Hyperbaric Oxygenation Therapy is a simple and non-invasive procedure that provides the body with higher-than normal oxygen levels. The delivery system used is a hyperbaric chamber (simply put a ‘pressure vessel’); whereby, the body is placed under various pressures. The dose of oxygen varies directly with the pressure that is administered, so the greater the pressure, the greater the dosage of oxygen. The effective dose of oxygen (during HBOT) can also be adjusted by the time and the percent of oxygen that is being breathed. The final piece to this puzzle is the frequency of application. But again, it’s the pressure that it the key so let’s explain this first:

  1. The Pressure
    • We require a constant and steady amount of oxygen, and this vital nutrient is given to us through the ‘normal process’ of breathing. During this process, oxygen travels down deep into the lungs until it finally transfers from the lung tissue into the bloodstream.
      • From there, the majority of oxygen (roughly 98.5%) in the bloodstream travels tightly bound to red blood cells and when these cells leave the lungs, they are pretty much at their capacity for carrying oxygen. They then transport their oxygen, by way of the circulatory system, until they finally reach metabolically-active tissue. At this point, they lose their tight bond and oxygen is released to the surrounding tissue. Keep in mind, the relative size of an oxygen molecule is microscopic compared to the red blood cell it’s being transported on — each red blood cell can carry up to one million of these oxygen molecules!
      • There is a tiny amount of oxygen (around 1.5%) that can freely travel from the lung tissue and absorb directly into the blood plasma (the liquid portion of the blood) and can travel very easily in the fluids without being restricted by being tightly bound and traveling on these red blood cells. The oxygen that travels in this compartment is able to get into areas where our large red blood cells (relatively speaking) cannot get into. So the plasma oxygen levels can be critically important when dealing with injured tissue and/or circulatory problems.
      • Under normal atmospheric conditions, only 0.3 ml per 100 ml of oxygen can be carried in our blood plasma. This amount is not even close to the amount needed for sustaining life.
      • Under hyperbaric pressure, the oxygen molecules exert a greater force, allowing for more oxygen to leave the lungs and travel in the blood plasma. So not only are you getting extra oxygen, you are also getting the extra oxygen traveling freely in the blood fluids and being able to get to all areas of tissue that is surrounded by fluids — virtually everywhere inside the body! This is almost what you can call ‘true’ liquid oxygen.
    • Hyperbaric pressure is typically dosed in “ATA” — a person living at sea level is at one atmosphere of air pressure absolute (ATA). This can be expressed as 760 mm (or 29.9 inches) or mercury, or 14.7 psi (pounds per square inch) of air pressure.
      • 1.0 ATA is our starting pressure when referring to HBOT and represents the normal atmospheric pressure at sea level. For every 33 FSW (feet of sea water) pressure, we are effectively adding another atmosphere of pressure, or 14.7 psi. Therefore, when a hyperbaric pressure of 2.0 ATA is administered, this pressure dosage is equivalent to 14.7 psi or 33 FSW.
      • Typically hyperbaric pressures in both private centers and wound care clinics are generally below 2.5 ATA.
  2. The time:
    • Generally, HBOT is limited to 60 – 90 minutes per session. This reduces the risk of too much oxygen building up inside the body, and adds to the incredible safety records shown by centers offering this service.
  3. The Percent Oxygen
    • Generally, hyperbaric oxygen involves breathing higher than normal concentrations of oxygen, right up to 100% oxygen. Currently, we are breathing air, which is composed of only 21% oxygen. Keep in mind, even breathing regular air in a hyperbaric chamber will still allow for extra oxygen to be delivered into the body.
  4. The Frequency of Delivery
    • The frequency of HBOT delivery can play a major role in helping to achieve many of the physiological benefits that HBOT has been recognized for. This is of critical importance when applying this procedure for wound care management or even in cases of chronic diseases. A very common protocol that has been shown to give these physiological benefits is called the ’40 hour hyperbaric protocol’. This protocol has been varied in pressure (from 1.3 ATA to 2.4 ATA) and in time (60 to 90 minutes). On one end of the spectrum you can have 1.3 ATA for 60 min, and on the other end, you can see 2.4 ATA for 90 minutes. What is most interesting to note, is that both protocols have been shown to produce powerful results. They are quite different in pressure and time, yet fundamentally the same in their frequency of delivery (with respect to the 40 hour hyperbaric protocol):
      The 40 Hour Hyperbaric Protocol:

      • It has been well documented that daily applications of HBOT, for as many as 40 sessions, can have the best results in helping to gain the full physiological benefits noted by HBOT.
      • During this protocol, It is not uncommon to have 2 sessions of HBOT per day, and this protocol has been commonly adopted by many centers and shown to have very good clinical outcomes. Note, in order to reduce the chance of oxygen toxicity and to maintain HBOT’s high safety records, a minimum 4 hour break is normally recommended between sessions.
      • Typically, 5 consecutive days are recommended, with a 2 day rest period.
      • With this protocol, a full 40 hours of HBOT can be accomplished in one month (with twice daily applications) or two months. (if only HBOT session was performed daily)

    We now have all the variables that can contribute to the effective dosage of oxygen, with respect to HBOT.