Undersea & Hyperbaric Medicine

Prevention of injury and illness from exposure to increased ambient pressure and therapeutic use of high-environmental pressure to treat disease.

Hyperbaric Medicine at UTMB Health

Hyperbaric Medicine is the medical specialty that utilizes hyperbaric oxygen therapy for the medical treatment of specified indicated conditions.

Hyperbaric oxygen therapy is the administration of 100% oxygen inhaled at pressure greater than sea level atmospheric pressure. This greater pressure of 100% oxygen, which is a drug, becomes the therapeutic dose of high-pressure oxygen to evoke specific mechanisms of action in the body that then induce beneficial and healing results.

Hyperbaric oxygen treatments can be given on elective, urgent, or emergent basis depending upon the condition. Different conditions require different doses of oxygen. The hyperbaric oxygen (HBO2) is either the primary treatment modality to resolve a specific problem or the HBO2 is adjunctive treatment in a multispecialty approach for a refractory or severe condition. In order to have therapeutic effect, the 100% oxygen must be inhaled and must be delivered at high pressure of at least 2.0 ATA (33 fsw). Topical oxygen — such as by inserting a foot into an inflatable device or incubator — is not hyperbaric oxygen and is not therapeutic.

HyperbaricChambers

Each patient receives a planned course of therapy that is specific to his or her condition. A routine HBO2 treatment will last for 120 minutes to 142 minutes. An urgent or emergent condition, such as decompression sickness, may require a longer HBO2 treatment protocol. Depending upon the medical condition, 20 to 60 HBO2 treatment sessions may be necessary for routine indications, and typically 1 to 20 HBO2 treatment sessions for urgent or emergent indications.


Hyperbaric Oxygen Treatment Indications

There are 14 accepted indications in the U.S. for treatment with hyperbaric oxygen (HBO2):

  • Decompression sickness (“the bends”)
  • Delayed radiation injury (soft tissue radionecrosis; osteoradionecrosis / bony necrosis)
  • Compromised skin grafts and flaps
  • Chronic or refractory osteomyelitis (bone infection)
  • Idiopathic sudden sensorineural hearing loss
  • Arterial insufficiencies
    • Central retinal artery occlusion
    • Adjunctive healing in microangiopathic wounds (e.g. diabetic foot ulcer)
  • Air or gas embolism
  • Crush injuries, compartment syndromes, acute traumatic ischemias
  • Carbon monoxide (severe) poisoning; cyanide poisoning
  • Necrotizing soft tissue infections
  • Clostridial myonecrosis (gas gangrene)
  • Intracranial abscess
  • Exceptional blood loss anemia
  • Thermal burns


The Hyperbaric Chamber

A hyperbaric chamber is necessary as the hard-hull vessel to achieve the high therapeutic dose of 100% oxygen in hyperbaric oxygen therapy. Inflatable or “home hyperbaric chambers” sold to the public are not hyperbaric chambers, do not provide hyperbaric oxygen, and do not constitute hyperbaric oxygen therapy. There are two types of hyperbaric chambers: (A) Multiplace chamber that can treat multiple patients at the same time and (B) Monoplace chamber that treats a single patient at a time. Currently at UTMB, two monoplace chambers are employed for use.

Hyperbaric Chamber