Hyperbaric Chamber
Overview
Michael J. Natoli
Center for Hyperbaric Medicine and
Environmental Physiology
Duke University Medical Center
Durham, NC 27710
Hyperbaric Surgery & Research at Duke, 1963-67
F.G. Hall Laboratory, 1968
Seven Multiplace Chambers
Main Deck
Second Deck
Golf
Foxtrot
Golf
Delta
Echo
Charlie
Bravo
Alpha
Pipe Color Coding - US Navy
Oxygen
Nitrogen
Helium
Air
Exhaust
Vacuum
Potable Water
Fire system
Alpha Chamber
Compressors
Air Storage Banks
Control Console
Don Bordeaux, 2005
Internal Environmental Control
Pneumatic
valves
Muffler
Cold water
Heating / Cooling
Coils
Hot water
Lubrication
level
Electric motor
Blower
Air flow
Shaft seal
Temperature
indicator
Thermistor
External Environmental Control
Blower
Thermistor
Need
Picture
Temperature
controller
Cold water
CO2 absorbent
Hot water
Breathing Gas Systems
BIBS Panel
Liquid Oxygen and Nitrogen
Oxygen Delivery

Head tent
 Face mask
Scott Duo-seal
Single
hose
Overboard dump
Plastic disposable
Mouthpiece
“T”
piece
Ambu-bag
Ventilator
Oxygen Delivery - Recirculating Head Tent
Eduction
Oxygen
Eduction
Line
Purge
Venturi
20
Purge
Line
10
0
30
40
50
60
Sample
Venturi
Sample
Line
Bubbler
Sodasorb
Canister
Ice
Bucket
Condensate Ice Water
Drain
Drain
Latex
Neckseal
Headtents
Oxygen Delivery - Single Pass Head Tent
Overboard Dump Line
Oxygen
Patient
Sample Line
Oxygen Supply Regulator
Oxygen
Dump
Regulator
Latex
Neckseal
Oxygen Administration by
Overboard Dump Mask
Ventilator
Eduction Manifold
Description
Outside
Building
Foxtrot
50 ft
Delta
Air Amplifier
1” pipe
Charlie
Bravo
3” pipe
Alpha
4 ft2 Chamber Exhaust Duct
Manifold
Inlet
Fire Suppression System
Relief
valve
200 psig reg.
check
valve
Muffler
OFF
Fire
Suppression
Tank
450 psig air
Pneumatic
valve
Air mask
Overhead
sprinklers
Manual
Pump
Level
indicators
ON
Drain
Hand-held
hose
Nitrogen Purge
Plantronics Headset
Telex TR-200 Wireless
Intercom
Two-way Mic/Speaker Box
Sound-powered Phone
Breathing Gas Analysis
 Chamber
Atmosphere
O2 (20.5% - 23.5%)
CO2 (< 1.0% SEV)
 Patients
O2 (> 98.0%)
CO2 ( < 1.0% SEV)
Breathing Gas Analysis
Patient Monitoring
Monitoring Connections
Inside the Chamber
Defibrillator
Transcutaneous
Oxygen Monitors
Suction
Medical Lock
Hyperbaric Oxygen Therapy
Program
• Each year, 300 patients breathe 100% oxygen at
about 2 times atmospheric pressure
• 13 UHMS approved conditions including air
embolism, decompression sickness, CO
poisoning, gas gangrene, problem wounds
35
Education Program
• Graduate students
• Intern & resident training
• 12 month Diving & Hyperbaric
Medicine Fellowship (2 per
year)
• Semester course in the
“Physiology & Medicine of
Extreme Environments”
36
Research Program

Supporting agencies
National Heart, Lung, Blood Institute
National Aviation & Space Agency
Navy, Army, Air Force
National Oceanographic & Atmospheric
Administration
Divers Alert Network
Commercial diving companies
37
Saturation Diving to 2,250 Feet (1970s-80s)
38
Right Heart Bubbles
RV
RA
LV
LA
39
40
Flying After Diving
Recreational Diving
(Divers Alert Network)
High Altitude Parachuting
(Army Special Forces)
41
‘Combat Edge’ Positive Pressure Suit
42
NASA Extravehicular
Activity (EVA)
43
O2 Breath-Hold
Diving
44
Differential Gene Expression



Affymetrix U133A chip
measures 14,000
genes per sample
Response to
decompression stress
(ONR)
Genetic
predisposition to IPE
(NAVSEA)
45
Immersion Pulmonary Edema
 Sudden dyspnea, hemoptysis during swim/dive.
Can be fatal
 Divers, triathletes, Navy trainees (NEDU, BUD/S)
 Pathophysiology may be exaggerated increase in
pulmonary vascular pressures during immersed
exercise in cold water
46
Biochemical Modification of
Susceptibility to Mountain Sickness
(DARPA)




Can adaptation to altitude be accelerated by a
combination of several drugs?
Can exercise performance be improved?
Increase systemic blood flow without increasing
pulmonary blood flow?
Initial tests in mice, then humans
47