Information for Healthcare professionals
Hyperbaric Oxygen Therapy should be considered an important adjunctive therapy in the management of acute trauma, which is often seen in sports injuries.
Trauma is a multi disciplinary medical problem as it could affect many different systems of the body. Trauma, direct or indirect, in turn, can be classified as either minor (contusions, ligament injuries, etc) or major (fractures, spinal injuries, severe contusions, crush injuries – compartment syndrome, burns, etc).
Hyperbaric Oxygen Therapy increases the Oxygen delivery to the tissues
HBO reduces swelling and pain
· Prevents Hypoxia of the traumatized tissues
· Speeds up the healing of tissues, ligaments and fractured bones
· Reduces scar tissue formation and damage
· Helps return players to the game sooner
Ischaemia and oedema are parts of a vicious cycle where hypoxia is the major component in the changes that affect the injured tissues. Oedema (swelling) of the tissues will compound the problem created by hypoxia as it increases the diffusion distance from the capillaries to the cell.
This also affects the microcirculation that further impedes oxygenation in already compromised tissue.
As the partial pressure of inspired oxygen increases, the oxygen dissolved in the plasma increases proportionately. This dissolved oxygen is sufficient to oxygenate tissues without haemoglobin bound oxygen. This is where the oxygen under pressure proves its benefits (Henry’s Law). Traumatized tissue’s auto regulatory mechanism increases blood flow to compensate for hypoxia. In a damaged microcirculation this mechanism causes undesirable swelling.
The increases in the oxygen carrying capacity of the plasma appear to have 2 important effects.
- In-spite of the impaired microcirculation, the plasma carries sufficient amounts of oxygen to avoid problems associated with hypoxia.
- Reduction of oedema through vasoconstriction. Oxygen under pressure causes a 20% reduction in the blood flow. Oedema is reduced at the same time as microcirculation improves. This enhances re-absorption of fluid and a further reduction of swelling.
The important part of treatment and rehabilitation of any injury is physical therapy with the associated application of Hyperbaric Oxygen Therapy using various protocols according to the type and origin of the injury.
In conclusion, data from many studies suggest that treatment should be instituted within the first 24-48 hours. Some studies indicate the first 12 hours are very important and it appears as if best results are obtained if the injury should is actively treated early on. The treatment protocol used by London Hyperbaric and Wound Healing Centre is our standard LHM 14m (2.4 ATA for 90 minutes) and at this pressure there is enough oxygen dissolved in the plasma to gain maximum benefit with minimal risk of toxic or side effects.