Complications of Hyperbaric Oxygen Treatment

During hyperbaric oxygen therapy (HBOT), you breathe pure oxygen inside a highly pressured environment. Often, pressure in the chamber is between 1.5 and 3 times greater than normal air pressure.

This therapy was first seen in the U.S. in the early 20th century. It was later used by undersea medicine specialists to treat deep-sea divers who developed decompression sickness (also called the bends.) It is now used to treat many conditions from severe burns to carbon monoxide poisoning. But like all medical procedures, it has some risks.

Side effects and possible complications of HBOT

During HBOT, you lie on a table in an enclosed chamber and breathe oxygen while the pressure inside the chamber is slowly increased. The therapy may last as little as 3 minutes or as long as 2 hours before the pressure is returned to normal levels. Because the pressure is so high, some people may have discomfort while in the chamber. You may have ear pain or a popping feeling in your ears.

To prevent oxygen poisoning, you may need to take short breaks during the therapy and breathe normal air. This can prevent tissues in the body from taking in too much oxygen.

The oxygen dose given during the treatment should be determined specifically for each person. Your healthcare provider will consider any health problems you have, as well as your overall health and your age. This helps to reduce the risk for side effects and complications.

Possible symptoms or side effects after HBOT can include fatigue and lightheadedness. More severe problems can include:

  • Lung damage

  • Fluid buildup or bursting (rupture) of the middle ear

  • Sinus damage

  • Changes in vision, causing nearsightedness, or myopia

  • Oxygen poisoning, which can cause lung failure, fluid in the lungs, or seizures

Side effects are generally mild as long as:

  • The therapy doesn’t last more than 2 hours

  • The pressure inside the chamber is less than 3 times that of the normal pressure in the atmosphere

HBOT cautions

Hyperbaric oxygen therapy is not safe for everyone. In general, you shouldn't receive HBOT if you:

  • Have certain types of lung diseases, because of an increased risk for a collapsed lung

  • Have a collapsed lung

  • Have a cold or a fever

  • Have had recent ear surgery or injury

  • Do not like small enclosed spaces (claustrophobia)

Precautions to take

The best way to avoid side effects and complications of HBOT is to be treated by certified and trained medical staff. Not many healthcare providers in the U.S. are board-certified in the field. The healthcare provider directing your therapy should have special training from the Undersea and Hyperbaric Medical Society. Ask to see his or her certificate of completion for the course.

Uses of hyperbaric oxygen therapy

Another way to prevent complications is to use HBOT only as intended. HBOT is used to treat many different health conditions including:

  • Carbon monoxide poisoning

  • Cyanide poisoning

  • Injury from crushing

  • Gas gangrene, a form of gangrene in which gas collects in tissues

  • Decompression sickness

  • Sudden or traumatic inadequate blood flow in the arteries

  • Select wound healing

  • Skin grafts and flaps

  • Infection in a bone called osteomyelitis

  • Delayed radiation injury

  • Flesh-eating disease called necrotizing bacterial soft tissue infections

  • Air or gas bubble trapped in a blood vessel. This is known as an air or gas embolism.

  • Long-term (chronic) infection called actinomycosis

  • Diabetic wounds that are not healing properly

Medicare, Medicaid, and many insurance companies generally cover these procedures. But they may not cover it in every case. Check with your insurance plan before you begin treatment.