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 first made an appearance in the United States in the early 19th century. It was later used by undersea medicine specialists to treat deep-sea divers who developed decompression sickness. This is also known as "the bends." It is now used to treat a number of conditions, from severe burns to carbon monoxide poisoning. But, like all medical procedures, it carries 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 gradually 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 sensation in the ears.

If done correctly by trained medical staff in a hospital setting, HBOT is considered safe. In order to prevent oxygen poisoning, some people may need to take short breaks during the therapy and breathe "normal" air to 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 health care provider will consider any health problems you have, as well as your overall health and your age to reduce the risk for side effects and complications.

Possible symptoms or side effects after HBOT can include fatigue and lightheadedness. More serious complications can include:

  • Damage to the lungs

  • Buildup of fluid or rupture of the middle ear

  • Damage to the sinuses

  • Changes in vision, causing nearsightedness, or myopia

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

Side effects are generally mild as long as the therapy lasts no longer than 2 hours and 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 trauma

  • Are claustrophobic

Precautions to take

The best way to avoid side effects and complications of HBOT is to be treated in a hospital setting with trained medical staff.  There are a very limited number of health care providers in the U.S. who are board-certified in the field. The health care 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.

Be aware that HBOT outside the hospital setting is largely unregulated. The FDA has approved the use of portable fabric hyperbaric oxygen chambers. They are used in some chiropractors' offices. But experts say their design and lack of oversight pose the risk for explosion or fire.

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

  • Acute 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.

  • Chronic infection called actinomycosis

  • Diabetic wounds

Medicare and many insurance companies generally cover these procedures, but may not do so in every circumstance. Check with your insurance plan. 

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