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Hyperbaric Oxygen Therapy

March/April 2007

Therapeutic Advantages from Penn's Institute of Environmental Medicine Experts

Hyperbaric oxygen (HBO) therapy involves exposing patients to 100 percent pure oxygen at greater than atmospheric pressure. This process results in several advantageous therapeutic principles:

• Increased overall pressure (important in the treatment of decompression sickness);
• Increased oxygen pressures are much higher under HBO therapy than normobaric conditions;
• Increased oxygen transport by blood plasma.

“The combination of increased air pressure and 100 percent oxygen stimulates new blood vessel growth in the body. The patient's oxygen tension decreases very quickly after leaving the chamber, but secondary effects are triggered because of the high oxygen exposure,” says Stephen Thom, MD, PhD, chief of Hyperbaric Medicine at the Hospital of the University of Pennsylvania.

“Although physicians and their patients may have heard about HBO therapy, they may not be aware of its many applications,” continues Dr. Thom. “Through our research, we've demonstrated that HBO therapy can mobilize the stem cells from bone marrow. These cells migrate to wounds to ultimately accelerate healing.”

As a national center for HBO therapy and research, Penn's Institute of Environmental Medicine offers the region's only large, walk-in hyperbaric oxygen chamber. An HBO therapy physician directly supervises all treatments and one or more attendants are continuously present in the chamber during a therapy session. Up to eight patients can be treated at one time and the chamber is fully equipped to provide intensive care.

Patient Comfort and Safety
Each HBO treatment is typically two hours long. In Penn's chamber, patients can sit in reclining chairs and watch a movie, read a book, or take a nap. A special safety lock permits people (staff and other patients) to move in and out of the chamber without decompressing it; if a patient is late and/or if there are issues with another patient's treatment, it will not impact the others in the chamber. Further, unlike monoplace (singleperson) chambers, the whole roomsized chamber is not compressed with oxygen. Instead, patients wear individual facemasks to facilitate oxygen flow.

“This is an important safety issue,” says Dr. Thom. “An entire chamber compressed with pure oxygen can be hazardous. To enter a monochamber, patients are usually required to change out of their clothes because the slightest spark in a pure oxygen environment can be disastrous. Because our room-sized chamber isn't filled with oxygen, there is very limited risk. In fact, patients can wear their normal street clothes, which helps them to feel more comfortable and at ease during the process.”

Emergent and Non-Emergent Care
Penn HBO therapy physicians are board-certified in a primary specialty and sub-certified in hyperbaric medicine, and are considered to be leading experts in the field. “We've had tremendous success with patients suffering from lower extremity ulcers due to diabetic complications,” says Dr. Thom. “HBO therapy often reduces the need for amputation.”

Penn is also using HBO therapy to treat cancer patients who have had complications from radiation treatment. “For example, in prostate cancer patients with radiation cystitis we've been able to resolve the damage in 70 to 80 percent of the cases,” says Dr. Thom. “For many patients, it's as though they never had radiation.” Many head and neck, chest, bowel, and bladder cancer patients with radiation necrosis or osteoradionecrosis are likewise experiencing improved outcomes with HBO therapy treatment at Penn. The therapy can also be used for emergent care such as carbon monoxide poisoning.

“Virtually any patient with a problem healing due to small-vessel arterial problems should be considered for HBO therapy,” says Dr. Thom. “We are also available to consult with a physician on a case or answer questions about the applicability of HBO therapy for an individual patient.”

For more information about HBO therapy or to obtain a patient consult, call Penn's physician referral line, PENNHealth at 1-800-789-PENN.

	Referring Physicians: To speak with a Penn physician or refer a patient, contact PennHealth through the secure online referral form or by calling 1-800-789-PENN (7366).