Hyperbaric Healthcare

Hyper Baric Oxygen Therapy

(HBOT)
- Shreyansh Shah
- 9712396079

. .
Hyper Baric Oxygen Therapy (HBOT)

History of HBOT
What is HBOT?
How HBOT Works?
Trends in Hyperbaric Mechanism
 History of Hyperbaric Therapy

British physician, Henshaw, in 1662 used a chamber fitted with a large

pair of organ bellows, so that air could either be compressed into the
chamber or extracted from it.
In this domicilium' increased pressures were used for the treatment of
acute disease, and reduced pressures for the treatment of chronic
diseases.
Oxygen discovered in 1775
 ..No oxygen?
Brain damage in 3-4 minutes.
..No vitamin C?
Scurvy in 3-4 months.
..No vitamin D?
Osteoporosis in 3-4 years.
We can supplement vitamins and minerals,
but
How do you get more
Oxygen?????
 Room Air 160 mmHg

Lung Capillaries 100 mmHg

Leaving Heart 85 mmHg

The brain makes up

2% of body weight Peripheral Arterioles 70 mmHg
but uses 20% of
body oxygen Organ Capillaries 50 mmHg

Cells 1-10 mmHg

Mitochondria 0.5 mmHg

(0.3% of inhaled oxygen)

Mitochondria is the final

site of energy production
 How To Get More Oxygen?

Breathing more oxygen not enough.

Room air contains 21% oxygen, enough to fill most of the oxygen-
binding sites on our red blood cells, carried by hemoglobin.
Breathing even 100% oxygen
Fills the few remaining sites on hemoglobin. Increases blood oxygen
by a small percentage. Can be life-saving, especially if blood oxygen
levels are low, but results in minimal gains when O2 levels start out
normal.
Encourage oxygen to dissolve in serum and plasma by increasing
pressure of oxygen.
Pressure is provided by a chamber with above-normal pressure, called
a hyperbaric oxygen chamber. Patient enters chamber and pressure
is slowly increased to a level appropriate for the persons condition.
Hyper Baric Oxygen Therapy (HBOT)

What is HBOT?
How HBOT Works?
Trends in Hyperbaric Medicine
 What is HBOT?

Hyperbaric oxygen therapy (HBOT) is the inhalation of

100 percent oxygen inside a hyperbaric chamber that is
pressurized to greater than 1 atmosphere (atm). HBOT
causes both mechanical and physiologic effects by
inducing a state of increased pressure and hyperoxia.
HBOT is typically administered at 1.5 to 3 atm. While the
duration of an HBOT session is typically 90 to 120
minutes, the duration, frequency, and cumulative
number of sessions have not been standardized.
pressure

O2 absorption
What does this have in common?
Oncology

Complicati
Vascular
HBOT on of
Diabetes

Orthopedic
 Tissue Compromise

Hypoxia generates signal to

commence wound healing cascade
Hyperbaric Oxygen environment
augments the signal
Action HBOT acts as a signal
transducer.
Recent studies suggest low oxygen state after a stroke, cerebral
palsy, autism, or chronic viral infections.
Some of the cells around the area of injury are still alive - not
sufficient oxygen to function well. Not dead, but too little oxygen
to do their jobs.
Thousands of people are affected every year by an event or
condition that causes some body tissues to live in a perpetually-
low oxygen state. Can be improved with acceptable blood flow,
oxygen saturation.
Limb reattachment
Radiation therapy
Head injury
Surgical wound
Skin graft
Plastic surgery
Severe burns
Carbon-monoxide poisoning
The macrophage is sensitive to variations in levels of
oxygen present in the tissues; sensitive to an oxygen
gradient
Persistent Hypoxia signal results in an attempt , by
local tissues to build new blood supply to the affected
area.
This is how tissues communicate to other neighboring
structures, the need for routine tissue repair to
commence.
Note that although there may be insufficient
stimulus to initiate the tissue repair cascade
under normal conditions, by increasing the
local oxygen delivery the oxygen gradient is
magnified .resulting in a stronger signal and
augmented repair.
 Emergency Indications
Diving injury
Carbon monoxide poisoning
Surgical infections

Acute traumatic ischemia

Clinical Hyperbaric Failed flaps and grafts
Oxygen Therapy Cerebral Edema
Burns

Scheduled Indications:
Generally related to healing of
compromised wounds
 Uses

Certain non-healing wounds (post-

surgical or diabetic)
Radiation soft tissue necrosis and
radiation osteonecrosis
Necrotizing fasciitis (flesh eating
bacteria)
Carbon monoxide poisoning
Decompression sickness
Air or gas embolism
 Uses (cont.,)

Acute arterial ischemia (crush injury,

compartment syndrome, etc.)
Compromised skin grafts or flaps
Severe infection by anaerobic bacteria
(such as gas gangrene)
Severe uncorrected anemia when blood
transfusion is not available (e.g., in a
Jehovah's Witness)
Chronic refractory Osteomyelitis
 Mechanism and Effects

Hyper-oxygenation Greater oxygen

carrying capacity
Increased oxygen diffusion in tissue fluid
Diffusion distance proportional to the
square root of dissolved oxygen
Severe blood loss anemia (unable to
carry oxygen)
Crush injury, compartment syndrome
graft, and flap salvage (decreased
perfusion)
 Mechanism and Effects

Edema (increased diffusion barrier)

Decrease gas bubble size
Boyle law - Gas volume inversely
proportional to pressure
Hyperbaric diffusion gradient favors gas
leaving the bubble and oxygen moving
in, metabolizing oxygen in the bubble
Decompression sickness
Air embolus syndrome
 Secondary Effects

Vasoconstriction
Decreased inflow into tissues
Decreased edema
Increased oxygen gradient between wound
and surrounding environment
Increased fibroblast proliferation leading to
increased collagen deposition and increased
fibronectin, which aids in neovascularization
Types of HBOT Chamber (Trend in HBOT Mechanism)

1. Multi Place Chamber: Jabalpur, Bangalore, Jaipur

2. Mono Place Chamber: Mumbai

 Cum to Business !!

ROI after Machine installation at the Setup !!

 ROI with Mono Place HBOT
Chamber
Years 1 2 3 4 5

Session per Year/ Year (Rs.) 1750 1750 1750 1750 1750

Cost per Session to the Pt. 3500 3500 3500 3500 3500

O2 Consumption/ Year (Rs.) 210000 210000 210000 210000 210000

Technician exp. Man power 216000 216000 216000 216000 216000

Total Revenue 6125000 6125000 6125000 6125000 6125000

Cumulative Revenue after exp. 5,699,000.00 So on .

Patient number will increase but we are keeping maximum number 5 a day

Calculating as a one technician for Mono Place Chamber no other staff require
Thank you !!!
Shreyansh Shah
Ahmedabad
9712396079