Hyperbaric Medicine

What is hyperbaric oxygenation treatment (HBOT)?

HBOT consists of breathing oxygen (O2) in high concentrations, inside a pressurized chamber above normal atmospheric pressure (at sea level, 1.0 absolute atmosphere or ATA). For clinical use, the pressure must be at least 1.4 ATA.

Hyperbaric oxygenation is used as primary therapy in some pathologies and intoxications, or as an adjuvant in pathologies with inadequate oxygen supply to tissues.

Hyperbaric chambers are medical devices where HBOT is carried out in a non-invasive and safe way, administering high concentrations of oxygen to the patient, by means of an inhaler, in an environment under pressure.

To understand the operation of this therapy it is necessary to remember the main function of respiration: to enter oxygen to the organism to be distributed by the circulatory system to all organs and tissues.

The physical-chemical foundation of the therapy is essentially based on two physical laws that describe the behavior of gases. Dalton’s Law establishes that, at a constant temperature, the pressure of a mixture of gases is equal to the sum of the partial pressures (Pp) of each of the gases that compose it. Therefore, by administering 100% O2 at 1.4 ATA pressure, an O2 Pp is obtained in the organism many times greater than under normal conditions (breathing normal air, 21% O2, at 1.0 ATA).

Henry’s law states that gases dissolve in liquids when under pressure. This implies that the O2 administered in a pressurized environment dissolves or distributes in the plasma and in the liquids with which the gas is in contact.

This effect takes place once the amount of inspired O2 increases, which generates a local pressure gradient in the alveolus and favors the diffusion of oxygen to the plasma. In addition, this mechanism is independent of the transport of O2 bound to hemoglobin (Hb), which under physiological conditions is almost completely saturated (~ 97%).

This allows ensuring the arrival of O2 to the tissues, not counting the contribution of O2 bound to Hb: when there is an obstruction to the perfusion and the flow of circulating red blood cells (edema, inflammation) and in anemic patients. In this way, most of the O2 is dissolved in the plasma and a high concentration of circulating O2 is reached, which in turn is available to diffuse and penetrate into tissues and cells.

Mechanisms that favor or stimulate the HBOT:

  • Vasoconstriction
  • Angiogenesis
  • Osteogenesis
  • Cellular immune response to infections
  • Collagen synthesis
  • Anti-inflammation and reduction of edema
  • Proliferation and cell differentiation
  • Wound healing
  • Neuroprotection