Use and Acceptance of HBOT

For the last forty or so years HBOT has been used all over the world.  Its use is comparatively restricted by comparison in the U.S.  Many familiar with the field are convinced that much suffering would be reduced and that many health dollars would be saved through expanded use of HBOT.  HBOT would be cost effective in reducing the length of hospital stays in many cases.  HBOT can save many patients from losing a limb, stroke patients from having to stay in a rehab facility, and patients with traumatic brain injury (TBI) from time lost away from work.

HBOT is not yet considered a part of routine medicine except in very specific conditions such as DCI, arterial air embolism and carbon monoxide poisoning. It is becoming part of complementary medicine, an adjunctive therapy used in combination with many conventional methods of healing.  An example would be the combination of antibiotic therapy with HBOT to enhance the action of the antibiotic treatment.

Evidence strongly points to the beneficial effect of HBOT in a variety of conditions.  It has been considered to have been overlooked by the medical community and the general public due to the lack of information on the subject.  Neubauer says that there are several reasons why there is a dearth of information on HBOT.3 One is that it is not generally known that HBOT can force O2 into the body’s tissues.  Many diseased areas are characterized by a lack of microcirculation and a resultant lack of O2.  HBOT supersaturates the blood plasma, as well as all the body’s fluids including the lymph and the cerebro-spinal fluid (the fluid bathing the brain and spinal cord), and the fluid in the bone marrow.

Many doctors are also not familiar with the basic science of HBOT since it is not taught in medical school in clinical terms (other than as a specialized elective).  There is a misconception that oxygen under pressure is chemically different from regular oxygen.  Other issues are the laws of gas physics, another topic not covered unless as a special elective for undersea and hyperbaric medicine.  Some doctors are under the mistaken impression that healing by HBOT is only temporary.  (In some cases it is, but not in most).

In the U.S. as 2001, fewer than 20 medical schools have their own hyperbaric oxygen facilities. Another 20 schools have access to chambers. Another factor is the regulatory system in the U.S.:  O2, while considered a drug while under pressure, is not patentable and cannot be promoted as a drug.  Given the very expensive double blind cross over placebo studies that would be required to put HBOT on the commercial map and the lack of financial incentive to do so, pharmaceutical companies do not promote it to physicians.

HBOT has had a long and checkered history in the mind of the general public and the medical establishment in a kind of boom and bust cycle where it was touted as a cure for everything and then proven to be less than was promised.

Notes
3R. Neubauer, (1998). Hyperbaric oxygen therapy. Garden City Park, NY: Avery Publishing Group, xv.