Oxygen therapy

Oxygen therapy or supplemental oxygen, is a treatment that provides you with extra oxygen. Oxygen is a gas that your body needs to function. The air you breathe contains about 21% oxygen, which is plenty for people with healthy lungs and many with lung disease. However, if you have bad enough lung disease, you may not be able to get enough oxygen from your lungs into your blood. Hence, if your oxygen level is low, your healthcare provider will recommend supplemental oxygen or oxygen therapy. Sometimes you only need extra oxygen in special situations. For example, you may need oxygen at very high altitudes (like in the mountains or in an airplane) even if you do not at sea level.

Normally, your lungs absorb oxygen from the air you breathe. But some conditions can prevent you from getting enough oxygen.

You may need oxygen therapy (supplemental oxygen) if you have:

COPD (chronic obstructive pulmonary disease)
Pneumonia
A severe asthma attack
Late-stage heart failure
Cystic fibrosis
Sleep apnea

Oxygen therapy increases the amount of oxygen your lungs receive and deliver to your blood. Oxygen therapy may be prescribed for you when you have a condition that causes your blood oxygen levels to be too low. Low blood oxygen may make you feel short of breath, tired, or confused, and can damage your body.

Oxygen therapy can be given for a short or long period of time in the hospital, another medical setting, or at home. You can receive oxygen therapy from nasal prongs (tubes resting in your nose,), a face mask, or a breathing tube placed in your trachea, or windpipe. If you have a chronic problem, you may have a portable oxygen tank or a machine in your home.

Oxygen is stored as a gas or liquid in special tanks. These tanks can be delivered to your home and contain a certain amount of oxygen that will require refills. Another device for use at home is an oxygen concentrator, which pulls oxygen out of the air for immediate use. Because oxygen concentrators do not require refills, they won’t run out of oxygen. Portable tanks and oxygen concentrators may make it easier for you to move around while using your therapy.

A different kind of oxygen therapy is called hyperbaric oxygen therapy. It uses oxygen at high pressure to treat wounds and serious infections.

Oxygen poses a fire risk, so you should never smoke or use flammable materials when using oxygen. You may experience side effects from this treatment, such as a dry or bloody nose, tiredness, and morning headaches. Oxygen therapy is generally safe.

How do I know I need oxygen?

Most people do not know when they need oxygen. Your health care provider will use special equipment to check the amount of oxygen in your blood. Your oxygen level is measured with either a blood sample or an oximeter. A blood sample is drawn from an artery (usually in your wrist) for an arterial blood gas (ABG) measurement. The arterial blood gas measures your oxygen level directly from your blood and is the most accurate of the tests. This can be done in the office, clinic or hospital, wherever the arterial blood test equipment is available. A pulse oximeter can estimate your oxygen level by measuring your oxygen saturation (O2 sat). The pulse oximeter is clipped on a finger, toe or earlobe and has the advantage of not requiring any needles. It can also monitor your oxygen during sleep or with walking. However, the pulse oximeter does not provide as much information as an arterial blood gas. It also can give a false reading if your circulation is poor, you are wearing dark nail polish, or if you are anemic.

How much oxygen should I use?

Oxygen is a medication and requires a prescription from your healthcare provider. They will prescribe your oxygen at a specific flow rate and a specific number of hours per day. If your oxygen level is lower during activity than at rest, you may have one flow rate prescribed for rest and a higher flow rate prescribed during activity. It is very important that you use your oxygen as prescribed. Using too little oxygen may put a strain on your heart and brain, causing heart failure, fatigue or memory loss. Using too much oxygen can also be a problem. For some patients, using too much oxygen can actually cause them to slow their breathing to dangerously low levels.

Will I need oxygen when I sleep?

Usually if you use supplemental oxygen during the day, you will need to use supplemental oxygen at night. This is because you tend to slow your breathing rate while sleeping. Some people may not require oxygen while awake but may need supplemental oxygen while sleeping. Your healthcare provider will determine if you need extra oxygen and how much you should take when sleeping.

How do I know if I need more oxygen when I exert myself?

You use more energy during exertion and therefore, need more oxygen than at rest. With lung disease, even breathing faster or deeper may not be enough to get oxygen into your blood. Your healthcare provider may therefore have you do an exercise stress test or a walk test to find out if your oxygen levels change with walking. In children, the amount of oxygen they need can be determined by measuring their oxygen level during play and with feedings.

How many hours a day will I need oxygen?

You should ideally use supplemental oxygen for 24 hours a day, unless your health care provider tells you you only need to use oxygen for exercise or sleep. Even if you feel “fine” off of your oxygen, your body’s oxygen level may be low and can cause brain and heart problems.

Will I always need to use oxygen?

Sometimes you may only need supplemental oxygen during or after a short illness, for example, around the time of a hospitalization. If your lung disease improves, oxygen therapy may be able to be reduced or stopped. However, you should never stop or cut back your oxygen without having your oxygen level checked and instructed by your healthcare provider.

What are the different kinds of oxygen systems?

Oxygen can be delivered from three types of systems: oxygen concentrator, liquid system or oxygen pressurized in a metal cylinder. The right choice for you depends on how much oxygen you need (your flow rate) and when you need it (day, night or both). The choice of delivery system also depends on where you live, your electrical supply, how active you are, cost to you and insurance restrictions.

Oxygen therapy benefits

Oxygen is a gas that is vital to human life. It is one of the gases that is found in the air we breathe. If you have a chronic lung disease, you may need additional (supplemental) oxygen for your organs to function normally.

More than 11 million Americans live with chronic obstructive pulmonary disease (COPD), including 203,700 in West Virginia which means you or someone you know may be living with this chronic lung disease and experiencing shortness of breath that interferes with planned activities. The main cause of COPD is smoking, but nonsmokers can get chronic obstructive pulmonary disease (COPD) too. Living with a chronic lung disease and the stress of struggling to breathe can be taxing for both the individual and their loved ones. While there is no cure for chronic obstructive pulmonary disease (COPD), there are treatment options that can drastically improve quality of life.

Here are some conditions that may require oxygen therapy, either temporarily or long-term:

COPD (chronic obstructive pulmonary disease)
Pulmonary fibrosis
Pneumonia
A severe asthma attack
Cystic fibrosis
Sleep apnea

Oxygen therapy is a treatment that provides you with supplemental, or extra, oxygen. Although oxygen therapy may be common in the hospital, it can also be used at home. There are several devices used to deliver oxygen at home. Your healthcare provider will help you choose the equipment that works best for you. Oxygen is usually delivered through nasal prongs (an oxygen cannula) or a face mask. Oxygen equipment can attach to other medical equipment such as CPAP machines and ventilators.

Oxygen therapy can help you feel better and stay active.

Oxygen therapy side effects

You may experience side effects from oxygen therapy, such as a dry or bloody nose, tiredness, and morning headaches. Oxygen therapy is generally safe.

Oxygen therapy at home

Home oxygen therapy involves breathing in air that contains more oxygen than normal from a cylinder or machine in your home.

It may be prescribed if you have a heart or lung condition that causes low oxygen levels in your blood. People with asthma, emphysema, chronic bronchitis, occupational lung disease, lung cancer, cystic fibrosis, or congestive heart failure may use oxygen therapy at home.

You can take oxygen in a number of ways using a:

tube positioned under your nose (nasal cannula)
face mask placed over your nose and mouth
tube placed into your mouth and down your windpipe

The tube or mask is attached to a ventilator machine.

How home oxygen therapy can help

If you have a health condition that causes low levels of oxygen in your blood, you may feel breathless and tired, particularly after walking or coughing. Fluid may also build up around your ankles.

Breathing air with oxygen increases the amount of oxygen in your blood.

This makes it easier to carry out activities that might otherwise be difficult, and helps reduce your symptoms.

Oxygen therapy also helps prevent damage to the heart and brain, which can be caused by low levels of oxygen in the blood.

It can help people with a range of health conditions, such as:

chronic obstructive pulmonary disease (COPD)
pulmonary fibrosis
heart failure
obesity-related hypoventilation
severe long-term asthma
pulmonary hypertension
conditions affecting the nerves and muscles or ribcage
cystic fibrosis

People who have oxygen therapy have different requirements. For example, you may only need oxygen for short periods during the day when you’re walking about (ambulatory oxygen), or you may need it for longer periods during the day and night.

When oxygen therapy shouldn’t be used

Oxygen therapy shouldn’t be used to relieve breathlessness if your oxygen levels are normal.

This is because it can decrease your fitness level and cause a delay in finding out what’s making you breathless.

Oxygen therapy assessment

If you have a long-term condition and your doctor thinks oxygen therapy might be helpful, you’ll be asked to visit your nearest oxygen clinic for an assessment.

The amount of oxygen in your blood will be measured by taking a blood sample from your earlobe or wrist, or by attaching a sensor to your finger (a pulse oximetry test).

You may also be asked to breathe into a device called a spirometer during a lung function test. Regular oxygen treatment may be recommended if your blood oxygen level is low.

If you decide to have oxygen treatment at home, a healthcare professional at the clinic will help you work out how much oxygen you’ll need and for how long. They’ll also discuss the different ways you can take it.

Once you’ve agreed this with the clinic, they’ll complete a home oxygen order form for you. It’s similar to a prescription, and gets sent to the company delivering your oxygen and equipment. The prescription will spell out the flow rate, how much oxygen you need per minute—referred to as liters per minute (LPM or L/min)—and when you need to use oxygen. Some people use oxygen therapy only while exercising, others only while sleeping, and still others need oxygen continuously.

You’ll be asked to fill in a consent form, plus a form that asks a number of safety-related questions, such as whether you’ve had any falls recently. The forms are needed to make sure oxygen is installed in your home in the safest way possible.

The oxygen clinician will need to share some information about your requirements with other key organizations, including the home oxygen supplier, your local fire and rescue service, and your electricity provider.

An engineer will visit your home to install the equipment, check that it’s working properly, and explain how to use it. They’ll also carry out a risk assessment and provide you with other important information, such as how to order oxygen refills.

The home oxygen therapy equipment

There are three common ways of providing home oxygen therapy:

A liquid oxygen system;
A standard oxygen concentrator, and
A portable oxygen concentrator

Home oxygen is rarely delivered in the older large, steel gas cylinders any longer since frequent and costly home deliveries are necessary every few days to replace empty tanks. Each of the three current methods of providing home oxygen is examined in more detail below.

Liquid Oxygen

Oxygen is stored as a very cold liquid (minus 300 degrees) in a large, barrel-like vessel (called a dewar) that acts like a large thermos. When released, the liquid oxygen immediately converts to a gas and you breathe it in, just like the compressed oxygen in the older steel cylinders.

An important advantage of liquid oxygen is you can transfer some of the liquid oxygen into a smaller, portable vessel that can be carried when you have to leave your home. The time you can spend away from the barrel-like vessel (a dewar) can be extended if there is an oxygen-conserving device built into the portable vessel. Oxygen-conserving devices will be explained below.

A liquid oxygen dewar must be periodically refilled by the home care company but not as frequently as with the older steel tanks. This is because 1 unit of liquid oxygen expands to 860 units of gaseous oxygen. However, liquid oxygen is expensive and will evaporate from the dewar when not being used. When used as directed, a full dewar can last up to 2 weeks.

Standard Oxygen Concentrator

This is an electrically powered device that plugs into an electrical socket and it’s about 75cm (2.5 feet) high and weighing about 50 pounds, that separates oxygen from the air by removing nitrogen and it is usually on wheels so that it can be moved from room to room. Since air is a mixture of 78% nitrogen and 21% oxygen, removing the nitrogen allows the oxygen to concentrate to over 90%. An oxygen concentrator has a number of advantages. Since a concentrator essentially makes its own oxygen, there is no need for resupplies by the home care company. A back-up oxygen cylinder will be provided in case there’s a problem with the oxygen machine or there’s a power cut. Regular maintenance checks will also be carried out to ensure the concentrator is always working properly. You should also advise your local electric utility company that you use oxygen in order to get priority services when there is a power failure.

The oxygen concentrator machine is very quiet and compact. The engineer will explain how to use it and answer any questions you have.

An oxygen concentrator machine is suitable if you’d benefit from having oxygen for many hours a day, including while you’re asleep. It ensures you have a source of oxygen that never runs out.

Your home care company can also provide you with small, lightweight, portable cylinders to use when you must leave your home, for example when you visit your doctor, or go grocery shopping. Empty cylinders will need to be replaced by your home care company. However, one way to make these smaller cylinders last longer is to use an oxygen-conserving regulator. These regulators deliver a short burst of oxygen, but only when you inhale. Since no oxygen is flowing when you exhale, oxygen is conserved. Cylinders with an oxygen-conserving regulator can last 3–4 times longer than when oxygen is flowing all the time, as is the case with older regulators.

Some home care companies now offer a special pressure booster that can take some of the oxygen produced by your concentrator to refill the small portable cylinders. This is a great advantage since you can refill your own cylinders when you get back home. By refilling your own portable cylinders, you don’t have to worry about calling your home care company to replace empty cylinders.

Portable Oxygen Concentrator

Advances in technology have significantly reduced the size and weight of the standard oxygen concentrator. There are various models of lightweight portable oxygen concentrators. Some weigh as little as 3 pounds (3-20 pounds) where others weigh closer to 17 pounds, but all are easily transportable. So, not only can a portable concentrator be used in your home, but you can also take it with you whenever you need to leave your home.

Portable concentrators can be powered from a standard household electrical outlet, from the power outlet in any motor vehicle, or from a rechargeable battery. This feature makes portable concentrators very convenient, and eliminates the need for small portable cylinders. Since they are battery operated, portable concentrators can also be used when taking a trip on an airplane. However, you might have to take along additional batteries depending on how many hours the flight will take.

Since there are many different models of portable concentrators, there are also differences in how much concentrated oxygen each model can produce. As a rule of thumb, the smaller the portable concentrator, the lower the amount of oxygen it can concentrate each minute. Also, some portable devices deliver a “pulse” of oxygen rather than a continuous flow. For some patients, the smaller portable concentrators may not be able to produce enough oxygen to meet their needs. It is therefore very important to have a respiratory therapist confirm that a particular model will work for you. Otherwise you might not get enough oxygen when you need it.

Portable (ambulatory) oxygen

It may be possible to use a small, portable oxygen cylinder outside your home. This is called portable oxygen or ambulatory oxygen.

You’ll need to be assessed to see whether you’re able to use portable oxygen and whether it’s likely to be beneficial. Portable cylinders can deliver oxygen at a wide range of flow rates. Your oxygen healthcare professional will be able to advise you about the flow of oxygen you need. Regulators or conserving devices can be fitted to your cylinder so it lasts longer.

When full, portable oxygen cylinders weigh just over 2.3kg (5lbs) and hold just under two hours of oxygen (at a rate of 2 liters a minute).

Oxygen Administration Devices

The most common way to administer home oxygen is with a nasal cannula. This is a two-pronged piece of soft vinyl at one end of plastic tubing that is placed about ¼ inch into your nostrils. The tubing rests over your ears, or can be attached to the frame of specially designed eyeglasses. The other end of the tubing is connected to the oxygen equipment, where the oxygen flow is set.

Another way to administer oxygen is with a transtracheal catheter, but this is not for everyone. It requires insertion by a physician of a small flexible plastic catheter in the neck, just below the Adam’s Apple. The catheter is held in place with a necklace and the oxygen supply tube is connected to the catheter. The oxygen is then delivered directly into your lower windpipe.

Transtracheal oxygen delivery has several advantages. When you button the collar of your shirt or wear a scarf, no one can tell that you are using oxygen. Also, since oxygen is delivered directly into the airway (bypassing the mouth, nose and upper throat), much lower oxygen flow rates are required. Some people using transtracheal can get by with oxygen flow rates of ¼ to ½ liters per minute instead of the more common 2 liters per minute.

There are a few disadvantages associated with transtracheal oxygen. One is that you might need to attach a humidifier bottle to your oxygen equipment to add some moisture to the oxygen. This is usually needed when the oxygen flow rate is 1 liter per minute or greater. You must also take special daily care of the small opening in your neck (called a stoma) to prevent infection. The catheter will also need to be replaced every so often.

Pulse (on-demand) device

A pulse oxygen delivery device delivers oxygen only when you breathe in. As you breathe in, the device senses the start of your inhalation and immediately gives a short “pulse” of oxygen. It can help you preserve the same amount of oxygen over a longer time. Young children and adults who are weak or do not inhale strongly may not trigger the sensor when they inhale, and hence, will not get enough oxygen. Such people should not use a pulse (on-demand) device. Oxygen concentrators, liquid oxygen systems and small cylinders all have the ability to provide ‘pulsed’ oxygen. You should confirm with your healthcare provider that you are getting enough oxygen through a pulse device before buying or renting it.

Safety advice

Oxygen is a fire hazard, so you need to take precautions if you’re using oxygen at home. Oxygen alone will not “explode” and does not burn. Oxygen will make a flame burn hotter and brighter. You should never smoke while using oxygen. Your nose, hair, and clothing can catch fire very quickly and cause life-threatening burns. Keep oxygen at least 6 feet (2 meters) away from any open flame. If a cylinder falls and cracks, it propels like a torpedo. Stabilize all cylinders by placing in a safe area or by securing them to a wall.

For example:

never let anyone smoke while you’re using oxygen
keep oxygen at least six feet away from flames or heat sources, such as gas cookers and gas heaters
don’t use flammable liquids, such as cleaning fluid, paint thinner or aerosols, while using oxygen
don’t use oil-based emollients, such as Vaseline, when using oxygen
install fire alarms and smoke detectors in your home and make sure they’re working
inform your local fire brigade that you have oxygen at home
keep oxygen cylinders upright to prevent them being damaged

Put up no-smoking signs in your home where you most often use the oxygen. When you go to a restaurant with your portable oxygen source, ask to be seated in the nonsmoking section. Stay at least five feet away from gas stoves, candles, lighted fireplaces, or other heat sources. Don’t use any flammable products like cleaning fluid, paint thinner, or aerosol sprays while using your oxygen.

If you use an oxygen cylinder, make sure it is secured to some fixed object or in a stand. If you use liquid oxygen, make sure the vessel is kept upright to keep the oxygen from pouring out; the liquid oxygen is so cold it can hurt your skin. Keep a fire extinguisher close by, and let your fire department know that you have oxygen in your home. If you use an oxygen concentrator, notify your electric company so you will be given priority if there is a power failure. Also, avoid using extension cords if possible.

Care of Equipment

The home care company that provides the oxygen therapy equipment you use should provide you with instructions on user care and maintenance of your particular equipment. Here are some general guidelines for your cleaning procedures. You should wash your nasal prongs with a liquid soap and thoroughly rinse them once or twice a week. Replace them every two to four weeks. If you have a cold, change them when your cold symptoms have passed.

Check with your health care provider to learn how to clean your transtracheal catheter. The humidifier bottle should be washed with soap and warm water and rinsed thoroughly between each refill. Air dry the bottle before filling with sterile or distilled water. The bottle and its top should be disinfected after they are cleaned.

If you use an oxygen concentrator, unplug the unit, then wipe down the cabinet with a damp cloth and dry it daily. The air filter should be cleaned at least twice a week. Follow your home medical equipment and services company’s directions for cleaning the compressor filter.

DO’s and DON’Ts

Don’t ever change the flow of oxygen unless directed by your physician.
Don’t use alcohol or take any other sedating drugs because they will slow your breathing rate.
Make sure you order more oxygen from your dealer in a timely manner.
Use water-based lubricants on your lips or nostrils. Don’t use an oil-based product like petroleum jelly.
To prevent your cheeks or the skin behind your ears from becoming irritated, tuck some gauze under the tubing. If you have persistent redness under your nose, call your physician.

Going on holiday

As long as you’re well enough to travel and you plan in advance, you should be able to go on holiday while using oxygen. Speak to staff at your local oxygen clinic as soon as possible if you’re thinking about going on holiday, particularly if you want to go abroad.

They can advise you about what you need to do to stay safe while you’re away. For example, you’ll need to take your usual medication and a copy of your home oxygen order form. Before traveling, you should tell the travel company that you use oxygen as they may need to make certain arrangements in advance. Travel insurance is essential.

Contact the airline well in advance to make sure it can be available. The airline will require a prescription from your health care provider. The airline may have limited choices for oxygen flows and the cost varies between airlines. If you use oxygen continuously, you must arrange for oxygen to use while waiting at the airport, at stopovers, or at your final destination. You also need to work with your healthcare provider to set up oxygen at your travel destination.

What is hyperbaric oxygen therapy

Hyperbaric oxygen therapy uses a special pressure chamber to increase the amount of oxygen in the blood. The air pressure inside a hyperbaric oxygen chamber is about three times higher than the normal pressure in the atmosphere. Under these conditions, your lungs can gather up to three times more oxygen than would be possible breathing oxygen at normal air pressure. This helps your blood carry more oxygen to organs and tissues in your body.

Your body’s tissues need an adequate supply of oxygen to function. When tissue is injured, it may require more oxygen to heal. Hyperbaric oxygen therapy increases the amount of oxygen dissolved in your blood. An increase in blood oxygen may improve oxygen delivery for vital tissue function to help fight infection or minimize injury.

Hyperbaric chambers are medical devices that require U.S. Food and Drug Administration (FDA) clearance. The U.S. Food and Drug Administration (FDA) clearance of a device for a specific use means FDA has reviewed valid scientific evidence supporting that use and determined that the device is at least as safe and effective as another legally U.S.-marketed device.

Thirteen medical uses of a hyperbaric chamber for hyperbaric oxygen therapy have been cleared by FDA. They include treatment of air or gas embolism (dangerous “bubbles” in the bloodstream that obstruct circulation), carbon monoxide poisoning, decompression sickness (often known by divers as “the bends”), and thermal burns (caused by heat or fire). Hyperbaric oxygen therapy can help wounds heal more quickly, especially infected wounds, wounds that won’t heal as a result of diabetes or radiation injury.

Hyperbaric oxygen therapy may be used to treat:

Air or gas embolism – bubbles of air in your blood vessels (arterial gas embolism)
Anemia, severe
Bone infections (osteomyelitis) that have not improved with other treatments
Brain abscess
Burns
Carbon monoxide poisoning
Certain types of brain or sinus infections
Crushing injury
Deafness, sudden
Decompression sickness (for example, a diving injury)
Gas gangrene
Necrotizing soft tissue infections
Radiation injury (for example, damage from radiation therapy for cancer)
Skin grafts or skin flap at risk of tissue death
Vision loss, sudden and painless
Wounds that have not healed with other treatments (for example, it may be used to treat a diabetic foot ulcer or very bad circulation)

Hyperbaric oxygen therapy may also be used to provide enough oxygen to the lung during a procedure called whole lung lavage, which is used to clean an entire lung in people with certain medical conditions.

Treatment for chronic conditions may be repeated over days or weeks. A treatment session for more acute conditions such as decompression sickness may last longer, but may not need to be repeated.

Hyperbaric oxygen therapy has NOT been proven to be the kind of universal treatment it has been touted to be on some internet sites. The U.S. Food and Drug Administration (FDA) ¹ is concerned that some claims made by treatment centers using hyperbaric oxygen therapy may give consumers a wrong impression that could ultimately endanger their health.

Hyperbaric oxygen therapy has NOT been clinically proven to cure or be effective in the treatment of cancer, autism, or diabetes ¹. But do a quick search on the internet, and you’ll see all kinds of claims for these and other diseases for which the device has not been cleared or approved by U.S. Food and Drug Administration (FDA).

The safety and effectiveness of hyperbaric oxygen therapy has NOT been established for these diseases and conditions, including:

AIDS/HIV
Allergies
Alzheimer’s Disease
Arthritis
Asthma
Autism
Bell’s Palsy
Brain Injury
Cancer
Cerebral Palsy
Chronic fatigue syndrome
Cirrhosis
Depression
Fibromyalgia
Gastrointestinal ulcers
Heart Disease
Heatstroke
Hepatitis
Migraine
Multiple Sclerosis
Parkinson’s Disease
Spinal Cord Injury
Sport’s Injury
Stroke

Hyperbaric oxygen therapy benefits

Hyperbaric oxygen therapy may be used to treat:

Air or gas embolism – bubbles of air in your blood vessels (arterial gas embolism)
Anemia, severe
Bone infections (osteomyelitis) that have not improved with other treatments
Brain abscess
Burns
Carbon monoxide poisoning
Certain types of brain or sinus infections
Crushing injury
Deafness, sudden
Decompression sickness (for example, a diving injury)
Gas gangrene
Necrotizing soft tissue infections
Radiation injury (for example, damage from radiation therapy for cancer)
Skin grafts or skin flap at risk of tissue death
Vision loss, sudden and painless
Wounds that have not healed with other treatments (for example, it may be used to treat a diabetic foot ulcer or very bad circulation)

Hyperbaric oxygen therapy side effects

Hyperbaric oxygen therapy is generally a safe procedure. Complications are rare. But this treatment does carry some risk.

Potential risks include:

Temporary nearsightedness (myopia) caused by temporary eye lens changes
Middle ear injuries, including leaking fluid and eardrum rupture, due to increased air pressure
Lung collapse caused by air pressure changes (barotrauma)
Seizures as a result of too much oxygen (oxygen toxicity) in your central nervous system
In certain circumstances, fire — due to the oxygen-rich environment of the treatment chamber

Patients receiving hyperbaric oxygen therapy are at risk of suffering an injury that can be mild (such as sinus pain, ear pressure, painful joints) or serious (such as paralysis, air embolism). Since hyperbaric chambers are oxygen rich environments, there is also a risk of fire.

If you’re considering using hyperbaric oxygen therapy, it’s essential that you first discuss all possible options with your health care professional. Whatever treatment you’re getting, you need to understand its benefits and risks. Your health care professional can help you determine which treatment is your best option.

What you can expect during hyperbaric oxygen therapy

Hyperbaric oxygen therapy typically is performed as an outpatient procedure and doesn’t require hospitalization. If you’re already hospitalized and require hyperbaric oxygen therapy, you’ll remain in the hospital for therapy. Or you’ll be transported to a hyperbaric oxygen facility that’s separate from the hospital.

Depending on the type of medical institution you go to and the reason for treatment, you may receive hyperbaric oxygen therapy in one of two settings:

A unit designed for 1 person. In an individual (monoplace) unit, you lie down on a table that slides into a clear plastic tube.
A room designed to accommodate several people. In a multiperson hyperbaric oxygen room — which usually looks like a large hospital room — you may sit or lie down. You may receive oxygen through a mask over your face or a lightweight, clear hood placed over your head.

During hyperbaric oxygen therapy, the air pressure in the room is about two to three times normal air pressure. The increased air pressure will create a temporary feeling of fullness in your ears — similar to what you might feel in an airplane or at a high elevation. You can relieve that feeling by yawning or swallowing.

For most conditions, therapy lasts approximately two hours. Members of your health care team will monitor you and the therapy unit throughout your treatment.

After hyperbaric oxygen therapy

You may feel somewhat tired or hungry following your treatment. This doesn’t limit normal activities.

Results

To benefit from hyperbaric oxygen therapy, you’ll likely need more than one session. The number of sessions depends on your medical condition. Some conditions, such as carbon monoxide poisoning, might be treated in three visits. Others, such as nonhealing wounds, may require 20 to 40 treatments.

Hyperbaric oxygen therapy alone can often effectively treat decompression sickness, arterial gas embolism and severe carbon monoxide poisoning.

To effectively treat other conditions, hyperbaric oxygen therapy is used as part of a comprehensive treatment plan and administered with other therapies and drugs that fit your individual needs.

References

Hyperbaric Oxygen Therapy: Don’t Be Misled. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm364687.htm

Oxygen therapy