Medicine evolves in many ways. New technologies , new procedures and new therapies are constantly arising, but there is also a lot of innovation in health resulting simply from the application of what is already used in other areas. Hyperbaric chambers have a long history, of more than a hundred years, having emerged associated with complications resulting from scuba diving. However, it was only in the 70s that physicians started to realize the therapeutic advantages of the so-called oxygen therapy in hyperbaric environment for multiple pathologies. Currently, hyperbaric medicine is a therapeutic resource relatively common in areas as diverse as traumatology, neurology, and oncology, also starting to be more used in sports medicine. This is the theme of yet another episode of SPORTCAST, Hospital da Luz podcast on sports medicine, with Cláudia Febra, physician specialized in Internal Medicine, Intensive Medicine, Medical Emergency, and Hyperbaric and Underwater Medicine, at Hospital da Luz Lisboa. The history of hyperbaric medicine is over a hundred years Over a hundred years ago, divers and submarines were already a widely used war strategic resource. But accidents were recurrent and often fatal. These diving accidents occur when the diver resurfaces too quickly disregarding the adequate stages of ascent. It is the so-called decompression sickness or “the bends”. It was then discovered that if the diver were to be artificially placed within the context he had emerged from, under safe pressure, the fatal effects of decompression sickness would be gone. In other words, the diver was placed under the higher pressure of sea depth, as if he were diving again, and that would be done for the time equivalent to the necessary to ascend the surface safely. Then, gradually, the pressure would be reduced until attaining the atmospheric pressure at the surface. As this artificial environment of deep sea became more and more used to treat decompression sickness – which was a military finding –, the many clinical advantages of the technology were realized. And what began as an exclusively military resource, gained an important dimension in medicine. Over the last 40 years, hyperbaric medicine has gained ground, with new clinical and therapeutic indications in increasingly more areas of medicine. But there is still much to discover. Today, hyperbaric oxygen therapy is used in the treatment of complications or diseases resulting from poor oxygenation: Wounds that are hard to heal; Prolonged diabetic wounds; Surgical interventions with tissue grafts / implants that fail; Wounds in patients with poor circulation and suffering from complex arterial or venous diseases; In oncology, in radiotherapy complications (tissue burns, complications at the level of the bladder and bowel, etc.; in fact, in the treatment of radiotherapy complications in the intra-abdominal structures, hyperbaric medicine is already first-line therapy); And in hospital traumatology, neurology and endocrinology, among others. Hyperbaric chambers in hospital context are used in the treatment of various pathologies and multiple patients simultaneously. These are vast and complex chambers that can have up to 8 or 16 spots, and where it is possible to reach significantly high pressures – the intended ones and which are the most successful regarding tissue healing. Smaller chambers, that have been used in aesthetic medicine for instance, do not reach such high pressures, therefore not achieving the same therapeutic results. Hyperbaric medicine for athletes Athletes mostly use hyperbaric oxygen therapy in the context of injuries and for treatment during recovery. Modalities such as tennis, skiing or even football resort to this technology, especially in more intense competitive stages. The basic principle of the oxygen therapy technique is quite simple, from the physical point of view. What we do is place the athlete inside a high-pressure chamber with high concentrations of oxygen. The pressure within the hyperbaric chamber emulates underwater diving, a pressure tolerated by humans. Under these special conditions and modifying the solubility of gases – namely, increasing the oxygen in the blood and tissues –, we can deliver more oxygen to places it wouldn’t reach in such quantity, through the arteries. Which enhances every biologic process in our body depending on oxygen – from normal cellular respiration to, for instance, the recovery of an injury in a muscle, thus obtaining a significant reduction in the time of recovery. For example, in an athlete intervened to meniscus or ligament injury – low vascularized structures, with very few arteries, and where normally little oxygen arrives –, we can deliver much more oxygen to these tissues, therefore the postoperative and post-injury recovery, in inflammatory processes and after intense muscle activity, is better and faster. For these reasons, the use of hyperbaric oxygen therapy is now increasingly widespread among top-level athletes. For it allows to accelerate the recovery of the whole inflammatory process of the muscle tissues, and thus resume training and competition in record time. For it also acts as a sort of anti-inflammatory treatment in the prevention of injuries that might result from intense training, from the body unpreparedness for high loads of exercise, or from prolonged pauses in training. For, as well as taking special care with diet and resorting to exercises of muscular and postural strengthening, or cryotherapy among others, the top-level athlete may also resort to this hyperbaric medicine technique to improve performance. Ultimately, this is a resource that will surely become intrinsic to the training and recovery plans of athletes and practitioners of regular physical exercise. The center of hyperbaric medicine at Hospital da Luz Lisboa operates a cutting-edge multi-seat hyperbaric chamber – the first of its kind in the Iberian Peninsula. Author: Cláudia Febra The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
