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Dear Mayo Clinic: What is hyperbaric oxygen therapy? What is it used for?

A: Hyperbaric oxygen therapy (HBOT) involves breathing pure oxygen in a pressurized room to increase a person’s blood-oxygen level.

The body’s tissues need an adequate supply of oxygen to function. When tissues are injured, they require more oxygen than usual to survive. HBOT increases the amount of oxygen the blood can carry to tissues.

Historically, hyperbaric oxygen therapy has been used for deep-sea divers who experience decompression sickness —also known as “the bends” — which occurs when dissolved nitrogen gas bubbles form in the body’s tissues when a diver returns to the water surface too quickly.

But HBOT can be used to treat an assortment of other medical conditions, too, including serious infections, bubbles of air in the blood vessels (arterial gas embolism), wounds that won’t heal due to diabetes or radiation injury, carbon monoxide poisoning, crush injuries, gangrene, brain abscesses, burns, skin grafts or skin flaps at risk of tissue death, and severe anemia.

Oxygen stimulates healing

In a hyperbaric oxygen therapy room, the air pressure is raised up to three times higher than normal. Under these conditions, the lungs can gather up to three times more oxygen than would be possible breathing pure oxygen at normal air pressure.

The increased oxygen dissolves in the blood and circulates throughout the body. The oxygen-rich blood stimulates the body to release growth factors and stem cells, which help heal wounds and fight infection.

HBOT is typically performed as an outpatient procedure and doesn’t require hospitalization. Depending on the type of medical institution and the reason for treatment, HBOT can be administered either in a unit designed for one person or in a room that can accommodate several people.

In an individual HBOT unit, the patient lies down on a padded table that slides into a clear plastic tube about 7 feet long. In a multi-person HBOT room — which usually looks like a hospital waiting room — the patient sits or lies down. A lightweight, clear hood may be placed over the patient’s head to deliver the oxygen, or oxygen may be administered through a mask.

To be effective, hyperbaric oxygen therapy requires more than one session. The number of HBOT sessions depends on the medical condition.

For example, carbon monoxide poisoning can be treated in as few as three visits. Other conditions, such as non-healing wounds, may require 25 to 30 treatments.

Hyperbaric oxygen therapy alone can often effectively treat decompression sickness, arterial gas embolism and severe carbon monoxide poisoning.

But to effectively treat other conditions, hyperbaric oxygen therapy is used as part of a comprehensive treatment plan and is administered in conjunction with additional therapies and medications tailored to the patient’s needs.

FDA-approved treatments

The FDA has approved HBOT to treat 14 to 16 conditions ranging from burns to bone disease.

More research regarding hyperbaric oxygen therapy is under way, including a study at NIH on its effect on traumatic brain injuries. HBOT is offered in various hospitals in the Baltimore area.

“It’s highly underutilized,” said Dr. Ziad Mirza, chief medical officer at MVS Wound Care and Hyperbarics in Lutherville. But the therapy can be “a wakeup call for our cellular signaling and our immune system,” Mirza said. “I’ve seen it work.”

If you have questions about HBOT, talk to your doctor. For more details, reliable information is available on the Undersea & Hyperbaric Medical Society’s Web site (uhms.org).

— Paul Claus, M.D., Hyperbaric and Altitude Medicine, Mayo Clinic, Rochester, Minnesota. Beacon staff contributed to this article.

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