Dr. Paul Harch is a board-certified hyperbaric and emergency medicine physician who has become one of the foremost authorities in the United States on the use of HBOT and SPECT brain blood flow imaging in neurology. His clinical experience through 2010 spans 26 years in hospital-based emergency medicine and 24 years in hyperbaric medicine. He graduated from Johns Hopkins University School of Medicine in 1980, specializing in general surgery and radiology.
Dr. Harch’s career in hyperbaric medicine began in 1985. He received initial diving accident management training through the National Oceanographic and Atmospheric Administration and then prolonged instruction and experience under the direction of one of the world’s most noted diving medicine experts, Dr. Keith Van Meter. Focusing on a number of injured divers from the Gulf of Mexico, Dr. Harch began an in-depth study of brain decompression illness (DCI) in the late 1980s. As he evaluated divers with brain DCI presenting for primary treatment weeks to months after their accident or with residual brain injury following neurological plateau on the standard U.S. Navy recompression protocol, it became obvious he was treating ischemic (low blood flow) brain injury and not residual gas.
This was unequivocally confirmed in 1990 and 1991 with two diving cases: a 43-year-old demented commercial diver 7 months after injury; and 5 months after U.S. Navy treatment plateau, a 33-year-old demented junior high school math teacher, misdiagnosed and committed to a psychiatric hospital after a diving accident and subsequent aborted suicide attempt.
After consulting with Dr. Richard Neubauer in April 1990, Dr. Harch began treating the first diver and eventually achieved clinical, psychometric, and SPECT brain blood flow improvement. The second diver experienced normalization of his EEG, complete recovery of neurological function and a recoup of his pre-accident IQ before the end of his treatment protocol.
Simultaneously, Drs. Van Meter and Sheldon Gottlieb, a colleague of Dr. Neubauer and director of research at the Baromedical Research Institute of New Orleans, were conducting a trial of hyperbaric oxygen therapy in brain-injured boxers. Encouraging preliminary results from this study and results from the divers and the small series of chronic traumatic brain-injured and stroke patients spawned the Perfusion/Metabolism Encephalopathy Study of Drs. Harch, Gottlieb, Van Meter, and Staab under the auspices of the JoEllen Smith Medical Center Institutional Review Board. This study commenced in 1993, terminated in 1999 and allowed the evaluation and treatment with HBOT and SPECT brain imaging of a large number of patients with a variety of chronic neurological diseases, including decompression sickness, stroke, traumatic brain injury, carbon monoxide poisoning, cerebral palsy, near-drowning, toxic brain injury, cardiac arrest, static encephalopathy of childhood, autism, and others.
The patients were evaluated with SPECT imaging before and after one and then a series of low-pressure hyperbaric oxygen treatments. In this group was the first reported North American case of cerebral palsy successfully treated with HBOT. The case was reported in 1994 and then the videos of this case and a second child treated in 1993-1994 were combined with a third case of Dr. Neubauer’s and presented at the International Conference on HBOT in Buenos Aires, Argentina in April 1996.
To date Dr. Harch has treated a very large number of children with cerebral palsy or static encephalopathy from various causes. Some of these videos and the accompanying SPECT brain scans were shown at the First International Symposium on Hyperbaric Oxygen Therapy and the Brain Injured Child in Boca Raton, Florida, July 23-24, 1999.
In 2007 Dr. Harch, in collaboration with Drs. Neubauer and James F. Toole, initiated a proposal for a pilot study of HBOT for acute stroke. The HOTFAST (The Hyperbaric Oxygen Therapy for Acute Stroke Trial) study will be an attempt to duplicate the published results of Dr. Neubauer and others using a rigorous experimental design to evaluate the feasibility and efficacy of HBOT in the first six hours of a stroke. Dr. Harch is the national coordinator and co-principal investigator of HOTFAST, which is currently still gathering funding.
In 2008 Dr. Harch launched an IRB-approved pilot trial of HBOT use in chronic blast-induced traumatic brain injury (TBI post-concussion syndrome) and TBI with post-traumatic stress disorder (PTSD). He has also secured a $1.2 million congressional appropriation to perform a randomized controlled study of HBOT in TBI and PTSD.
Dr. Harch has lectured and presented his work at numerous scientific meetings throughout the U.S. and overseas. He is the author of numerous articles on hyperbaric medicine that have been published in various journals including, Undersea and Hyperbaric Medicine, Annals of Emergency Medicine, The Neurologist, Archives of Physical Medicine and Rehabilitation, Brain Research, Resuscitation, The American Academy of Pediatrics, and Hyperbaric Medicine Today.
Dr. Harch was a significant contributor to the Textbook of Hyperbaric Medicine published in 2004, but his prominent book is The Oxygen Revolution, co-authored with Virginia McCullough (2007). As of 2010 HBOT is only approved by the FDA for 14 different conditions, most of which treat gas embolism, carbon monoxide poisoning and a variety of soft tissue injuries. HBOT treatment for neurological conditions is excluded from FDA approval.
Dr. Harch wrote The Oxygen Revolution for the lay public and their healthcare providers in an effort to educate them about how HBOT works and what conditions might be treated with it. In the book, he describes the mechanism of traumatic brain injury and the phenomenon of “idling neurons” that can be reawakened by HBOT months or even years after an injury.
Hoping to raise public awareness about the efficacy of HBOT to treat brain trauma, Dr. Harch envisions a future where HBOT is used as a life-saving technique in emergency room settings, preventing coma and permanent damage. In The Oxygen Revolution, Dr. Harch also proposes the use of HBOT for treatment of other “off-label” conditions such as stroke, cerebral palsy, MS and autism. By enlightening the general public, Dr. Harch hopes to advance the use of HBOT as a promising treatment for neurological conditions within the conservative medical community.
Dr. Harch treats stroke and traumatic brain injury with HBOT. He worked in the 7,000-inmate Orleans Parish Prison for five years. He testified before the U.S. House of Representatives’ Labor, Health & Human Services, and Education Appropriations Subcommittee on using hyperbaric medicine to treat brain injuries. He also made presentations to the NIH, Bethesda Naval Hospital, Walter Reed Army Medical Center, the Substance Abuse and Mental Health Services Administration, and the Centers for Disease Control and Prevention.
In recognition of his accomplishments in clinical practice, teaching and research he was awarded the Edgar End Award from the American College of Hyperbaric Medicine in 1993. He was given fellowship status in the American College of Hyperbaric Medicine in 1997. He received the Richard A. Neubauer Award for Excellence in Hyperbaric Oxygen Therapy in Pediatric Neurology in 2003. In April 2004 Dr. Harch was nominated and became a semi-finalist for the National Institutes of Health (NIH) Director’s Pioneer Award. In 2008, he was awarded the HBOT Doctor of the Year by the Richard A. Neubauer Research Center. In 2010 he was awarded the “Most Innovative Use of Hyperbaric Oxygen” award from the Richard A. Neubauer Research Institute and the Leonardo da Vinci award from the Institutes for the Achievement of Human Potential. The Leonardo da Vinci award is conferred to “those unconventional thinkers, who like Leonardo, have solved human problems that the world believed had no solution.”
Dr. Harch is the first President of the International Hyperbaric Medical Association (established in 2001) and President of the International Hyperbaric Medical Association Foundation. He is currently clinical assistant professor in the Department of Medicine, Section of Emergency Medicine at LSU (Louisiana State University) School of Medicine, New Orleans, Co-Medical Director of the Hyperbaric Medicine Department at St. Charles General Hospital, New Orleans, Clinical and Research Director of the LSU Hyperbaric Medicine Fellowship, and former Director of the JoEllen Smith Hyperbaric Medicine Unit of New Orleans.
He stays active in emergency medicine at two hospitals in New Orleans, while maintaining a large full-time clinical hyperbaric medicine practice at Harch Hyperbarics – Family Physician’s Center, which has become one of the most prominent centers utilizing neurological applications of HBOT. Dr. Harch currently divides his time between his practice there and his satellite Chicago facility, the Midwest Hyperbaric Institute, where he continues to explore the effect of HBOT on neurological disorders, animal and human research, teaching and medical society projects.