Written by Jacob Yaad Hassan, qualified Chamber operator in hyperbaric therapy, member of EBAss and UHMS
In recent years there is a growing interest, both in the medical and public domain, in an old technology. Hyperbaric oxygen Therapy was initially of interest due to its ability to heal wounds that simply wouldn’t otherwise heal, think an open wound for several weeks. Researchers then looked into its benefits for internal injury.
Hyperbaric oxygen therapy is now a well-established treatment for the following FDA approved indication:
- Severe anaemia
- Brain abscess
- Bubbles of air in your blood vessels, known as arterial gas embolism
- Carbon monoxide poisoning
- Crushing injury
- Deafness, sudden
- Decompression sickness
- Infection of skin or bone that causes tissue death
- Non Healing wounds, such as a diabetic foot ulcer
- Radiation injury
- Skin graft or skin flap at risk of tissue death.
- Traumatic brain injury
- Vision loss, sudden and painless
How does Hyperbaric Oxygen Therapy work?
- Helps wound healing by bringing oxygen-rich plasma to tissue starved for oxygen. By reducing swelling while flooding the tissues with oxygen. The higher pressure in the chamber increases the amount of oxygen in the blood, breaking the cycle of swelling, oxygen starvation, and tissue death.
- Prevents "reperfusion injury" by encouraging the body's oxygen radical scavengers to seek out the problem molecules and let healing continue.
- Block the action of harmful bacteria and strengthen the body's immune system, by disabling the toxins of certain bacteria while increasing oxygen concentration in the tissues. Furthermore, the ability of white blood cells to find and destroy pathogens increases.
- Stimulate the formation of stem cells (our “repair shop”) collagen and new skin cells. It does so by encouraging new blood vessels to grow- vascular growth factor.
What is Hyperbaric Oxygen Therapy?
Discovered almost centuries ago with relatively simple laws of physics - hyperbaric means, involvement of gas at a pressure greater than normal.
This technique is using a pressurized chamber and pure oxygen to deliver maximum oxygen to the body’s tissues. It’s non-invasive, with little to no side effects involving breathing pure oxygen in a controlled pressurised environment.
Under these conditions, the lungs can observe much more oxygen than would be possible breathing pure oxygen at normal air pressure.
Oxygen can reach blocked, infected and damaged tissues, this influx of oxygen helps fight bacteria, triggers the release of substances called growth factors and stem cells, which promote healing.
Hyperbaric Oxygen Therapy and Concussion/Traumatic Brain Injury
Traumatic Brain Injury (TBI) has become a major public health concern worldwide for both civilian and military populations.
At least 10 million new head injuries occur annually worldwide, and these account for a high mortality rate of deaths in young adults.
TBI is defined as damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration, impact, blast waves, or projectile penetration.
This can be physical disability, cognitive, psychological, and emotional impairments.
Currently, there is no effective treatment/metabolic intervention in the daily clinical practice for post TBI patients with chronic neurological dysfunction.
The pathophysiology of brain injury has primary and secondary components.
The impact - the brain crashes back and forth inside the skull causing bruising, bleeding, and mostly shearing and tearing of nerve fibres- this is known as the primary injury, it can involve a specific lobe of the brain or can involve the entire brain.
Secondary injury, the brain undergoes a delayed trauma, swelling and inflammation cascades are pushing the tissues against the skull and reducing the flow of oxygen-rich blood, often more damaging than the primary injury.
Post-Concussion Syndrome (PCS) is a set of symptoms succeeding mild TBI in most patients. This include headache, dizziness, neuropsychiatric symptoms, behavioural and mood changes, confusion, difficulty balancing, fatigue, changes in sleep patterns, and cognitive impairments (including memory, attention, concentration, and executive functions disorders) this condition can become chronic and may continue for weeks or months.
In a randomized controlled study hyperbaric oxygen therapy can improve post-concussion syndrome years after mild traumatic brain injury - The HBOT showed significant improvements in all cognitive domains:
- Executive function
- Information processing speed and motor
- Quality of life score
- Compared to the controlled group.
- Significantly increased cerebral blood flow
- Generation of new blood vessels in the brain
- Significant regeneration at the level of the microstructure of the brain
Hyperbaric Therapy and Long Covid
COVID-19’s long-term impact on the brain
“A ground-breaking study by the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center and Tel Aviv University, suggests that the COVID-19 virus can cause chronic brain injury affecting brain regions responsible for cognitive function, mental status and pain interpretation. Cells, tissues, and blood vessels are compromised, and these damaged structures can degrade natural clotting and blood flow to these specific regions of the brain. As such, the brain needs a proactive, therapeutic approach to recover, because on its own, healing can take months, or perhaps even years.”
- Introduced almost 400 years ago by a British physician and clergyman named Nathaniel Henshaw.
In 1662 Henshaw attached two bellows to a chamber, he believed that acute and chronic diseases can be treated with an increase or decrease in the chamber’s pressure.
His revelation was ground-breaking and set the course of hyperbaric therapy.
- Joseph Priestley (1733-1804) was the first scientist who isolated oxygen
- In 1859, the term - "The Bends" was coined for decompression sickness during the building of bridges and tunnels, workers had to go down in such depths in, while coming up from those tunnels and bedrocks bridges, they suffered a range of signs and symptoms but mostly significant pain in their joints. To the point they would “Bend in agony”.
Just like all unique discoveries in life, during 1890 an accident happened when one of the bells (the lifts carrying workers up and down) got stuck between levels for a couple of hours. The workers in that bell did not suffer from sickness or pain that raised a question- that led to more experiment - suspending the workers in between levels as they ascended to the surface.
- Dr. John S. Haldane is considered the Father of Oxygen Therapy, he was first to document the scientific approach to using Hyperbaric Oxygen Therapy back in 1900.
- During the 50’s - 60’s hyperbaric medicine grew, and research was focused on the effects, efficacy and clinical applications of such treatment modality.
- During the 70s- 90s global associations and societies formed and placed hyperbaric medicine in recognized platforms.
How can I get involved?
There aren’t many chambers around however there is one in central London ran by Jacob Yaad Hassan
The Process with Better Never Ends
Each patient is going through a battery of tests and assessments tailored to their condition and needs:
- Psycho-Emotional testing
- Validated Sleep Quality Index (PSQI)
- BrainCare Test - memory, executive function, attention, visual spatial, verbal function, problem solving, working memory.
- Complete Blood Testing
Once baseline and initial assessment are complete a patient will go to a series of treatments inside the chamber, each session is 90min, the duration/frequency will be discussed as part of the plan and strategy.
A patient may experience ear pressure, like when diving or aeroplane departure, swallowing or chewing gum will "pop" the ears back to normal.
When a session is done, you may feel lightheaded, mild fatigue, and headaches.
Between 10-40 sessions are often needed, depending on the severity and duration of the condition.
We encourage you to reach out and have a free 15 min consultation! Should this fit our treatment matrix we can set a plan for your recovery https://betterneverends.com
Adel Abdul Aal,MD, Bahrain, 2012. Hyperbaric Oxygen Therapy, Vol. 34, No. 3.
Bitterman H. 2007. Oxygen: an anti-inflammatory drug. Isr Med Assoc J.
Daniel J. Buysse, Charles F. Reynolds, Timothy H. Monk, Susan R. Berman, David J. Kupfer,
1989, The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research,
Psychiatry Research, (28), 2, pp193-213, ISSN 0165-1781, doi.org/10.1016/0165-1781(89)90047-4.
Efrati S, Fishlev G, Bechor Y, Volkov O, Bergan J, Kliakhandler K, Kamiager I, Gal N, Friedman M, Ben-Jacob E, Golan,. 2013. H. Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial.;8(1):e53716. doi: 10.1371/journal.pone.0053716.
Hajhosseini B, Kuehlmann BA, Bonham CA, Kamperman KJ, Gurtner GC. 2020, Hyperbaric Oxygen Therapy: Descriptive Review of the Technology and Current Application in Chronic Wounds.25;8(9):e3136. doi: 10.1097/GOX.0000000000003136.
Hadanny A, Efrati S. 2020. The Hyperoxic-Hypoxic Paradox. Biomolecules. 25;10(6):958. doi: 10.3390/biom10060958.
Hadanny A, Abbott S, Suzin G, Bechor Y, Efrati S. 2018. Effect of hyperbaric oxygen therapy on chronic neurocognitive deficits of post-traumatic brain injury patients: retrospective analysis. British medical journal. 28;8(9). doi: 10.1136/bmjopen-2018
Qiaoyu Fu, Ran Duan, Yu Sun, Qingfeng Li, 2022, Hyperbaric oxygen therapy for healthy ageing: From mechanisms to therapeutics, Volume 53, ISSN 2213-2317, doi.org/10.1016/j.redox.2022.102352.
Tal Sigal, Hadanny Amir, Sasson Efrat, Suzin Gil, Efrati Shai. .2017, Hyperbaric Oxygen Therapy Can Induce Angiogenesis and Regeneration of Nerve Fibers in Traumatic Brain Injury Patients Frontiers in Human Neuroscience, (11) ISSN=1662-5161 DOI=10.3389/fnhum.2017.00508
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