Hyperbaric oxygen therapy for Degenerative Discs

Hyperbaric oxygen therapy is a used to treat difficult wounds in many cutting-edge hospitals and wound centers mainly due to it’s ability to promote growth of new tissue and blood vessels. Researchers have now taken this further to see if the healing effects of oxygen can also be shown for the intervertebral discs. This is a debilitating condition for a wide range of the population and are seen in more as people age and also for those who have suffered physical trauma to the area (ie, contact sports or accidents and falls). The following study shows us the mechanism involved in hyperbaric oxygen’s application for treating degenerative discs. Since this treatment modality is non-invasive, it should now get considerable attention for an adjunct treatment modality for disc degeneration <view study>

Hyperbaric Oxygen therapy — The earlier the better!

Sciatic Nerve Regeneration:

“The aim of the study was to determine the effect of different application timings of hyperbaric oxygen treatment (HBO) on nerve regeneration in rats”

“Our results suggest that initiating HBO early after nerve repair will make a positive impact on recovery” <view study>

Hyperbaric oxygen therapy in the treatment of COVID-19 — severe cases

From Wuhan China — promising results have just been published in a preliminary report by Dr. Zhong Yangling for the treatment of 5 COVID-19 patients (2 of which were critical and 3 were severe) with hyperbaric therapy at the Department of Hyperbaric Oxygen in Wuhan Yangtze River Shipping General Hospital.

In this report, hyperbaric oxygen was added to the current comprehensive treatments being performed at the hospital for COVID-19 affected patients, with a dose of 90-120 minutes at treatment pressures of 1.4 to 1.6 ATA. The results were very encouraging as these 5 patients received significant therapeutic benefits, including rapid relief of symptoms after the first session. The rationale for adding this procedure is to help combat the progressive hypoxemia (low blood oxygen levels) that COVID-19 can cause. Hyperbaric oxygen has the ability to add a substantial supply of extra oxygen into the bloodstream and therefore can help during these times of hypoxemia.

Hypoxemia is the key determinant to the deterioration of patients seen with COVID-19. The virus attacks the lungs and causes inflammation and the body has a difficult time getting enough oxygen transferred from the lungs into the body. This progressive hypoxemia leads to an increase in mortality rates as patients can become critically ill. At this time, they are typically in complete reliance on ventilators to help restore oxygen levels, to keep them alive, while the body fights the virus and repairs the lung damage.

The advantage of hyperbaric oxygen for the treatment of progressive hypoxemia is that the higher pressure environment allows greater levels of oxygen to pass through the thickened and inflamed lung tissue into the bloodstream; thereby directly treating the hypoxemia. Add to this, the greater solubility of oxygen in the blood (in hyperbaric conditions) and it’s now easy to see why all 5 patients reported dramatic relief of their symptoms — Dr. Zhong reported that after the first session of hyperbaric oxygen, symptoms such as dyspnea (shortness of breath) and chest pain were reduced. After the second session, the respiratory rate decreased gradually and the shortness of breath (after movement) was relieved slowly. To correlate with these subjective results, Dr. Zhong was able to objectively chart a significant upward trend of oxygen levels, day by day. In addition, lung inflammation was re-evaluated through CT scan, and all 5 patients significantly improved.

It should be noted, that hyperbaric oxygen is not a treatment for the COVID-19 virus and this report should NOT lead people to look for hyperbaric chambers for treating the virus, particularly within private centers that are not equipped for treating infectious diseases. However, this is a very important paper outlining the potential clinical role that hyperbaric therapy can play in the symptomatic relief of hypoxemia that is seen in the COVID-19 affected population. Hopefully, this will lead the medical community to take a much harder look at integrating hyperbaric therapy and utilizing its key physiological benefits (ie, reducing hypoxia). In turn, this could lead to a much larger demand for the use of hyperbaric chambers in hospitals and infectious disease centers to coexist as a supportive therapy, during these critical stages. Deploying hyperbaric chambers in this manner could offer major lifeline support to patients, while aggressive medical treatments are being administered in the hospital setting. This applies to both current hospital-type chambers and portable hyperbaric chambers as these chambers can be performed in the open area of the hospital.

Hospital chambers — According to Dr. Zhong, these chambers can help “improve the treatment efficiency, reduce the medical pressure and the risk of infection, and decrease the mortality rate of critical patients”. With the limited supply of ventilators, hyperbaric chambers can offer valuable relief. Hyperbaric Oxygen Department of Wuhan Changjiang Shipping General Hospital has established complete infection control procedures and measures for the hyperbaric treatment of patients with coronavirus. If followed, this could lead to a widespread movement of hyperbaric chambers to help in areas where the local demand is too great from community infection. In Wuhan, Huoshenshan hospitals are not equipped with hyperbaric chambers so construction of a new hyperbaric oxygen chamber system started at Huoshenshan Hospital and is being installed and commissioned for use within 15 days!

Portable chambers — These chambers are typically operated at lower pressures of 1.3 ATA and can have physiological benefits in reducing hypoxemia. Of note, Dr. Zhong also tested 1.2 to 1.4 ATA and found that the oxygen levels were still kept in a high level and this was even with ambient air application. Again, as a supportive therapy, this could be very valuable for helping to maintain oxygen levels. Here in the United States, these types of chambers have been making steady growth in the hyperbaric industry (over the past 20 years) and fueled lately by high-profile athletes promoting its benefits. As this industry grows, many private hyperbaric centers are now writing prescriptions for patients for home use. This may help during times of isolation and the early infection period when patients are told to stay at home until symptoms become severe and hypoxemia begins to take its toll.

To summarize, this publication by Dr. Zhong should encourage us to look into hyperbaric medicine in a new way, when it comes to severe respiratory diseases caused by a coronavirus. Since this study, Dr. Zhong has now treated a total of 35 COVID-19 cases. As this pandemic continues, we do not know how much of the public will be affected and the extra load that will impact our medical system. What we do know is that this virus primarily targets the lung tissue, causing severe inflammation and hypoxemia. Hyperbaric oxygen may offer a valuable therapeutic delivery of oxygenation during times of hypoxemia. More research should be looked into this.

Disclaimer — is very important that this article is not construed as an article that promotes treating COVID-19 with hyperbaric therapy. Anyone who has been diagnosed with COVID-19 or suspected of having this infection should follow the CDC guidelines (and not seek treatments in a hyperbaric chamber as an alternative). This is purely educational material on the new preliminary report published from Wuhan China <view report>

Hyperbaric oxygen therapy may be effective to improve hypoxemia in patients with severe COVID-2019 pneumonia: two case reports

Two male patients ages 57 and 64 years old were treated with a 1-week course of hyperbaric oxygen therapy at 1.5 ATA (60 minutes per session)

Shortness of breath subsided immediately with both patients after the first hyperbaric session and resolved by the end of the 7 days. More notably, neither patient became critically ill and the lung CT scans showed remarkable improvement in lung pathology.

The authors of this study concluded this report by suggesting that “hyperbaric oxygen therapy may promptly improve the progressive hypoxemia of patients with COVID-2019 pneumonia” <view study>

Hyperbaric oxygen therapy for COVID-19 patients with respiratory distress

This is a single-center clinical trial of 20 COVID-19 patients aged 30 to 79 years being treated with 5 sessions of hyperbaric oxygen therapy at 2.0 ATA (90 minutes) at NYU Winthrop Hospital from March 31 to April 28, 2020.

“The results demonstrated the safety of hyperbaric oxygen among COVID-19 patients and strongly suggests the need for a well-designed, multi-center randomized control trial” <view study>

Hyperbaric oxygen therapy shows benefit for pulmonary fibrosis

Pulmonary fibrosis is a chronic progressive lung disease that is becoming more prevalent and poses medical challenges due to the limited therapeutic options available. The rise in the aging process along with the rise in pulmonary complications from long COVID has led to new research studies to help identify potential treatment options. Hyperbaric oxygen therapy (HBOT) is emerging as one of them, showing good promise with clinical outcome measures.

To demonstrate HBOT’s influence on this disease, researchers in this study first exposed a group of rats to bleomycin (a chemotherapeutic agent that is known to cause acute pulmonary toxicity) directly into the trachea. This is to induce pulmonary fibrosis. They waited 7 days and then treated the rats with 14 days of HBOT at 2.5 ATA&nbsp; for 90 minutes.

The rats that were treated with this 2-week course of HBOT demonstrated a marked reduction in TGF-β, which is normally elevated and plays an active role in the development of fibrosis.

The findings in this study support the use of HBOT as a potential “life-changing” therapy for patients with pulmonary fibrosis <view study>

Hyperbaric therapy reduced long COVID related fatigue in just 10 sessions

Long COVID-related fatigue can be debilitating, and may affect young people who were previously in economic employment. All patients had been suffering from long COVID symptoms for over 3 months. The results presented here suggest potential benefits of HBOT, with statistically significant results following 10 sessions of HBOT at 2.4 ATA <view study>

Hyperbaric oxygen for Concussions — A multi center observational study

Concussions, classified as mild traumatic brain injuries, are currently a major growing concern. The more we learn about this condion, the more we are able to see its devastating and long-lasting effects – even from just one concussion! Hyperbaric oxygen therapy is a very simple and safe procedure that has helped many patients recover from traumatic brain and head injuries. Recently more attention has been focused on hyperbaric oxygen therpay for concussion recovery, with overwhelmingly positive results. This study supports these reported benefits and demonstrated improvement in 21 of 25 neurocognitive test measures that were observed. Subjects received 40-82 one-hour treatments at 1.5 atmospheres absolute 100% oxygen <view study>

Preconditioning the brain with hyperbaric oxygen therapy before stroke/TBI to reduce the damage

Currently, there is a great deal of focus and attention being put on hyperbaric oxygen therapy, due to the promising results seen in clinical research and the potential application that this can have for those individuals who have suffered a stroke or TBI. Now, there is strong evidence supporting the use of hyperbaric oxygen therapy BEFORE brain trauma or injury, by preconditioning the brain with hyperbaric oxygen therapy.

This study shows that HBOT preconditioning stands as a robust prophylactic treatment for sequestration of inflammation inherent in stroke and TBI. Though we can’t predict when the brain will be under traumatic stress (unless it’s a planned surgical procedure), hyperbaric oxygen may become one of the best ways to protect our brain from future injuries. The following groups of individuals would be the ones that would most likely benefit:

• Athletes and contact sports affect the head

• Patients undergoing planned brain surgery

• High-risk stroke patients

• Those who are at risk for neurodegenerative conditions

• Elderly

The future holds bright for the application of hyperbaric oxygen therapy for being part of both the treatment of brain trauma and the prevention of the severity of damage that can subsequently occur <view study>

Hyperbaric oxygen therapy for persistent post concussion syndrome

All participants in this study were diagnosed with persistent post-concussion syndrome related to mild traumatic brain injury. A randomized group received a full course of 40 hyperbaric treatments at 1.5 ATA, daily for 60 minutes, 5 consecutive days per week, for a total of 8 weeks (2-month long hyperbaric intervention).

The hyperbaric subjects experienced significant improvements in memory, anxiety, sleep, PTSD symptoms, and quality of life.

More importantly, After crossing over to HBOT the Control Group experienced near-identical significant improvements. Further improvements were experienced by both groups after completion of their last hyperbaric session, during the 2-month follow-up period.<view study>

1.6 vs 2.2 ATA of hyperbaric oxygen for traumatic brain injuries?

The benefits of hyperbaric oxygen therapy for dramatic brain injury (TBI) has been confirmed by many studies. Now the question is “what is the best dose (ie, pressure protocol) to achieve the optimal benefits.

As new research becomes available, it appears that the lower the pressure, the stronger the benefits. This study confirms the recent data, by showing that 1.6 ATA hyperbaric intervention was superior to 2.2ATA for neurological impairment and the restoration of symptoms following TBI.

Researchers in this study suggested that “for the first time that 1.6 ATA HBO has an important protective role in inhibiting both the cytotoxic and the pro-inflammatory actions of histones in the early stage of secondary brain injury”. <view study>

Hyperbaric oxygen suppresses HIV replication

This was a laboratory-based “in vitro” study which showed that hyperbaric exposure was able to suppress HIV-1 replication.

“The exposure to hyperbaric oxygen at the pressure of 2.4 ATA and 98% oxygen was able to produce ROS and RNS molecules, which play a role in cellular adaptive responses through increasing the expression of nfĸb, p21 and mRNA of interferon α2 plays a role in inhibition mechanism of HIV-1 replication in cells.” <view study>

Hyperbaric therapy reduced long COVID related fatigue in just 10 sessions

Long COVID-related fatigue can be debilitating, and may affect young people who were previously in economic employment. All patients had been suffering from long COVID symptoms for over 3 months. The results presented here suggest potential benefits of HBOT, with statistically significant results following 10 sessions of HBOT at 2.4 ATA <view study>

The Debate is over — Low pressure hyperbaric oxygen therapy proves its effectiveness

Major News — A landmark study, in a mainstream and peer-reviewed hyperbaric medical journal has just been released, and it supports the use of lower pressure protocols for hyperbaric medicine. This is groundbreaking, because for over two decades now, there has been a constant and heated debate going on between hyperbaric physicians on the use of low pressure protocols, and whether or not they were as effective as higher pressures. Advocates of lower pressure protocols have clearly focused their opinion on the scientific rationale of the gas pressure laws of physics and say that ANY pressure will have a physiological effect – they also have growing support from empirical data. On the other hand, skeptics of lower pressure protocols say “where is the research”, and they also quote that “most of the clinical research is at higher pressures”.

This study should finally put these to rest. Here, they looked at 3 different pressure protocols: 1.3 ATA (ambient air), 1.5 ATA (pure oxygen), and 1.75 ATA (pure oxygen). They then added all 3 pressure protocols to a standard intensive exercise program for CP children and followed them with for an 8-month period of time. The results were astonishing. Not only did they find that all 3 hyperbaric oxygen pressures gave significant improvements, but there was no difference between the pressures. More startling to skeptics of lower pressure protocols, the lower pressure protocol did not even use the conventional pure oxygen, and instead only used regular ambient air.

Why this is groundbreaking is because typically in past studies, a lower pressure protocol using regular ambient air has been used as the placebo dose in studies. This is really the point of contention. The supporters of lower pressure protocols argue “how can you use 1.3 ATA ambient air as a placebo when the laws of physics clearly show that this is actually a treatment dosage” This study clearly supports their notion pressure is the key variable in hyperbaric oxygenation therapy. Pandoras box is open! <view study>

Hyperbaric oxygen restores mitochondrial function

A 14 day course of hyperbaric pretreatment for 14 days (once a day at 2.5 ATA) improved mitochondrial morphology and significantly increased the levels of ATP. This study shows a “restoration of mitochondrial function” and helping to improve cellular energy levels. <view study>

Survival outcomes of metabolically supported chemotherapy combined with ketogenic diet, hyperthermia, and hyperbaric oxygen therapy in advanced gastric cancer

The combination of metabolically supported chemotherapy, together with a ketogenic diet, hyperthermia and HBOT, appears to be promising in the treatment of advanced gastric cancer. <view study>

The effect of hyperbaric oxygen treatment on late radiation tissue injury after breast cancer

“In this case-series, 67 patients who underwent HBOT for late radiation tissue injury after breast cancer reported significant improvement in pain, fibrosis, edema, and shoulder movement. The improvement persisted up to 12 months after HBOT” <view study>

2.0 ATA treatment protocol for radiation-induced cystitis

Hyperbaric protocols can vary in dosages, based on both pressure and time. Higher-pressure protocols are typically used in hospitals and wound care centers for radiation induced damage. These pressure protocols range from 2.0 to 2.4 ATA. This study shows that 2.0 ATA (120 minutes) was equally as effective as 2.4 ATA (90 minutes) for treating radiation-induced cystitis <view study>

Hyperbaric Oxygen therapy helps the body fight solid tumors

The emergence of cancer immunotherapy has already shown some remarkable results for the treatment of solid tumors. As good as this is, patients, seem to lack the ability to respond to immune checkpoint inhibitors, thus demonstrating a primary resistance to immunotherapy.

By reducing tumor hypoxia (low oxygen) within solid tumors. hyperbaric oxygen therapy (HBOT) can help reinvigorate anti-cancer immunity.

In this study, HBOT was able to stimulate a suppressed immune system and help PD-1 Ab trigger robust cytotoxic T lymphocytes and long-lasting immunological memory to inhibit tumor relapses.

Emerging research suggests that T cell-directed checkpoint antibodies such as anti-programmed cell death protein-1 (PD-1) or programmed death-ligand-1 (PD-L1) can impact innate immunity by both direct and indirect pathways, which may ultimately shape clinical efficacy. Normally, the immune system fights foreign substances like viruses and bacteria, and not your own healthy cells. Some cancer cells have high amounts of PDL1. This allows the cancer cells to “trick” the immune system, and avoid being attacked by foreign, harmful substances.

Hyperbaric Oxygen Boosts PD-1 Antibody Delivery — “The results illustrate that HBO bolsters antitumor efficacy of PD-1 Ab, and the HBO-PD-1 Ab combination is a promising stroma-rich solid tumors’ treatment in the clinic” <view study>

Aging and obesity related cognitive decline restored by hyperbaric oxygen therapy

The combination of aging and obesity play major factors in the accelerated aging and degeneration of the brain. Commonly seen symptoms are characterized by problems with memory, language, thinking or judgment.

In this study, a simple 2 week course of hyperbaric oxygen therapy was shown to be effective in restoring cognitive function. The protocol used was 2.0 ATA, 80 minutes daily, for 14 days. The researchers noted that “HBOT restored insulin sensitivity, hippocampal functions, cognition in aging and aging-obese models” in this study done on rats <view study>