Hyperbaric Oxygen Therapy
Dispelling the Confusion and Controversy over "Soft" or "Hard" Chambers
Inflatable Chambers (aka mild or soft hyperbaric therapy chambers) . . . mHBOT
vs.
Hospital Grade Chambers (AKA Hard Chambers) . . . HBOT
Robert L. Sands, gave his opinion on the zippered urethane inflatable chambers,
now becoming popular in the United States and elsewhere.
Robert L. Sands is uniquely qualified to comment on the science relating to the
inflatable chambers. For three years Sands administered research and development
for the Commonwealth of Australia and his first hyperbaric chamber patent
application was lodged in 1983 for an inflatable chamber. Sands abandoned the
inflatable concept after expending considerable resources and went on to design
and build chambers in the “conventional” manner meeting American Society of
Mechanical Engineers, Pressure Vessels for Human Occupancy (“ASME PVHO-1")
standards. Simply put, the inflatable chamber could not meet the pressure
requirements to treat certain maladies and traumas, particularly those encountered
in diving, aviation and bio-warfare response. Sands eventually designed and
developed the revolutionary transportable recompression chamber system that is
now in fleet-wide use with the U.S. Navy, Marine Corps and Coast Guard. Sands holds
the patent for that transportable chamber system. Sands, the Founder of Healing
Chambers International, Inc, is a prolific author and travels nationally and
internationally lecturing about this medicine. Below is an extract from his
forthcoming book "The Incandescent Corridor or the Sunlit Tunnel ? -- a Journey to
Health" Cool Change Press.
A recent headline appeared in the Autism Research Institute (ARI) newsletter:
"Center for Autism and Related Disorders Study Finds Hyperbaric Oxygen Therapy
Ineffective Treatment for Children with Autism".
The accompanying article reported on a recent randomized trial conducted by
respected specialist physicians Dr. Jeffery Bradstreet and Dr. Doreen Granpeesheh.
We use HBOT "hard" hospital grade as an adjunct to the many therapies required to
normalize patients and consistently achieve favorable outcomes. So, why the
discouraging report in the ARI newsletter?
Not All HBOT Chambers Are Created Equal
When we look closely at the study reported in the ARI newsletter, we find that the
researchers at the Center for Autism and Related Disorders, Inc. (CARD) only
worked with the inflatable low-pressure "mild" chambers which are known in the
field as mHBOT. Their report, entitled The Randomized Trial of Hyperbaric Oxygen
Therapy for Children with Autism, describes HBOT as “consisting of 24% oxygen
delivered at 1.3 atmospheres of pressure” and they find it “does not have a
significant effect on symptoms of autism."
But—and here’s the important point—the research on soft chambers should not be
generalized to the efficacy of hard chambers. True, many clinicians and parents who
have purchased these inflatable low-pressure chambers would vigorously dispute
this study. Nonetheless, the positive anecdotal reports and scientific data
documented in both SPECT and PET scans involve children treated in hospital grade
hard chambers where 100% oxygen is administered at a higher pressure.
As you can see, mHBOT and HBOT are not quite the same thing. The pacing of good
outcomes and the results they produce are as different as a automobile is from a
Bell Jet-Ranger helicopter. If you want to take a journey back to good health, which
one gets you there faster?
Much of the reason the less effective mHBOT chamber has even entered the
discussion is due to simple economics. Hospital grade chambers capable of
delivering the correct pressures of 100% oxygen are expensive, on average costing
around $150,000 USD apiece. An inflatable chamber will typically run about $10,000
USD. Coffee table or helicopter? Which do you choose for your child?
Physics do not support the claims of the proponents of mHBOT (inflatable) and
Bradstreet may have arrived at an appropriate conclusion in stating that mHBOT is
of no use for children with autism. The ARI newsletter headline was accurate also,
but a little confusing, since it did not specify the type of hyperbaric oxygen that was
used in the trial. The physics indicate that you will get a higher amount of oxygen
and more benefits from just sitting in a room and breathing 100% oxygen through a
mask, as shown in the graph and comments on the science below.
However, to balance the discussion, physiological effects need to be factored in.
These are much harder to measure in vivo (inside the body) than to measure with
oxygen meters in room air. There is vigorous debate between the proponents of
each type of chamber and oxygen percentages. For instance, a Canadian report,
known as the "Collete" study, documented that the lower pressures and percentages
of oxygen indicated some improvement in young patients. Many responded by
attributing these results to a placebo effect. But oxygen is metabolized by the body,
which is why any additional percentage will have some impact. To deny this by
ascribing any benefits to a placebo is illogical.
An important source of data for hard chambers with 100% oxygen at 1.5 ata is the
Louisiana State University approved pilot study (#7051) of 2008 pioneered by Dr.
Richard Neubauer. Here, Neubauer observed significant results for both adult
patients and children. Obviously, more trials need to be conducted with 100%
oxygen at 1.5 ata. Currently, the United States Air Force and its administrative
umbrella, the Department of Defense, are looking into the effect of this protocol to
treat veterans from Iraq and Afghanistan who suffer many of the same symptoms as
autism because, it is believed, the concussive blasts shake loose neuronal wiring and
lead to post-traumatic stress disorder (PTSD).
Bottom Line: Can HBOT or mHBOT Help?
Oxygen is a cellular nutrient, the cell-food that we cannot see. The cells in your body
require oxygen to metabolize the food that we can see into glucose, thus creating
energy in the form of electricity and heat. A healthy body consumes around 1.3
pounds (weight) of oxygen molecules each day just to maintain itself. So you could
say that the body’s oxygen supply system, meaning the blood circulatory system,
normally operates at 95% of its maximum capability.
That only leaves a buffer of 5% extra capacity, not much leeway if the body is faced
with a situation where it needs more energy to fight off disease or repair broken
bones or other trauma. An oxygen deficiency in some part of the body can cause
many bad things to happen.
There may be a breakdown of the nervous system. The electrical system that runs
that marvelous computer called the brain may be short-circuited, and can create
symptoms such as those seen in autism spectrum disorders. By
supplementing oxygen intake, with either mHBOT or HBOT can help the body to
overcome these problems. Neuro-circuits in the brain may reconnect. Bacteria and
fungus can be killed. That wonderful immune system in a body often can be
jumpstarted, fueled into action by supersaturating it with the extra oxygen of a
regular HBOT session.
It is all about science
In particular, three laws of physics known as the Universal Gas Laws. Boyle’s,
Dalton’s and Henry’s laws. Linked at all times together, they become Universal. Alter
or tweak any one and the other two adjust to keep pace. Henry’s seems the most
prominent in HBOT because “gas becomes soluble according to its partial pressure.”
Henry’s law is the explanation of how carbon dioxide melts into a soda, fizzing back
into a gas when the bottle or can is popped open. Likewise, oxygen obeys these same
gas laws and melts into the liquid human body when there is an increase in its
partial pressure or density. The additional dissolved oxygen acts as an energy
catapult and vigorously increases cellular oxidative metabolism, promoting healing
and repair. Thus the growing popularity of hyperbaric (high density or dosage)
oxygen therapy, or “HBOT.”
There are two ways to dissolve additional oxygen
into the body. One is tinkering with the percentages of oxygen in the air we breathe.
The other is to put the patient in a pressure chamber and increase the amount of
molecules of oxygen or density.
Tinkering with oxygen percentage
The air we breathe is approximately 80% nitrogen with the balance oxygen – about
20%. According to Dalton’s Law, we can increase partial pressures (density) of
oxygen by altering the percentage of oxygen in the air we breathe. Paramedics carry
oxygen all of the time to do just that. By giving a casualty 90% oxygen Dalton’s law
dramatically kicks up the density (partial pressure) or the amount of oxygen
molecules in each lungful and Henry’s Law keeps pace. The extra oxygen gaseous
molecules dissolves and the dense oxygen, now chemical molecules, flood into
plasma and clear fluids, easing the burden on the heart. The Universal Gas Laws
working, saving many lives each day. A paramedic’s sophisticated oxygen set-up
to get this extra oxygen into the body is not the only way. Here are some low cost
alternatives . . .
Nasal prongs increase oxygen partial pressure from normal air
20% to 36%
Hudson masks increase oxygen partial pressure from normal air
20% to 50%
Tinkering with pressure plus oxygen percentage
To supersaturate the body, you do need a pressure vessel, commonly known as
HBOT chambers. This extra pressure (Boyles’s Law) dramatically alters Dalton’s and
Henry’s Law.
In Hospital quality HBOT chambers all patients breathe100% medical
grade oxygen. All of these chambers reach pressures of 15 psig at minimum, some of
these chambers can reach pressures of 100 psig. The Universal Gas Laws produce
healing miracles in chambers that have 100% oxygen and correct pressure (or
oxygen density) capability. Remember, pressure equals density and this equals the
dose. Different illnesses require different treatment pressures. The "one size fits all"
just is not so in a hyperbaric chamber because there is a distinct drug-dose response
by the patient. Just as with prescription drugs, it is the physician who makes the
dosage decision, the technicians operating the chambers merely dispense the high
dosage oxygen according to orders.
To illustrate this, a couple of examples are
appropriate. In such a hospital HBOT chamber, gas-gangrene is treated at 29 psig (3
ATA) of 100% oxygen. This provides the patient almost 16 times the partial
pressure of oxygen of breathing room air at sea-level Diabetic ulcers respond to 19
psig (2.3 ATA) and heal quickly. Lyme disease and chronic fatigue syndrome
patients need the same pressures to achieve a positive result. The inflatable fails to
deliver both the required treatment pressure and oxygen percentages for these
health problems.
The inflatable is pressurized to a mere 4 pounds per square inch
(“psig.”) By adding 4 psig air pressure, the oxygen density (partial pressure) jump
from 20% to 26%.
About the inflatable chamber:
Identical partial pressures of oxygen occur if you spend an hour at the bottom of
a 9 foot deep swimming pool, breathing from a SCUBA tank and the
physiological changes to the human body are virtually the same!
As an FDA Class II medical device, whether the bag is full of air
or oxygen, a licensed physician or dental surgeons’ prescription
is mandatory for any use. While many chiropractors and other
health practitioners have great skills, the law is the law. Despite
their skills, they cannot write that prescription. You must have
a prescription from a physician (M.D. or D.O.) or a dental
surgeon (D.D.S.) to purchase an inflatable
chamber. Referring to the air filled chamber as “mild”
hyperbaric oxygen therapy does not erase FDA rulings.
Chiropractors (D.C.) naturopathic doctors (N.D.) or any other practitioners are
breaking the law if they prescribe mild hyperbarics and face arrest by their
local district attorney. Unfortunately, so too are any well-meaning caregivers
that allow others to use their personal inflatable chambers.
Code compliance – the local fire department:
In addition to the FDA rules, the
local fire marshal will insist that any clinic that uses hyperbaric chambers comply
National Fire Protection Agency (NFPA) 99-11 codes with fire walls and certified
fire doors, sprinklers and other code compliance.
Eleven States and three U.S. cities are now enforcing the PVHO-1 codes
and scrutinizing health care practitioners who advertise for patients.