Hyperbaric Oxygen Therapy (HBOT)


Hyperbaric oxygen therapy involves the administration of 100% oxygen at a controlled pressure which is greater than surface pressure. Hyperbaric chambers are known to help scuba divers treat decompression sickness, but researchers also discovered that oxygen delivered at a high pressure could increase the oxygen amount in the cells of the body to promote healing of damaged tissues. The air we breathe daily contains 21 percent oxygen which is not enough to serve this purpose. Hyperbaric oxygen therapy delivers oxygen quickly and in high concentrations. It is considered to be a more effective treatment than forcing oxygen into tissues by topical applications.


  1. Hyperoxygenation
    Oxygen is normally carried throughout the body in the red blood cells. The elevated pressure within the chamber causes the blood vessels to carry far more oxygen into the plasma than red cells in a healthy body; this increases the delivery of oxygen to the cells even in cases of tissue injury where less oxygen gets to. Elevated levels of oxygen at a high pressure can also purge toxins including carbon monoxide, and shrink gas bubbles, this is important in the treatment of arterial gas embolism and decompression sickness.
  2. Neovascularisation
    Increasing the oxygen intake to the bloodstream promotes the formation of new capillaries (tiny, thin-walled blood vessels), which improve blood flow. Swelling occurs when tissues are damaged; HBOT increases blood flow and brings nutrients to the injured area which reduces swelling.
  3. Vasoconstriction (narrowing of blood vessels)
    High pressure oxygen causes constriction of the blood vessels without reducing oxygenation (hypoxia). Vasoconstriction is known to reduce oedema in injured tissues, treat ischemia (decrease of oxygenated blood to the tissue) and burns.
  4. Antibacterial activity
    HBOT also boosts the immune system; it enhances the killing ability of white blood cells, which can then destroy germs, toxins and free radicals. HBOT neutralises the bacterium Clostridia which grows in the absence of oxygen and causes gas gangrene.


The treatment takes place in a special chamber that can accommodate one or several individuals. The pressure inside the system is gradually increased, patients can watch television or listen to music and parents can accompany their child in the chamber. The duration of the treatment is around 60 minutes. When the treatment is completed, normal pressure is restored slowly.

A course of several sessions is needed.

The cost of one session is between £10 to £20.

Side effects

The treatment may have some side effects such as ear discomfort (some children will require tubes in their ears), blocked sinuses or temporary changes in vision. HBOT is not recommended to patients with a lung abnormality.

Conditions that may respond to HBOT

HBOT is normally accepted as a treatment for the following conditions:

  • Air/gas embolisms
  • Carbon monoxide poisoning and smoke inhalation
  • Carbon tetrachloride poisoning
  • Crush injuries
  • Decompression sickness
  • Enhanced healing of selected wounds
  • Exceptional blood loss
  • Gas gangrene
  • Necrotizing soft tissue infection
  • Osteomyelitis
  • Radiation
  • Skin grafts and flaps
  • Thermal burns

HBOT therapy is controversial for the treatment of cerebral palsy and multiple sclerosis due to a lack of clinical evidence.



- Wherrett CG, Mehran RJ, Beaulieu MA. Cerebral arterial gas embolism following diagnostic bronchoscopy: delayed treatment with hyperbaric oxygen.Can J Anaesth 2002 Jan;49(1):96-9.

" A patient with presumed CAGE made a complete recovery following treatment with hyperbaric oxygen therapy even though it was initiated after a significant time delay."


- Vescio G, Battaglia M, Sommella L, Gallelli G, Manzo F, Cristiano SF, Valente A, Musella S. Ann Ital Chir 2001 May-Jun;72(3):355-9 Fournier's gangrene.

"This disease requires prompt treatment: early diagnosis, antibiotic therapy, nutritional support, immediate extensive surgical debridement and hyperbaric oxygen therapy"


- Grolman RE, Wilkerson DK, Taylor J, Allinson P, Zatina MA. Am Surg 2001 Nov;67(11):1072-9; discussion 1080

"Transcutaneous oxygen measurements predict a beneficial response to hyperbaric oxygen therapy in patients with nonhealing wounds and critical limb ischemia."


- Mayer R, Klemen H, Quehenberger F, Sankin O, Mayer E, Hackl A, Smolle-Juettner FM.

Hyperbaric oxygen--an effective tool to treat radiation morbidity in prostate cancer. Radiother Oncol 2001 Nov;61(2):151-6

Colitis and Crohn's disease

Buchman AL, Fife C, Torres C, Smith L, Aristizibal J. Hyperbaric oxygen therapy for severe ulcerative colitis. J Clin Gastroenterol 2001 Oct;33(4):337-9

"Hyperbaric oxygen therapy has been used to successfully treat perineal Crohn's disease"

Brain injuries

- Sukoff MH. Effects of hyperbaric oxygenation. Neurosurg 2001 Sep;95 (3):544-6

" This is the first study to demonstrate a prolonged effect of HBO treatment on CBF and cerebral metabolism. On the basis of their data the authors assert that shorter, more frequent exposure to HBO may optimize treatment."

Multiple sclerosis

In 1996 the Cochrane Library (evidence based research available on the internet) reviewed the use of HBOT for multiple sclerosis and declared there was not enough evidence to prove its benefits. More recently in December 2001, PM Kidd found that "Long-term hyperbaric oxygen therapy can slow or remit the disease "(Multiple sclerosis, an autoimmune inflammatory disease: prospects for its integrative management Altern Med Rev 2001 Dec;6(6):540-66)

- Kleijnen J, Knipschild P. Hyperbaric oxygen for multiple sclerosis. Review of controlled trials. Acta Neurol Scand 1995 May;91(5):330-4

"The majority of controlled trials could not show positive effects. Further evidence might consist of trials in patients with disease of recent onset or with other dosing regimens but the case for such further trials is not strong. Considering the state of affairs we cannot recommend the use of hyperbaric oxygen in the treatment of multiple sclerosis."

Cerebral Palsy

It is hypothesised that cells around the damaged area of the brain are not dead but "dormant" and that HBOT can reverse the degeneration of tissues and revive them.

Patients undergo a series of single photon emission computed tomography (SPECT) scans which help identify which parts of the brain are damaged or dormant.

Not much research has been carried out on HBOT as a treatment for cerebral palsy. The findings appear contradictory: A recent study in the Lancet was not conclusive:

- Collet JP, Vanasse M, Marois P, Amar M, Goldberg J, Lambert J, Lassonde M, Hardy P. Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group.The Lancet 2001 Feb 24;357(9256):582-6

"In this study, hyperbaric oxygen did not improve the condition of children with cerebral palsy compared with slightly pressurised air"

- Montgomery D, Goldberg J, Amar M, Lacroix V, Lecomte J, Lambert J, Vanasse M, Marois P. Effects of hyperbaric oxygen therapy on children with spastic diplegic cerebral palsy: a pilot project. Undersea Hyperb Med 1999 Winter;26(4):235-42

"----Results showed improved gross motor function in three of the five items in the GMFM test, improved fine motor function in three of the six hand tests, reduced spasticity in three of four muscle groups when assessed by a physician specializing in CP, and improvements for four of nine questions posed to parents."

More studies can be viewed at the following website:


Hyperbaric Oxygen Trust for Brain Injured Children (HOT)
Ryton House
Primrose Lane
Forest Row
East Sussex RH18 5LT
Tel: 01342 823127

The initial evaluation fee will be £400 and will include physical consultation and programme. Each HBOT session, on the basis of collective use of the chamber, will be £15. Oxygen receiving helmet for each patient will cost £85.

There are 60 multiple sclerosis centres in the UK where children with cerebral
palsy can be treated with this therapy, for further information contact the Federation
of Multiple Sclerosis Therapy Centres on: 01234 325 781. http://www.ms-selfhelp.org/centres.html

A Breath for Life Unit 4,
Lake Enterprise Park
Ladies Walk
Lancaster LA1 3NX
Tel: 01524 380 363

This charity offers various treatments: naturopathy, homeopathy, osteopathy and
craniosacral therapy


- http://health.medscape.com/cx/SimpleSearch?QueryText=hyperbaric.
Medscape health

- http://www.medicalmultiplex.com/faq.html
Frequently asked Questions on HBOT

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