DALLAS, Texas — You’re not 20,000 leagues under the sea but inside a hyperbaric oxygen chamber at Texas Health Presbyterian Hospital Dallas. The hyperbaric medicine unit, which treats wounds, serious infections and critically ill patients, had a highly successful year in 2018. The unit contributes to reducing length of hospital stay, reducing readmission rate, increasing discharge rate and improving patient outcomes.

Trained hyperbaric specialists at the Institute for Exercise and Environmental Medicine, led by physicians on the medical staff at Texas Health Dallas and UT Southwestern Medical Center, treated more than 1,000 patients in 2018 — that’s about a 50 percent increase from 2016.

“Hyperbaric oxygen therapy is not just to correct the lack of oxygen in the body, it’s really used as a medication,” said Renie Guilliod, M.D., medical director of the IEEM’s hyperbaric medicine unit at Texas Health Dallas. “It is the primary treatment for carbon monoxide poisoning and decompression illness in divers, but it is particularly useful for conditions related to decreased tissue oxygenation. It produces new blood vessels, corrects swelling, inflammation and heals infected tissues and wounds.” 

Hyperbaric oxygen therapy infuses 100 percent oxygen at pressure levels that are two to three times greater than normal. The high oxygen pressure allows the lungs and body tissues to absorb oxygen. This process promotes and accelerates healing.

Inside the chamber

Caregivers provide direct hands-on patient care to up to seven people, simultaneously, in the hyperbaric chamber.

“They have someone to assist them at all times inside the chamber, a nurse or emergency technician,” said Adam Mottley, C.H.T., a safety officer on the hyperbaric medicine unit. “It’s big enough for a patient to walk in or be wheeled in, and they don’t feel claustrophobic.”

The chamber is pressurized with air. Patients wear either a mask or see-through vinyl hood/helmet that is connected to tubes — one for oxygen and one to remove carbon dioxide. “For critical care patients, we may administer the oxygen through an endotracheal tube,” Mottley said. “It’s connected to a ventilator that’s operated by a technician in the chamber.”

A single treatment typically lasts about 90 minutes. “Once they get used to the helmet, it’s like it’s not even there,” Mottley said. “Patients are more concerned about what movies they can watch or if we have Netflix.”

Patients are asked to use the restroom before treatment begins but when nature calls, there is a private toilet in the chamber. 

Once the chamber door is closed, clinicians are monitoring everything inside the chamber from a control center. They can see patients from interior cameras, monitor the oxygen levels and carbon dioxide. If there’s an issue, a clinician can quickly enter the chamber. “We communicate with the medical attendant who’s inside the chamber,” Mottley said. “There’s always more than one pair of eyes on our patients.”

Guilliod, who’s on the medical staff at Texas Health Dallas, is in contact with each patient’s physician. He gives updates to the referring physicians throughout the treatments.

Not only for scuba divers

Hyperbaric oxygen therapy helps patients with complications from radiation treatments, skin grafts, diabetes, surgical incisions, trauma wounds, as well as decompression illness, carbon monoxide poisoning, sudden blindness and hearing loss.

“In addition to treating outpatients, this is essentially a critical care unit,” Guilliod said. “We’re here to treat the most complex and time sensitive conditions.”

Unlike other hyperbaric facilities, patients at Texas Health Dallas have access to critical care, ICU nurses and paramedics. “Emergency physicians can call us right away,” Mottley said. “With crush injuries or retina injuries, if you wait two or three days — it may be too late to fix it.”            

The hyperbaric medicine unit is part of the Institute for Exercise and Environmental Medicine. The joint program between Texas Health Dallas and UT Southwestern Medical Center promotes clinical research, clinical practice and human physiology education. Over the years, the IEEM has helped Olympic athletes as well as patients with heart, lung and muscle disease improve their exercise capacity, mountain climbers summit Mount Everest and long-distance swimmers set world records. The faculty at the IEEM has published hundreds of papers in premier scientific journals with more than 1,200 citations each year. Their work has advanced new knowledge in human physiology and changed thinking about how to improve health for men and women across a lifespan.

Systemwide, it’s the only Texas Health facility that offers hyperbaric oxygen treatment for critical care patients. It’s the largest multi-place hyperbaric unit in North Texas.

“Hyperbaric medicine benefits patients at every Texas Health entity,” Mottley said. “We can improve patient outcomes and help hospital readmissions.”

To refer a patient for hyperbaric oxygen therapy or for more information, please email: IEEMoxygen@TexasHealth.org.