Anil Kapoor’s Hyperbaric Oxygen Therapy: Why is it not for you?

This involves breathing pure oxygen in a pressurised environment. This is done in a specialised chamber where the air pressure is increased two to three times higher than normal air pressure. Under pressure, the oxygen liquefies and courses through your blood plasma, going to tissues that need immediate repair, where oxygen breathed in by the lungs is not able to reach properly. Even your lungs can gather much more oxygen than would be possible breathing pure oxygen at normal air pressure. The accepted measure of atmospheric pressure is 1.4 ATA (atmospheric pressure absolute). Anything between 1.7 and 3 ATA of oxygen is given to patients. When your tissues are stressed or injured, they require extra oxygen for fast healing. Hyperbaric oxygen therapy increases the amount of oxygen your blood can carry, helps fight bacteria and triggers the release of substances called growth factors and stem cells, which promote healing.

It is known to neutralise certain toxins caused by severe bacterial infections and by increasing oxygen concentration in the tissues, helps them fight these infections. It increases the capacity of white blood cells to find and destroy invaders.

UNDER WHAT CONDITIONS CAN HYPERBARIC THERAPY BE USED?

Originally, this therapy was a derivative of a protocol administered to deep sea divers to relieve them of decompression sickness. Now it is used to treat serious blood infections, gangrene, traumatic brain injury, carbon monoxide poisoning, arterial gas embolism or when air bubbles go into your blood vessels, diabetic wounds and radiation injuries (a side effect in cancer patients).

When blood flow is interrupted by a severe accident or trauma, for instance, the affected tissues in the body release oxygen radicals, which can cause irreversible damage to blood vessels and stop blood flow. So, by administering more oxygen, the doctors neutralise the effect.

WHO CANNOT USE IT?

This therapy is not considered safe at all for people with asthma or COPD. In asthma the primary problem is the spasm and resistance of the air passage, which prevents oxygen from entering the body. Hence the treatment should be to overcome the resistance of the air passage. Since it is not an oxygen deficiency, additional oxygen will not benefit the patient. In fact, in cases of chronic severe asthma, where the stimulus for respiration is high, giving excess oxygen can be dangerous as it raises levels of carbon dioxide. Research from the British Thoracic Society (BTS) notes that people with acute severe asthma who received 100 per cent oxygen experienced high levels of carbon dioxide in their blood.

WHY IS IT CONFUSED AS A WELLNESS ROUTINE? WHAT YOU NEED TO KNOW?

Somewhere down the line, the therapy’s efficacy to heal and regrow blood vessels has gotten confused with cell renewal. And since it promotes growth of endothelial cells, the kind that line blood vessels, lymph vessels and the heart, it is probably considered disease-fighting and protective therapy.

And as licensing of equipment is currently unregulated, private wellness clinics procure the equipment and offer it to unsuspecting clients as a cell rejuvenation routine at Rs 7,000 per session, higher than many private hospitals.

WHY MILD HYPERBARIC OXYGEN THERAPY IS JUST A SALES GIMMICK? WHY ISN’T IT SAFE?

Mild hyperbaric chambers have been marketed as a way to improve energy, athletic performance and healing and have predictably gained popularity in recent years. The worst part is these centres offer a “mild” hyperbaric oxygen therapy, which means anything between 1.2 or 1.5 ATA, and claim it has virtues of the “real” hyperbaric oxygen. But this is far from the truth. What good would this low infusion do to a normal person who is already exposed to 1.4 ATA?

Also, these facilities are located in shopping centres and malls whereas the safety of oxygen therapies can be guaranteed only when strict norms of use are maintained in a secure set-up. First, the therapy varies on a case-specific basis, as little as a few minutes for some and an hour for others, before the oxygen pressure is returned to normal levels. At high pressure, some people may experience discomfort like an ear pop. Some may need to take short breaks during the therapy to prevent oxygen intoxication, which means protecting tissues from taking in too much oxygen. There is no clear level of oxygen or pressure that is completely safe. People could be harmed by too much oxygen or pressure changes in the chamber. There is also a risk of fire if there is too much oxygen. It is impossible to maintain such strict adjustment protocols in a commercial set-up, which often does not employ trained staff. Unregulated administration of oxygen by centres and manufacturers, driven purely for financial gains, places the public at risk.

NEED FOR CAUTION

Oxygen is a “drug” and its administration is a “treatment” which must be given at a defined “dose” and “duration” for it to have a desired effect. The treatment must be prescribed and delivered by an expert in “hyperbaric medicine” and followed up from review to recovery. Despite the buzz generated around these chambers, concerns about their safety and effectiveness have been steadily growing.

In a policy statement, the American Medical Association has called out the use of mild hyperbaric chambers as a public health and safety concern. They state that these devices have not been adequately studied and may pose risks to patients due to the lack of regulation in the industry, leading to rampant commercialisation. The lack of regulation, in particular, is concerning as usage is not always guided by medical opinion. The European Committee of Hyperbaric Medicine has also highlighted potential risks in a position statement, pointing out that there is no medical evidence to support the use of these chambers for conditions other than those approved by regulatory authorities. We are also in discussions with the Indian Medical Association (IMA) and the government about the need for a strict regulatory code. This may include requirements for training and certification for operators of the devices, as well as safety features such as oxygen sensors and emergency shutoffs.

Patients should be aware that there is no evidence to support the use of these chambers for conditions other than those approved by regulatory authorities. Companies that make exaggerated claims about the benefits of the therapy should also be approached with caution. And the celebrity endorsements can only worsen the myths surrounding this therapy.

(The author is one of the pioneers of Hyperbaric Medicine, having started the first private hyperbaric centre in Apollo Hospital, Delhi in 2000.)