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The most common side effects are related to the direct effects of the pressure change during compression on the middle eardrum. If not recognized and managed effectively, injury to the eardrum (tympanic membrane) can occur. Oxygen breathing at increased pressure may also produce acute toxic reactions that are reversible and usually preventable by adjusting the oxygen dosing schedule. You and your physician will discuss the side effects and potential complications in detail prior to treatment.
Normally the air we breathe contains 21% oxygen. We’re surrounded by a column of air stretching from the surface of the earth to infinity, exerting a pressure we refer to as sea level pressure or one atmosphere of pressure. During hyperbaric oxygen treatment, 100% oxygen is breathed at a pressure greater than sea level pressure or greater than one atmosphere of pressure. This increases the amount of oxygen dissolved in the liquid portion of the blood (plasma) as much as 3-5 times over what is possible breathing oxygen at sea level pressure.
The resulting increased oxygen-carrying capacity is delivered to all tissues where there is sufficient blood flow, and produces a number of beneficial effects that improve the body’s elimination of certain poisons such as carbon monoxide, improve the body’s response to infection, and support tissue growth and wound healing.
Hyperbaric oxygen treatments include three phases: compression to the prescribed treatment pressure, the prescribed time at pressure, and decompression from the treatment pressure back to surface or atmospheric pressure. Because the pressure change associated with the treatment is similar to pressure changes while scuba diving, each treatment is called a “dive.”
Compression: During the compression phase patients feel a “fullness” in their ears similar to what is experienced during descent while scuba diving, or as a commercial airliner lands. This increase in pressure on the tympanic membrane or eardrum must be equalized by performing a valsalva maneuver or by swallowing or yawning. The temperature in the chamber also increases slightly during compression.
Treatment: The treatment phase begins when the pressure reaches the prescribed level. The patient breathes 100% oxygen with brief interruptions to breathe air to reduce the risk of any toxic reaction to prolonged oxygen breathing. During the treatment patients may rest, sleep, listen to music, or watch television.
Decompression: During decompression, the pressure within the chamber is reduced to that at the surface. Decompression results in mild cooling. Once the chamber pressure equals the outside or surface pressure, the treatment is completed and the patient is removed from the chamber.
Hyperbaric oxygen treatment was originally used to treat divers suffering from the “bends” or decompression sickness, but is now used to treat people with a variety of wound healing problems.
This treatment involves breathing 100% oxygen at a pressure greater than one atmosphere, which is the pressure of air at sea level. To accomplish this, a patient must be enclosed in a specially constructed chamber. Most treatments are administered in a monoplace hyperbaric chamber filled with 100% oxygen, which holds a single patient.
Patients may also be treated in a multiplace chamber that is larger, holds multiple patients, and is filled with air. Patients breathe 100% oxygen by wearing a mask or hood during treatment.
The Undersea and Hyperbaric Medical Society’s Oxygen Therapy Committee has recommended hyperbaric oxygen treatment as beneficial for:
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