatment.
Please do not wear any other clothing into the Hyperbaric Oxygen Chamber without checking with our staff.
Other preparations: You need to go to the bathroom before you start your treatment. You cannot leave the chamber mid-treatment or this will end your session.
You may eat a light meal but no carbonated drinks or pop 2 hours prior to Hyperbaric treatment.
No smoking 2 hours prior and 2 hours after treatment as it decreases the amount of oxygen that can be transported by the blood.
If you are an insulin dependent diabetic, take your regular meal and insulin prior to treatment.
Do not hold your breath during Hyperbaric Treatment
Let us know if you have had ear pressure issues before eg. during flying.
For high pressure or long treatments, you may also have to wear a mask intermittently for what are called “air breaks.”
IV Therapy & Hyperbaric Oxygen
The Naturopathic Doctors at TruMed love IV Therapy treatments. We've seen more rapid and dramatic results in our Edmonton patients with treatments of IV nutrients.
Most commonly, IV Therapy is incorporated in the treatment of Neurological injury (i.e. Stroke, Concussion).
The reality is that Hyperbaric Oxygen drives oxidative phosporylation in the cell and our Naturopathic doctors can provide raw substrate for the Krebs cycles with IV Therapy.
The result: massive synergy and enhanced results when Hyperbaric Oxygen is combined with IV Vitamin Therapy. The pressure gradient is also thought to enhance nutrient uptake.
With treatments like IV Vitamin C, one group has proposed that because the level of tissue oxygenation may be the most important factor in the anticancer activity of IV vitamin C, that the utilization of Hyperbaric Oxygen immediately after IV vitamin C therapy is thought to increase its effectiveness as an anticancer agent.
Likely through it's mechanism related to the formation of hydrogen peroxide.
One group out of Seattle has remarked "In our experience, the addition of HBOT to any IV protocol improves efficacy."