Latest / 20-Minute Health Talk / How hyperbaric oxygen therapy heals the body - Part 2

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How hyperbaric oxygen therapy heals the body - Part 2 · 20-Minute Health Talk

• 0:04
  Hello,
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  I'm Rob Hoell, and welcome back to 20-Minute Health Talk.
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  This is part two of our deep dive into the fascinating
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  world of hyperbaric medicine.
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  Our guests are two world-renowned experts in the field
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  and in part one of this interview — which listeners can find in our feed
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  and show notes — they shared insights into hyperbaric oxygen therapy's
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  many benefits, how it works, and what it's like to receive treatment
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  in the largest hyperbaric chamber in the northeastern United States
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  located, at
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  Phelps Hospital. In part 2, we discussed the research driving
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  hyperbaric medicine forward, the training required to conduct this
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  brand of medicine, and what patients should look for
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  if they want to pursue hyperbaric oxygen therapy. Here is part two of
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  our interview with Dr. Owen
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  O'Neill, founding and current Medical director of the Department of
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  undersea and hyperbaric medicine at Phelps Hospital, and John Peters,
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  Executive director of the undersea and hyperbaric Medical Society.
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  John, are there studies showing how effective this can be?
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  Yes,
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  absolutely.
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  On the magnitude of thousands of studies,
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  hyperbaric medicine has come along and evolved
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  from diving really in the 50s, including wound car, aggressive
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  bacterial infections, life without blood,
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  Ite Boerema out of Amsterdam. A lot of that research
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  now too is real-world research and is where we're actually looking at
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  patients that have
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  multiple comorbidities. They're coming to us, and they're pretty sick.
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  Unless it's something that is an acute injury — carbon monoxide, Navy
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  or decompression sickness — but most of the patients that we're treating
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  are ill with multiple conditions, and they are going to come for, you
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  know, somewhere in the neighborhood of 20 to 60 treatments
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  depending.
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  Well, you know, we talked about different conditions that hyperbaric
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  oxygen therapy can help treat,
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  it's also being studied for covid-19 and Dr.
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  O'Neill, during the pandemic, you began using hyperbaric oxygen hoods
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  to help improve covid-19 patient's oxygen saturation levels.
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  Tell us about that.
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  Okay, well, first just to differentiate the hyperbaric
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  oxygen treatments for covid-19 patients were proving to be very
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  successful.
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  So at Phelps Hospital,
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  you had to be part of an IRB
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  (Institutional Review Board)
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  study research project in order to use hyperbaric oxygen on patients
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  for that condition because it's an experimental condition.
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  So we were not part of an IRB so we looked at the patients at the time
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  who were very sick from the lung standpoint.
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  They had a very hard time breathing,
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  they were not able to maintain tissue oxygen oxygenation, and they were
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  put on various modes of breathing oxygen, high flow oxygen and in some
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  patients it
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  worked and in some patients it didn't.
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  The majority of the patients were it did not work,
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  they had to be intubated.
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  So that means they had a breathing tube and had to be put on a breathing machine.
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  So once that happened, they had about a 98 percent mortality rate.
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  So if you were put on a breathing machine, that was almost like the
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  the end of your life, you were not going to come off of that breathing
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  machine.
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  The other part of that is that there were not enough machines to give
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  patients because everybody was on them,
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  there were none to be had.
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  There were also some other drugs coming up at the time
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  that seem to be helping the patient.
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  So,
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  We came up with the idea of putting an oxygen hood from the hyperbaric
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  chamber on the patient because those hoods are completely enclosed.
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  So, while wearing that hood and breathing 100% oxygen,
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  we knew the patients could be delivered that oxygen.
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  We could also put valves on that hood, that would help them keep their
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  oxygen levels
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  even a little bit higher. We call those a peep valve, and when we did
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  that, we put them on the patients
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  and we found that the number of the patients
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  we first put the hood on,
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  those were patients that needed to be on the breathing machine, but there
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  wasn't a breathing machine available, so we put them on the hood, and
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  we found that a number of them, maintained an oxygen level high enough
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  that they didn't need to be put on the machine.
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  So, in a sense, that also decreased their chances of dying; for those
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  patients who were on it for maybe two, three, or four days before they
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  required the breathing machine, that gave them another three or four
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  days of medication treatment to help them along.
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  better chance of getting off of it.
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  So, all in all we probably prevented about 57 percent of the patients
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  we put the hood on from requiring the breathing machine,
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  and hence we decrease their mortality
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  of either chance of being alive,
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  we increased that. Based on that work and the decades of diligence and
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  excellence in the practice of hyperbaric medicine, the undersea and
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  hyperbaric medicine
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  society awarded Dr.
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  O'Neill, the 2022 excellence in hyperbaric medicine award,
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  tell us more about this award.
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  Yes, really
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  we were pleased to have Dr.
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  O'Neill picked for this excellence in hyperbaric medicine award.
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  The award is presented at our annual scientific meeting to an
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  individual UHS member in recognition of continued diligence and
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  excellence in the practice of hyperbaric medicine, particularly in the
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  areas of basic, and clinical research, as it might impact patient
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  care.
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  So, Owen is a perfect recipient for this award.
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  He has been
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  Been working diligently for over 30 years
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  in the specialty and has really raised raises the bar for
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  all of our practitioners, and he's expanded his practice into
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  commercial diving and tunneling and he continues to grow.
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  So even at 30 years as a 30-year veteran, he continues to grow
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  his practice and improve his knowledge base and he's helping to mentor
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  others.
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  And this is
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  demonstrated in his award this past year.
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  It seems to me that hyperbaric treatment is so complex
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  and yet, so simple, in a way, what's the training like to be able to
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  use hyperbaric medicine?
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  Well, the Platinum standard now for being trained in undersea and
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  hyperbaric medicine, which is the specialty
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  name is a fellowship program.
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  So physicians who come out of residency training they've completed
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  residency training
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  in internal medicine, family Medicine, emergency medicine,
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  anesthesia. If they desire to become board certified in
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  undersea and hyperbaric medicine they would be required to take a one
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  year undersea ann
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  hyperbaric medicine fellowship.
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  That's one way.
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  The second way is there are 40 hour programs.
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  So a physician, a nurse, or a technologist who wants to learn more on
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  undersea and
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  hyperbaric medicine, they can sit in one of these 40 hour programs,
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  take the examination when they're all done, if they pass the
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  examination,
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  they can then go back to their hospital with this introductory course
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  in hyperbaric medicine, and start to actually learn the specialty.
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  Once a physician, nurse, or technologist, has done that, for the
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  physicians who can't take that one year off to go back and do a
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  fellowship training program in undersea hyperbaric medicine,
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  the undersea and hyperbaric medical society now has what we call the
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  path program, which is basically an online program that will last
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  approximately six to nine months, where you have a tailored
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  study program and then a test to qualify you at the end for the
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  knowledge and then also a technical piece that the physicians know how
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  to actually function with their hands, controls, Etc.,
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  when necessary. There's also an accrediting process that hospitals
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  must go through to be able to use hyperbaric oxygen therapy, John,
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  can you tell us about that and what people seeking this treatment
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  should know? The UHMS had established a hyperbaric facility
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  accreditation program in 2000
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  and we've surveyed approximately 350 hospitals in the United
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  States.
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  This accreditation program was established to set the standard really
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  for how programs operate, and how patients are managed, and for a safe
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  outcome.
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  Hopefully, at some point
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  we'll actually get some of our large payers or even CMS actually
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  mandate accreditation.
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  We do see variation
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  and that's because we see variation in practice.
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  practice and really helping those individuals, those professionals, and
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  those facilities to actually to do a better job and
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  deliver better patient care.
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  So it's a win for the patient.
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  It's a win for the caregivers. Dr.
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  O'Neill, in addition to the program you run at
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  Phelps Hospital,
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  there are several other Northwell facilities that offer hyperbaric
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  medicine.
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  Do you ever work with other programs in the health system?
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  And what does that collaboration look like?
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  Here at Northwell,
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  I started the hyperbaric collaborative.
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  So basically it's a collaboration among all of the medical directors
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  for all of the hyperbaric facilities in the system.
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  And we've gotten together to look at exactly how we should do things,
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  make sure we're all on the same page, how we get the message out to
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  individuals, and how we do things according to the undersea and hyperbaric
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  medicine rules and regulations
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  and those that CMS or Medicare put in our way,
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  Awesome.
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  We always like to end on a positive note here
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  on 20-Minute Health Talk. Dr.
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  O'Neill we'll start with you.
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  What gives you hope?
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  What gives you optimism going forward?
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  Well, as John explained, we have accreditation process now, we have
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  hospitals becoming more aware of undersea and hyperbaric medicine,
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  I have patients that self-refer now because they're becoming
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  interested in it.
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  So we really would like the patients to know what it is that we do and
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  how we can help them. Especially patients that have chronic wounds
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  that are not getting better.
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  As with radiation damage, they may have bleeding from their bladder,
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  from radiation cystitis, or bleeding from their bottoms, from
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  radiation proctitis.
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  These are all patients and especially our breast patients now are
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  cancer breast patients that require radiation.
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  They require extensive reconstruction after the cancer is removed,
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  they tend to have a fair number of problems as well
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  that hyperbaric oxygen is able to alleviate.
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  So there are, again, a number of conditions out there.
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  We just want patients to know that they feel as they
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  have a condition that oxygen is required to make it better.
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  Regular Oxygen by face
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  mask is not going to help you, climbing into a zip-up chamber is not
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  going to help you,
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  you need to contact a hospital facility that has an undersea and
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  hyperbaric medicine program and speak to the proper specialist. And
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  John, what gives you hope? What gives you optimism moving forward?
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  Well yeah,
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  I'm very hopeful actually for the field.
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  I think some the items that Owen has mentioned, I
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  think, are
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  really key.
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  I think that our focus on dose-response is really critical for our
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  future and that is looking at the indication studying the indications
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  that are already approved and new indications and actually zeroing in
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  on exactly the right pressure that is needed for
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  determining the length of treatment based on those responses.
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  And so, I think that we're gaining more data around
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  that topic,
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  and I think that's
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  going to help ultimately benefit the patient. I believe
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  that they open the door for additional educations out there.
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  And then again, I think as I mentioned Hyperbaric facility,
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  accreditation standardization, I think it's key.
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  We need to look at practice and
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  make sure that we are determining and we have determined what the best
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  practices are for our patients
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  so that both the patient and our physicians and the caregivers are
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  having or have a great experience.
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  I think that's key especially in today and we need to really bring
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  down
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  the cost of the treatment, and we can do that through this mechanism
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  through evaluation oversight and engagement. Dr.
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  O'Neill, John Peters,
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  thank you so much for joining us today, and best of luck in your new
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  role as President elect of the undersea and hyperbaric medical
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  society.
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  And for you, the listener.
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  thank you so much for tuning in and listening.
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  I'm Rob Hoell and stay safe and have a great week.
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  Thanks Rob.
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  Get more expert insight from the leading voices in healthcare today.
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