How does it work?
Getting oxygen to workConcentrated oxygen at a pressure of 1.45 ATA causes an increase in oxygen delivery to injured or hypoxic tissues at a level 400% deeper than our normal blood supply can penetrate. This utilizes the properties of liquids and gases under pressure (Henry’s Law), which causes oxygen (a gas) to become dissolved into fluids such as plasma, cerebrospinal and synovial fluid, creating a systemic saturation of the brain, nervous system, muscles, joints and organs, penetrating difficult to reach regions in an effort to promote healing.
In interpreting table values, what’s important to know is the relative HBOT oxygen concentration over breathing regular air at ambient pressure. This relative value changes with pressure and the concentration of oxygen being delivered. I have listed this increase in parenthesis as a multiple over the ambient room oxygen concentration. Take for example a person breathing 100% oxygen at 1.45 ATA. From the table, the multiple is (5.7 – 7.7). This means the person breathing 9#% oxygen has roughly 9 times as much oxygen in their blood vessels as a person sitting outside the chamber breathing room air.
Roughly 9 times the amount of oxygen
The following article from Dr. Kenneth Stoller eloquently describes HBOT and its benefits:
Hyperbaric therapy is truly a benign and benevolent intervention for children and adults with brain injuries.
It works as its name implies – hyper (more of) and baric (pressure) and in fact that is how it works. It is the increased pressure of the gas we breathe everyday that can actually signal the DNA in our cells to perform healing tasks that the body normally can’t do.
Ground zero for this activity is the mitochondria, which are the little organelles inside of our cells that convert oxygen and sugar into the gasoline the cells run on (ATP) – this is called cellular respiration. It doesn’t take much to knock mitochondria off-line and then that cell can’t perform the job it was assigned. So, be it oxygen deprivation, external toxic exposure, stroke, trauma, or a hyper-immune reaction to an infection or a vaccine the mitochondria will be damaged.
We know how Hyperbaric therapy works – it works by reviving the little mitochondria and actually causes mitochondrial biogenesis, so that if you need more mitochondria in your neurons more of them will form. It is interesting to note that the reason the keotgenic diet helps patients with certain types of neurological problems is that ketone bodies help support mitochondrial function. It is a back door way the mitochondria can receive energy if glucose transport has been compromised. My opinion is that hyperbaric therapy is the most effective way to do this. It is that simple – this is not rocket science, but it is non-invasive brain repair.
Another main physiological effect of oxygen relates to vasoconstriction. Increased levels of oxygen cause a decrease in local nitric oxide (NO) production by endothelial cells, thereby leading to vasoconstriction. Conversely, increased levels of carbon dioxide, the byproduct of respiration, promote NO production and vasodilation. This is especially important as it relates to cerebral blood flow as short-term hyperoxia causes cerebral vasoconstriction and reduced blood flow. However, even with reduced blood flow, more oxygen is delivered to the cerebrum as a result of the hyperoxic state. Additionally, hyperoxia has also been shown to decrease cerebral edema, although the mechanisms behind this are still not well understood and further studies are needed to characterize this proposed phenomenon. Applications of these effects have some promise in acute brain injury.
It is first imperative to understand some basic terms to understand mechanical ventilation.
- Ventilation: Exchange of air between the lungs and the air (ambient or delivered by a ventilator), in other words, it is the process of moving air in and out of the lungs. Its equally important effect is the removal of carbon dioxide (CO2) from the body, and increasing blood oxygen content. Ventilation is measured as minute ventilation in the clinical setting, and it is calculated as respiratory rate (RR) times tidal volume (Vt). In a mechanically ventilated patient, the CO2 content of the blood can be modified by changing the tidal volume or the respiratory rate.
- Oxygenation: Interventions that provide greater oxygen supply to the lungs, thus the circulation. In a mechanically ventilated patient, this can be achieved by increasing the fraction of inspired oxygen (FiO 2%) or the positive end-expiratory pressure (PEEP).
- PEEP: The positive pressure that will remain in the airways at the end of the respiratory cycle (end of exhalation) that is greater than the atmospheric pressure in mechanically ventilated patients. For a full description of the use of PEEP, please review the article titled “Positive End-Expiratory Pressure (PEEP).”
- Tidal volume: Volume of air moved in and outside the lungs in each respiratory cycle.
- FiO2: Percentage of oxygen in the air mixture that is delivered to the patient.
- Flow: Speed in litres per minute at which the ventilator or oxygenator delivers breaths.
- Compliance: Change in volume divided by change in pressure. In respiratory physiology, total compliance is a mix of lung and chest wall compliance as this two factors cannot be separated in a live patient.
mHBOT provides 8 times the normally breathed amount of oxygen to the recipient when under 1,45 ATA.
An incorrect assumption may therefore be that, the more oxygen the better. This is partially true, but large doses of oxygen are normally beneficial for the treatment of classic HBOT treatable conditions, viz,:
- Air or Gas Embolism, Carbon Monoxide Poisoning, Decompression Sickness, Gas Gangrene,Crush Injury, Compartment Syndrome, and Other Acute Traumatic Ischemias
Prolonged sessions are very useful when the condition is critical and patients can receive up to 3 sessions per day for 60 min per session. Such interventions can be arranged for special conditions and critical assistance.
- Oxygen therapy, like most physical treatments require multiple sessions to achieve the healing and change that is required.
- It is very common to have 10 sessions of 90 min duration for conditions that are needing immediate treatment. It is not uncommon for serious conditions to require up to 40 sessions to show noticeable changes and healing. It needs to be borne in mind that it is the combination of several factors, medication and mHBOT sessions that bring about the desired treatment.