Overview

Overview

For wounds that won’t heal through traditional treatments and a number of other conditions, hyperbaric oxygen therapy can help. This treatment consists of breathing 100 percent oxygen at two to three times the normal atmospheric pressure in a pressurized acrylic-enclosed chamber.

Breathing pure oxygen effectively delivers an increased supply of oxygen to your body’s tissues. It encourages the formation of new blood vessels and stimulates cells to help promote healing. Use of hyperbaric therapy and other treatments can possibly save a limb from needing amputation.

Hyperbaric oxygen therapy is used to treat a variety of diagnoses, including:

  • Acute limb ischemia (inadequate blood flow and oxygen to a specific part of the body)
  • Chronic bone infections
  • Delayed radiation injuries (including wounds, bleeding, necrosis, and other conditions)
  • Compromised skin grafts or flaps
  • Diabetic foot ulcers
  • Acute skin necrosis
  • Severe anemia, when blood transfusion is impossible due to religious or medical issues
  • Sudden sensorineural hearing loss
  • Carbon monoxide poisoning

Planning and Recovery

Patients are carefully evaluated by a hyperbaric medicine physician, who develops an individualized treatment plan for each patient. Patients with complicated wounds or poor circulation may be candidates for hyperbaric oxygen treatment, but only after trying other treatments first.

Most treatments are scheduled for two hours either once or twice a day, depending on the nature of your condition. The number of treatments varies as well and could number between 10 to 60 sessions.

Our hyperbaric chambers are some of the largest full body chambers available (41 inches in diameter) and provide patients with a 360-degree visual field. During therapy, you can comfortably sit up, watch a movie, listen to music, or sleep. A hyperbaric technician is present during your entire treatment, and can easily talk back and forth with you. We are also the only hyperbaric oxygen therapy center in Washington D.C. that accepts emergency patients.

Throughout your course of treatment, our hyperbaric oxygen therapy team will keep in touch with your referring doctor. Our specialists will work closely with your doctor to discuss your progress and create a treatment plan tailored to your needs and health history.

Why Choose Us?

MedStar Georgetown’s Center for Wound Healing and Hyperbaric Medicine is the only center in Washington, D.C., accredited by the Undersea and Hyperbaric Medical Society. Our dedicated team of technicians, nurses, and physicians have special training in hyperbaric oxygen therapy, and the program has a 97 percent success rate in saving limbs from amputation.

Our location inside MedStar Georgetown University Hospital means you’ll benefit from efficient outpatient and inpatient services for a broad spectrum of hard-to-treat wounds and other conditions. Our center has four single-person HBOT chambers and the capacity to treat up to 16 patients every day. This helps to streamline care delivery—and offers our patients services with little or no wait time.

HBOT-Team

 

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Frequently Asked Questions

Hyperbaric oxygen therapy (HBO) is a treatment in which patients breathe 100% oxygen while pressurized to a depth greater than sea level. The use of hyperbaric pressurization as a treatment for medical conditions dates back to the 1600’s, prior to the discovery of oxygen. While many people are familiar with the use of hyperbaric oxygen therapy for decompression sickness (“the bends”) in SCUBA divers, hyperbaric oxygen therapy is also used as a treatment for other medical conditions.

A hyperbaric chamber is a device used to administer hyperbaric oxygen therapy. Hyperbaric chambers are generally cylindrical in shape and are composed of steel and clear acrylic. Monoplace hyperbaric chambers can accommodate one patient; multiplace hyperbaric chambers can accommodate multiple patients. In the United States, monoplace chambers are the most commonly encountered hyperbaric treatment vessels in hospital settings.

MedStar Georgetown University Hospital has four monoplace hyperbaric chambers. The chambers are 41 inches in diameter; the larger size of these chambers allows for enhanced patient comfort during the hyperbaric treatment process. The hyperbaric chambers have communication systems to allow patients to talk back and forth with the hyperbaric medicine staff, so patients are never alone during the treatment process.

The air that we normally breathe is 21% oxygen and 78% nitrogen. Patients who receive hyperbaric oxygen therapy breathe 100% oxygen under pressure. This allows significant amounts of oxygen to be dissolved in the bloodstream. For patients who have wounds, the extra oxygen can result in new blood vessel formation and faster wound healing. In addition, hyperbaric oxygen therapy can enhance antibiotic activity, reduce certain inflammatory processes in the body, and increase oxygen levels in tissues which have been deprived of oxygen.

Currently, HBO is used as a primary treatment for decompression sickness, air embolism, and carbon monoxide poisoning. It is also used as an adjunctive treatment for other medical conditions. The Undersea and Hyperbaric Medical Society currently recommends the use of HBO as a treatment of the following conditions:

  • Air or gas embolism
  • Decompression sickness
  • Acute carbon monoxide poisoning
  • Arterial insufficiencies, including enhancement of healing in selected problem wounds
  • Radiation-induced soft tissue and bone necrosis
  • Intracranial abscess
  • Clostridial myonecrosis
  • Necrotizing soft tissue infections
  • Compromised grafts and flaps
  • Crush injuries and compartment syndromes
  • Chronic refractory osteomyelitis
  • Thermal burns
  • Severe anemia where transfusion is impossible due to religious or medical concerns
  • Idiopathic sudden sensorineural hearing loss
  • Patients are referred for hyperbaric medicine evaluation by their primary care physician or specialist. A hyperbaric medicine physician evaluates each patient and prescribes the hyperbaric treatment course, prior to the start of hyperbaric treatments. A consultation with the hyperbaric medicine physician is required before a patient can start hyperbaric oxygen therapy treatments.

    Health insurance companies consider hyperbaric oxygen therapy to be medically necessary for most or all the conditions listed above. As each insurance company has a different list of conditions considered medically necessary for hyperbaric oxygen therapy, we encourage patients to confirm with their own insurance company whether hyperbaric oxygen therapy is covered for their diagnosis. The hyperbaric medicine staff will obtain preauthorization for hyperbaric oxygen therapy, if needed, prior to the start of treatments. Patients are responsible for any insurance deductibles or co-pays that may be associated with each treatment.

    When administered correctly, HBO is a safe procedure with minimal adverse effects. However, just like any other medical procedure, there are risks associated with hyperbaric oxygen therapy. A hyperbaric medicine physician is present and immediately available in the treatment area during each hyperbaric oxygen therapy treatment, to assist with any complications that may arise.

    Side effects of hyperbaric oxygen therapy are rare and generally are preventable.

    Middle ear barotrauma (“ear squeeze”) is the most common complication of HBO. This is similar to the “popping” sensation or ear fullness that can occur during the landing process on an airplane. This sensation is generally self-limited and can be prevented by carefully instructing patients on appropriate ear pressure equalization techniques.

    Very rarely, oxygen toxicity may result in seizures. However, the hyperbaric medicine staff uses careful techniques to prevent oxygen toxicity, and as a result, seizures are rarely encountered in clinical hyperbaric practice.

    In diabetic patients, hyperbaric pressurization may result in hypoglycemia (low blood sugar). Some patients may experience a temporary change in their visual acuity during their hyperbaric treatment course.

    Patients with a history of anxiety or claustrophobia may exhibit confinement anxiety during hyperbaric treatments.

    Finally, as the hyperbaric environment is oxygen enriched by definition, fire safety is of paramount importance. The hyperbaric medicine physician will discuss these side effects with you in detail, during the initial hyperbaric medicine consultation.

    Each hyperbaric treatment is approximately two hours in duration. For patients with decompression sickness (“the bends”), longer treatments may be required.

    During the initial hyperbaric medicine consultation, the hyperbaric medicine physician will prescribe a course of hyperbaric treatments at a specific treatment depth. The depth may range from 2.0-2.5 atmospheres absolute (equivalent to 33-50 feet of sea water). The treatment depth and number of treatments is individualized for each patient and is based on the patient’s diagnosis and underlying medical conditions.

    The number of hyperbaric treatments required differs for each patient, as different conditions are treated with different numbers of treatments. For wound healing purposes, many patients receive 20-40 treatments. Patients with carbon monoxide poisoning or decompression sickness may require only 2-3 treatments. Hyperbaric treatments are generally administered once a day, Mondays through Fridays; weekend treatments may be available for patients who require treatments on an urgent or emergent basis.

    To maximize patient safety, patients are not allowed to bring cell phones, tablets, books, magazines, or other personal belongings into the hyperbaric chamber. Patients may watch a movie during the treatment. Some patients prefer to sleep or meditate during hyperbaric oxygen therapy.

    Patients must wear garments containing at least 50% cotton in the hyperbaric environment. At MedStar Georgetown University Hospital, we provide comfortable robes for our hyperbaric patients to wear during each treatment. Jewelry, lotions, deodorants, hair products, and certain types of eyeglasses must be removed prior to each hyperbaric oxygen therapy treatment.

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