Oxygen therapy

Encyclopedia of Medicine, Apr 06, 2001 by Rebecca J. Frey

Oxygen therapy is a form of treatment that uses oxygen in elemental or compound forms to heal various disease conditions and strengthen the immune system. Hyperbaric oxygen therapy (HBO) is a mainstream treatment that involves placing the patient in a pressurized chamber with pure oxygen (O2). Bio-oxidative therapies are alternative treatment approaches that emphasize increasing the oxygen content of the blood through proper breathing and diet, together with the use of ozone and/or hydrogen peroxide in the treatment of specific diseases or weakened immune systems. Ozone therapy is considered a mainstream form of medical treatment in Germany, Austria, Switzerland, France, and Russia.

The purpose of HBO therapy is the reversal of conditions or processes caused by inadequate oxygen in the body (e. g., asthma, carbon monoxide poisoning, smoke inhalation, decompression sickness, and mountain sickness); or the speeding-up of healing in traumatic injuries or infections by increasing the amount of oxygen present in body tissues (e. g., crush injuries, skin grafts, soft tissue infections, bone inflammation, or damage caused to bone and soft tissue by radiation therapy).

Bio-oxidative therapies are used to treat conditions ranging from AIDS, cancer, and cardiovascular diseases to acne, dental surgery, allergies, arthritis, and herpes infections. Ozone therapy and hydrogen peroxide therapy are considered multi-disease treatments, and are based on the oxidizing capacity of these substances. Ozone and hydrogen peroxide are thought to inhibit tumor growth, kill viruses, help the immune system by stimulating the production of white blood cells and interferon (a family of proteins that can both stimulate the immune system and exert antiviral action), and improve the efficiency of oxygen transfer from the blood to body tissues.

In addition to direct treatment of human beings, ozone is used to purify city water supplies; disinfect beverage containers prior to bottling; inhibit the growth of molds and bacteria in stored fruits and vegetables; and remove odors from the air in sewage treatment plants, railways and tunnels, paper mills, and food processing plants. Hydrogen peroxide is used in the treatment of drinking water for farm animals, to cleanse milk cans and storage tanks, and to increase plant growth rate and productivity.

Consultation with a physician is essential before these therapies are administered.

HBO is not given to patients with untreated pneumothorax, a condition in which air or gas is present in the cavity surrounding the lungs. It is also not used for premature infants, because of the risk of retrolental fibroplasia, a condition in which the blood vessels in the retina of the infant's eye do not develop normally. Retrolental fibroplasia can cause blindness in children born prematurely.

HBO is used cautiously in patients with a history of pneumothorax, chest surgery, emphysema, middle ear surgery, uncontrolled high fevers, upper respiratory infections, seizure disorders, or hereditary disorders of the red blood cells.

Patients using in-home oxygen tanks and delivery devices are cautioned to keep them away from flammable products and sources of direct heat.

Safety precautions are also necessary with ozone and hydrogen peroxide. Ozone is a gas and should not be inhaled directly into the lungs. Modern medical ozone generators are designed to prevent accidental ozone escape. Although hydrogen peroxide is commonly, and safely, used by dentists to rinse a patient's mouth after dental surgery or to disinfect ulcers in the mouth, patients should not drink it in quantity. Hydrogen peroxide is not poisonous in the standard 3% pharmacy dilution; it irritates the stomach lining, however, if it is taken directly into the digestive tract.

Each form of oxygen therapy has its own methods of administration:

In HBO therapy, the patient is placed in a pressurized chamber in which he or she breathes pure oxygen within the chamber itself or administered through a mask, head tent, or endotracheal tube. A tight-fitting aviator or anesthesia mask is used for patients with carbon monoxide or smoke inhalation poisoning. The "rebreather" masks commonly used in hospital emergency rooms do not fit tightly enough for patients with carbon monoxide or smoke inhalation injuries and should not be used with them.

A nasal cannula or catheter may be used for small infants who need oxygen therapy for lung diseases because it allows them more freedom of movement. Otherwise, endotracheal tubes or anesthesia masks can be used with children as well as adults.

The length of time in the oxygen chamber, the degree of pressurization, and the number of treatments depend on the condition being treated. Decompression sickness from diving accidents may require up to two weeks of oxygen treatment. Patients with gas gangrene are given seven treatments over a three-day period. Skin graft patients are given two treatments daily for three to seven days. Patients with osteomyelitis may require as many as 40-60 treatments. Most treatment sessions for most conditions are 90 minutes in length, with one or two five-minute "air breaks" at 20-minute or half-hour intervals. Pressures are usually 2.5 or 3 ATA (atmospheres absolute).