August Pic Of The Month

Mobile hyperbaric chamber: Equine Rapid Recovery
Photo: Skip Dickstein/Albany Times Union

Postscript: HBOT And H. Pylori

Since posting our A. Stone Freedberg obit Monday, a few astute O2.0 readers hasten to add the bacterium H. pylori is anaerobic—microaerophilic, to be precise—and proved susceptible to hyperbaric oxygenation in a 1989 Russian study. Borrelia burgdorferi, the spirochete that causes Lyme Disease, falls in the same category. See also our July 6 post, "Of Dog Days And Deer Ticks...," and expect our continued fascination with this topic.

HBOT: Outerwear For The New Millenium?

O2.0 congratulates Flagsuit LLC for winning the 2009 NewSpace Business Plan Competition, with extra thanks for providing a not-so-sci-fi footnote to last week's HBOT In Space story. Sponsored by the Space Frontier Foundation and the Heinlein Trust (Stranger in a Strange Land, anyone?), the NewSpace competition awards $5,000 and access to the investment community. What caught our eye was Flagsuit's focus on private spaceflight and its plan to commercialize

a hyperbaric (pressurized) suit with excellent mobility at a price that enables affordable spacesuits. The same product will fill a nonspace consumer need for a mobile chamber for hyperbaric oxygen therapy, creating a convenient way for people to treat and prevent disease.

Now that would be a portable chamber! Godspeed, Peter K. Homer.

Wired: How Smart Is That?

Hey, we display this magazine on our coffee tables! HBOT landed the 3 Smart Things About column in the September issue of Wired. Okay, so we're a little miffed HyperbaricLink didn't make the shortlist. But we're not at all surprised autism and sports injuries captured the editors' imagination over all the really smart things about hyperbarics. All those professional fighters and ballplayers using inflatable chambers can't be wrong, we guess they guessed. Awesome illustration, though.

What would make your list of 3 Smart Things About Hyperbaric Chambers? This blog has a comment section, you know.

Evidence: Enough To Give You An Ulcer

A. Stone Freedberg died last week. His story is a sobering reminder that evidence-based medicine advances only by hard work and good luck, by fits and starts, past deep chasms and long cul-de-sacs. Were history any kinder, and clinical research any fairer, Freedberg surely would have won the Nobel Prize for discovering that the bacterium Helicobacter pylori causes peptic ulcers. He made his discovery in the 1940s. A pair of Australians, Marshall and Warren, didn't confirm Freedberg's findings until the 1980s and nabbed the prize in 2005. (To add irony to insult, Alfred Nobel himself died of a duodenal ulcer some 110 years earlier.) Doctors today diagnose H. pylori infection with a breath test and treat ulcers with antibiotics instead of milk and stress management.

Fire Safety Standards for Hyperbaric Facilities

The death of an Italian boy and his grandmother resulting from an explosion and fire at a hyperbaric facility in Florida tragically demonstrates the consequences that can result from lapses in vigilance when working with oxygen under pressure. A press release issued by a Florida law firm states that a Miami television station reported that the private hyperbaric center had unresolved safety problems. WPLB reported that there were building, fire safety, and FDA violations with the facility's oxygen tanks and hyperbaric chambers.

What are the national standards for hyperbaric chamber safety? The FDA's database of consensus standards lists the National Fire Protection Association (NFPA) as the recognized source of safety standards for hyperbaric medical facilities. The relevant section is NFPA Standard 99, Health Care Facilities, Chapter 20, Hyperbaric Facilities.

HBOT In Space

Hyperbaric oxygen therapy has made it into space, at least in a fictional sense. In the second episode of the new ABC space thriller, Defying Gravity, the crew of the Antaries tests a special space suit by pumping the the internal pressure up to a whopping five atmospheres to check for leaks. They do this with an astronaut inside the suit, so the inevitable leak leads to a life-threatening drop in pressure.

Decompression sickness ensues. The quick-thinking crew (there's no other kind on TV) calls for "the hyperbaric chamber." Something like a large Ziploc bag is produced. Fifty years from now chambers will apparently be very portable.



You'll have to watch to learn how it all works out. Remarkable in that the science is roughly accurate and that the scriptwriters felt they could include the hyperbaric chamber without getting the audience totally lost.

Finger Clips, Firefighters, and Hyperbaric Oxygen

Carbon monoxide, "the silent killer," is responsible for more poisonings than any other source in the industrialized world. As reported in the New York Times last year, recent research suggests as many as 11,000 undetected cases of CO poisoning occur annually. At particular risk are firefighters, who work takes them into close proximity with CO and other harmful products of combustion.

Detecting carbon monoxide poisoning in the field or in the emergency room can be difficult, since the symptoms are often flu-like and may be misdiagnosed as being caused by another condition. Early detection is critical. CO leaves the bloodstream quickly, but its effects on heart tissue and the brain can be lasting.

Last year a leading manufacturer of medical devices, Masimo, introduced a pulse oximetry device, the finger clip familiar to hospital patients, that can detect both oxygen and carbon monoxide levels in the blood. With the device, emergency room personnel and first responders have a better chance of identifying high levels of CO in the blood.

Now the company is working with the International Association of Firefighters (IAFF) on a campaign to increase CO poisoning awareness and encourage firefighters to have their CO levels checked at the scene. Because the risks are significant and early detection critical, it's essential firefighters and other first responders understand the symptoms of CO poisoning and have the tools to identify it promptly.

We applaud their efforts. At HyperbaricLink we have a special interest in the issue of carbon monoxide poisoning and its neurologic effects. We also see the potential for increasing use of HBOT in first responder work and willcover both topics with dedication.

Although a multi-center, randomized controlled trial has not been conducted, hyperbaric oxygen therapy is used to treat both acute and chronic CO poisoning and the neurologic effects that result. The HyperbaricLink Evidence Index identifies four clinical trials being conducted to learn more about the treatment of CO poisoning with HBOT. The Undersea and Hyperbaric Medical Society, which approves the use of HBOT for CO poisoning, provides additional information here.

Stay turned for the latest news about HBOT treatment protocols for carbon monoxide poisoning and hyperbaric oxygen in emergency medicine.

Contrarian View of the VA

Following the progress of hyperbaric medicine at Veterans Administration hospitals? Best Care Anywhere, by Phillip Longman, is sure to be of interest.



Using an impressive line-up of research and statistics, Longman argues that recent changes at the VA light the way toward more reliable and inexpensive healthcare. It's a tall order to fill, and some readers will be stunned by the claim "VA healthcare is better than yours" but the case is well presented.

Of particular interest to us technology types is the section on VistA, the healthcare administration system developed by the VA and made available freely as an open source software project. It's used by healthcare providers around the world. We'd love to hear from readers with VistA experience, especially if they're using it to run their hyperbaric clinic.

Hyperbaric Economics for Veterans

Yesterday's story about Marine Casey Owens got us thinking more about Veteran's Administration healthcare and hyperbaric medicine. We know HBOT is accepted for many of the conditions the VA treats, including some like wound care in which the VA has a special interest. There are encouraging results for other conditions, like the traumatic brain injury (TBI) in yesterday's story, when hyperbaric oxygen is included in the treatment plan.

To get some background, we searched the VA's directory of facilities for "hyperbaric". Out of 1185 entries, just three included our search term. While there are probably many other VA medical centers with hyperbaric facilities, finding them isn't easy.

As we reported previously, the legislation sponsored by Congressman Pete Sessions can help. But with rising healthcare costs and financing reform being the talk of the day, we started wondering what's the most effective way for veterans to start quickly receiving the HBOT treatment they need.

Could a mix of public and private resources be the answer? There are clearly some situations, such as post-operative wound care, where access to a hyperbaric chamber at the hospital is the best approach. We hope the funding provided in through the legislation enables the VA to build them quickly.

For conditions like TBI that can be treated on an out-patient basis, would reimbursement for hyperbaric treatment at private HBOT clinics enable veterans to get treatment faster, more conveniently, and more economically? We welcome reader perspectives and encourage your comments.

VA Slow On HBOT, Marine Suffers

Last night's CBS Evening News with Katie Couric included the story of an Iraq War veteran, Casey Owens, who almost didn't get the hyperbaric oxygen therapy he needed. Even then, he didn't get it through the Veterans Administration hospital as he should have.

Severely injured by a landmine over five years ago, Owens lost part of both legs and suffered a tramatic brain injury. Repeated operations to repair what was left of his right leg were unsuccessful, failures that might have been avoided if HBOT was available for his post-operative therapy.


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The VA dismissed his TBI symptoms as headaches or stress-related. Convinced otherwise, Owens found Dr. Paul Harch and has been making such good progress recovering he's starting college in the fall.

The final injury: Owens had to raise the money for hyperbaric treatment himself. The Veteran's Administration won't pay for it. At HyperbaricLink, we hope recent research on TBI and HBOT leads to a rapid change for the better at the VA.

Meet The HyperbaricLink Evidence Index

Want an at-a-glance summary of the clinical evidence on HBOT for your disease or condition? Check out our new Evidence Index. Just open any condition page on our site and look for the little green table.

For now scoring is based solely on our reading and interpretation of the medical literature. In short order we'll be assembling a panel of hyperbaric experts to place the check in one of six categories:

• Disproved - Strong evidence against using HBOT.
• None - Unfavorable results or no published evidence.
• Scant - Early or mixed results with lingering questions.
• Promising - Repeatedly favorable results urging further study.
• Compelling - Strong body of evidence meriting approval.
• Approved - HBOT indicated and widely reimbursed.

To start your own research, you can follow the links to our primary sources and read the papers and analyses that have shaped our views.

We're sure the Evidence Index will become more and more valuable to HyperbaricLink visitors as we add more and more investigational conditions to our library. Stay tuned. And let us know what you think.

Check? Check.

Sechrist Names New Leader

Early last week Sechrist Industries named Edward Pulwer its new President and CEO. Pulwer was previously a senior operating executive in the respiratory care division of Cardinal Health and COO of Viasys. Welcome to the business, Ed.

The New Math: HBOT For Chronic Wounds

There's something pleasingly pure about arithmetic. And it's a whole lot cheaper than a clinical trial. A new paper in PLoS Computational Biology looks at the numbers behind the healing of nonhealing chronic wounds, especially limb- and life-threatening diabetic leg ulcers. It's not light reading. In short, the authors find:

• Hyperbaric O2 accelerates healing.
• Treatments should continue until healing is complete.
• Healing action begins at the capillary tips.

They further hope, as we do, their work is a first step toward better identifying patients and wounds that will benefit most from HBOT.