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Hyperbaric Oxygen Therapy


Catherine Spader, RN

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy is a treatment for oxygen-deprivation diseases and conditions, including decompression illness, non-healing wounds, and carbon monoxide poisoning. Hyperbaric oxygen therapy, also known as HBOT, increases the amount of oxygen in your blood. It helps your blood carry more oxygen to your organs and tissues. 

Hyperbaric oxygen therapy involves breathing 100% oxygen in a pressurized chamber or through a pressurized mask or hood.

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Hyperbaric oxygen therapy is only one method of treating oxygen-deprivation diseases, disorders and conditions. Discuss all of your treatment options with your doctor to understand which options are right for you.  

Why is hyperbaric oxygen therapy performed? 

Your doctor may recommend hyperbaric oxygen therapy to treat the following diseases, disorders and conditions:  

  • Blood and vascular problems including peripheral arterial insufficiency and severe anemia from blood loss when blood transfusions are not an option

  • Certain serious infections including gas gangrene, necrotizing (dying) soft tissue infection, brain abscess, and osteomyelitis (bone infection)

  • Decompression sickness including “the bends,” which affects scuba divers who surface too quickly and extreme mountain climbers, astronauts, and fighter pilots who climb too quickly

  • Gas embolism including air or gas bubbles in the blood

  • Injury including crush injuries, compartment syndrome (increased pressure in the muscles), reattachment of severed limbs, and severe burns

  • Non-healing wounds including diabetic foot ulcers and compromised (failing) skin grafts and tissue flaps

  • Poisoning or toxic inhalation including carbon monoxide poisoning, cyanide poisoning, and smoke inhalation

  • Tissue damage due to radiation including soft tissue damage and osteoradionecrosis (bone damage)

Who performs hyperbaric oxygen therapy?

A doctor who specializes in undersea and hyperbaric medicine supervises hyperbaric oxygen therapy. An undersea and hyperbaric medicine doctor specializes in treating acute and chronic oxygen-deprivation diseases and conditions. A specially trained nurse, respiratory therapist, or technician often performs the procedure.

How is hyperbaric oxygen therapy performed?

Your hyperbaric oxygen therapy will be performed in a hospital or outpatient setting. It generally includes these steps:

  1. You will lie on a padded table that will slide you into a clear, tube-like hyperbaric chamber (monoplace hyperbaric chamber for a single person). Some treatments involve a multiplace (multiperson) chamber. Patients walk or are wheeled into a multiplace chamber.

  2. Your technician or nurse will gradually increase the sealed monoplace hyperbaric chamber pressure with 100% oxygen. In a multiplace chamber, you will breathe the pressured oxygen using an individual hood, mask or ventilator.

  3. You will relax and breathe normally until the treatment is over. Treatments take 30 minutes to two hours.

  4. The monoplace chamber or your multiplace hood or mask is slowly depressurized. Then, the table slides you out of the monoplace hyperbaric chamber or you exit the multiplace chamber.

Will I feel pain with hyperbaric oxygen therapy?

Your comfort and relaxation is important to you and your care team. You may feel ear popping or mild discomfort, which should pass if the pressure is reduced for you. Tell your technician or nurse if you have pain, are uncomfortable in any way, or feel anxious or claustrophobic in a monoplace hyperbaric chamber. 

What are the risks and potential complications of hyperbaric oxygen therapy?  

Side effects of hyperbaric oxygen therapy are generally mild, but complications can occur and become serious in some cases. Risks and potential complications of hyperbaric oxygen therapy include: 

  • Fatigue

  • Headache

  • Myopia (nearsightedness), which is usually temporary

  • Oxygen toxicity, pulmonary edema, and respiratory failure

  • Pneumothorax (collapsed lung)

  • Ruptured middle ear

  • Sinus damage

Reducing your risk of complications

Certain people have an increased risk of complications and side effects and should not have hyperbaric oxygen therapy. Tell your doctor if any of the following applies to you:

  • You have congestive heart failure.

  • You have a pneumothorax (collapsed lung).

  • You are pregnant. Hyperbaric oxygen therapy may be appropriate in critical cases in which there are no other treatment options.

  • You are taking certain medications including disulfiram (Antabuse), mafenide acetate cream (Sulfamylon), and some types of cancer chemotherapy.

Certain precautions can reduce the risk of complications and side effects from hyperbaric oxygen therapy. This includes keeping therapy sessions short (no longer than two hours) and keeping oxygen pressure below three times the normal atmospheric pressure. Some patients may need to take breaks from the pressurized oxygen to breathe normal air during their hyperbaric oxygen therapy sessions. 
Ask your doctor about your risk of side effects and complications, the length of your sessions, and the level of pressure. You can reduce the risk or the seriousness of certain complications by following your treatment plan and: 

  • Ensuring that your care team is aware of your complete medical history, including your allergies and medications

  • Informing your care team about having a pacemaker, problems with claustrophobia or anxiety, and any eye, ear, sinus, respiratory or heart diseases or conditions

  • Telling your doctor and hyperbaric technician if you have any new symptoms since your last treatment, even minor symptoms of a cold

  • Telling your doctor and care team if there is any chance you are pregnant

How do I prepare for hyperbaric oxygen therapy?

You are an important member of your own healthcare team. The steps you take before your hyperbaric oxygen therapy can improve your comfort and outcome. This includes answering all questions about your medical history and medications, and following all of your doctor’s instructions. 

Questions to ask your doctor

Having hyperbaric oxygen therapy can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before hyperbaric oxygen therapy and between appointments.

It is also a good idea to bring a list of questions to your appointments. Common questions include:

  • Why do I need hyperbaric oxygen therapy? What are the other options for treating my condition?

  • How many hyperbaric oxygen therapy sessions will I need? How long will each treatment take? How high will the pressure be?

  • When can I go home?

  • What restrictions will I have? When can I return to work and other activities?

  • How should I take my medications?

  • How will you treat my pain or discomfort such as headaches?

  • What other tests or treatments might I need?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after hyperbaric oxygen therapy?

Knowing what to expect after hyperbaric oxygen therapy can help you get back to your everyday life as soon as possible.

How will I feel after hyperbaric oxygen therapy?

Side effects of hyperbaric oxygen therapy are generally mild and temporary. Some people experience no side effects at all. Side effects can include mild fatigue and headache. Tell your doctor care team about any side effects or symptoms you have, even if they seem minor.  

When can I go home?

You may go home right after your hyperbaric oxygen therapy or stay in the hospital for observation and further treatments, depending on your condition. 

When should I call my doctor?

It is important to keep your follow-up appointments after hyperbaric oxygen therapy. Contact your doctor for questions and concerns between appointments. Call you doctor right away or seek immediate medical care if you have: 

  • Blurred vision or change in your vision

  • Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Dizziness or vertigo

  • Severe headache

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 12, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Decompression Illness: What Is It and What Is the Treatment? Divers Alert Network.
  2. Hyperbaric Oxygen Therapy.American Cancer Society.
  3. Indications for Hyperbaric Oxygen Therapy. Undersea & Hyperbaric Medical Society.

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