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Hyperbaric Oxygen Therapy for Cerebral Palsy

Page 8 of 10

What are the benefits of HBOT

  • Improved quality of life. By promoting healing of the problem wound, adding HBO therapy can mean the difference between disability, loss of limb, and healing.

  • Improved care. By delivering high oxygen under pressure, hypoxic tissue can be restored and healing takes place.

  • Lower costs. By accelerating healing and the reduction of extensive medical care, HBOT coincides with cost-containment goals of major insurance providers.

What are the contraindications of HBO?

  • Upper respiratory infections and chronic sinusitis make it difficult for the patient to clear his/her ears. Often decongestants are used to open the sinuses, and occasionally surgical myringotomy is necessary to maintain open Eustachian tubes. Sometimes it is better to interrupt treatment for three or four days to allow the respiratory infection to clear.

  • High fever can predispose to oxygen seizures but in such cases drugs can be given to lower the fever.

  • In some patients with severe emphysema and COPD the only stimulus to breathe is hypoxemia, as they have lost their sensitivity to normal levels of CO-2. These patients may cease breathing if placed in the hyperbaric chamber.

  • Patients who have a lower than normal seizure threshold may be more prone to develop seizures due to oxygen toxicity. If HBO treatment is a requirement, additional anticonvulsants can be added to these patients' regimens.

  • HBO treatment is absolutely contraindicated for patients with pneumothorax, or collapse lung, and caution is used with HBO treatment if a patient has a history of spontaneous pneumothorax.

  • HBO is not recommended for patients who have active cancerous conditions.

  • If a woman is pregnant, HBO is not recommended for precautionary reasons, except in life-threatening emergencies.

What are the possible side effects of HBOT?

  • Barotrauma or ear and sinus discomfort. A patient may experience a fullness and an uncomfortable pressure in the ears. This can be relieved by slowing the rate of descent/ascent so that the patient is comfortable with the change in pressure. Also, decongestants taken prior to treatment is sometimes helpful.

  • Oxygen toxicity. This may occur, particularly when therapy is given at more than 2.4 ATA. This is minimized by not exposing the patient to greater pressure or longer times than are known to be safe for the body and its organs. Some patients are susceptible to high O2 partial pressures. Treatment is the discontinuance of HBOT.

  • Serous otitis. Rarely, fluid accumulates in the ears as a result of changes in pressure in the ears and sinuses resulting in a possible ruptured membrane. Treatment is the discontinuance of HBOT and a referral to an ENT physician.

  • Temporary worsening of near-sightedness (Myopia). After twenty or more treatments, especially if the patient is over forty years of age, it is possible to experience a temporary diminution in the ability to focus on thins far away. This is temporary and vision typically returns to its pre-treatment level about six weeks after cessation of therapy. It is not advisable to get a new prescription for glasses until at least eight weeks have passed after hyperbaric therapy.

  • Temporary improvement in far-sightedness (Presbyopia). Also, after twenty or more treatments, especially if the patent is over forty years of age, there is a possibility to experience an improvement in the ability to see things close up or to read without glasses. However, this is temporary and the vision should return to its previous level of acuity in about six weeks following cessation of Hyperbaric treatment.

  • Numb fingers. A small portion of patients sometimes notice a numb feeling in the fourth and fifth fingers of the hands after twenty or more treatments. This should not be of concern and should disappear within about six weeks following cessation of therapy.

What is the treatment process like?  

The treatment process may be modified for different types of chambers, either the monoplace or the multi-place chamber. In the monoplace chamber, one person at a time is treated, whereas in the multiplace chamber where more than one patient is treated at the same time, with an attendant present in the chamber.

Only 100% cotton gown, which is supplied, is permitted in the chamber. No cosmetics, perfumes, deodorants, hair preparations, wigs or jewelry are worn during the treatments. Patients are advised not to take carbonated drinks or alcohol for at least four hours prior to each treatment, and that they should give up smoking and tobacco products, as these interfere with the body's ability to transport oxygen.

Once inside the chamber, the patient will be experience the changing pressure which is the same as that felt in an airplane when ascending or landing. Prior to the treatment, the patient is instructed in techniques of equalizing the ear/sinus pressure by yawning, swallowing, or attempting to blow through the nose while holding it shut. During the treatment the individual will be breathing 100% oxygen, dispersing oxygen into the blood plasma and delivering up to 15 times as much oxygen to tissues as would breathing room air. The treatment length is 60 - 90 minutes, depending the diagnosis and the physician's determination of treatment. The acrylic walls allow for the trained technicians to closely monitor the patient, as well as providing comfortable viewing out of the chamber. From inside the chamber the patient can always communicate with the attending technician via intercom, as well as watch TV, listen to music, or just take a nap.

What does the Hyperbaric technician need to know before giving HBOT?

  • you experience a cold, flu symptoms, sinus or nasal congestion, or chest congestion

  • there may be a possibility of pregnancy

  • your medications have changed

  • you have skipped a meal prior to HBO treatment

  • you are a diabetic and did not take your insulin prior to treatment

  • you have any concerns or anxiety

 

RETURN TO: Hyperbaric Oxygen Therapy (part 2) (9)