Hyperbaric Oxygen Therapy

  • a brief history of hyperbaric oxygen therapy

  • an explanation of the basic principles of hyperbaric oxygen therapy

  • answers to the questions, which are most frequently asked, relating to hyperbaric oxygen therapy

  • guidance to patients attending hyperbaric treatment sessions

History of hyperbaric oxygen therapy

Hyperbaric chambers have been in use for centuries, as early as 1662. However, hyperbaric oxygen therapy has only been used clinically since the mid 1800's.

Hyperbaric oxygen therapy was tested and developed by the U.S. Military after World War I, and it has been used regularly since the 1930's to help treat deep-sea divers with decompression sickness.

Clinical trials in the 1950's uncovered a number of beneficial mechanisms from exposure to hyperbaric oxygen. These early trials, were the forerunners of contemporary applications of hyperbaric oxygen in the clinical setting.

Today there are a number of increasing indications, approved by the health authorities, as primary or adjunctive treatment modalities. Hyperbaric oxygen treatment has proved to be a life and limb saving treatment as well as cost effective. It is therapeutic in a variety of clinical conditions.

What is Hyperbaric oxygen therapy ?

Hyperbaric oxygen therapy (HBO) is defined as breathing 100% oxygen while in an enclosed system pressurised to greater than one atmosphere (sea level). Breathing 100% oxygen at atmospheric pressure or applying topical oxygen without enclosing the entire patient in a pressurised chamber does not produce the same effects and is not recognized as hyperbaric oxygen therapy.

Many health professionals may be astonished, at the reaction of some doctors to the word 'hyperbaric', The public continue to find some referring physicians, dismissive and some even openly hostile. The primary reason for this is that the teaching about oxygen in our medical schools was, until recent years, inadequate, particularly in the following areas:

  • The importance of barometric pressure in determining oxygen dosage.

  • Understanding that the plasma concentration alone determines the rate of transport of oxygen into tissue.

  • The most essential function of blood flow is to transport oxygen.

  • Oxygen not only acts in relation to metabolism, it also acts as a modulator of many cellular functions.

  • That most diseases affect not only the cells of a tissue, but also the blood supply.

  • That both a decrease and an increase in blood supply can cause hypoxia, defined as a deficiency in the level of oxygen required for normal function.

  • That an adequate level of oxygen is essential to recovery in disease.

Epictatus in the third century BC postulated that:

 "It is impossible to learn something that we think we already know".


For several decades hyperbaric medicine has steadily evolved and is gaining momentum. Acceptance is growing throughout the world, At the moment, the comprehensive information and experience derived from many years of clinical experience and trials have prompted major developments. The advancements in diagnostic medicine is partially responsible for the elevation of hyperbaric medicine; for example magnetic resonance imaging, which constantly points to hypoxia and the increased tissue water content of oedema as critical components in many diseases - from the exotic territory of the brain to the mundane problem of varicose ulceration.

The applications of hyperbaric oxygen for a wide range of suitable conditions, are proving a cost effective and a satisfactory form of treatment in the twenty-first century.

 David P Downie MBE FIMT CHT