HBOT Safety: Common Side Effects, Risks, and How They Are Managed
Hyperbaric oxygen therapy, or HBOT, is a medical treatment that involves breathing high-concentration oxygen inside a pressurized chamber.
HBOT is used for a variety of medical conditions, including certain non-healing wounds, radiation tissue injury, carbon monoxide poisoning, and other approved indications. It is also being used for a growing number of other conditions.
Like any medical treatment, HBOT has potential side effects and risks. Fortunately, when treatment is provided in an appropriate medical setting with proper screening and supervision, serious complications are uncommon.
What Are the Most Common Side Effects of HBOT?
The most common issue patients experience is related to changes in pressure, particularly in the ears.
As the chamber pressurizes, patients may feel fullness or pressure similar to what happens during airplane travel.
Possible side effects include:
- Ear pressure or discomfort
- Difficulty equalizing the ears
- Sinus pressure
- Temporary fatigue after treatment
- Temporary changes in vision
- Anxiety or claustrophobia
Most of these effects are mild and manageable.
Patients are taught techniques for clearing their ears before treatment begins, and chamber pressure can be adjusted more slowly when needed.
Can HBOT Cause Ear or Sinus Injury?
Yes, although significant injury is uncommon.
Pressure changes can sometimes cause barotrauma, which means injury caused by pressure differences.
The middle ear is the most common area affected. Sinus discomfort can also occur, particularly if a patient has a cold, congestion, or difficulty equalizing pressure.
This is why patients should tell their hyperbaric team if they develop an upper respiratory infection or significant nasal congestion before a treatment.
What About Oxygen Toxicity?
Because HBOT uses high concentrations of oxygen, patients sometimes worry about oxygen toxicity.
At therapeutic pressures and treatment durations, oxygen exposure is carefully controlled.
Rarely, excessive oxygen exposure can trigger a seizure. These events are uncommon and usually stop once oxygen exposure is discontinued.
Treatment protocols often include air breaks, during which the patient temporarily breathes room air, to help reduce oxygen exposure.
Can HBOT Affect Vision?
Some patients undergoing a longer series of hyperbaric treatments experience temporary nearsightedness, known as myopia.
This occurs because repeated oxygen exposure can temporarily affect the lens of the eye.
Vision usually returns toward baseline after treatment ends, although this may take several weeks.
Patients with certain eye conditions should discuss them with their hyperbaric physician before beginning treatment.
Is There a Fire Risk With Hyperbaric Oxygen Therapy?
Oxygen itself does not burn, but it can make other materials burn more rapidly.
For that reason, accredited hyperbaric facilities follow strict fire-safety procedures.
Patients are typically required to wear approved clothing and avoid bringing items such as electronics, petroleum-based products, lighters, or other restricted materials into the chamber.
These precautions are an important part of safe hyperbaric treatment.
Who Should Be Screened Carefully Before HBOT?
Before beginning hyperbaric oxygen therapy, patients should undergo a medical evaluation.
The hyperbaric physician will review factors such as:
- Lung conditions
- Ear or sinus problems
- Recent surgery
- Medications
- Pregnancy
- Seizure history
- Diabetes
- Claustrophobia
- Certain eye conditions
One important contraindication is an untreated pneumothorax, or collapsed lung, which must be addressed before HBOT.
The Bottom Line
Hyperbaric oxygen therapy has a well-established safety profile when it is delivered by trained professionals in an appropriate medical setting.
Most side effects are mild and temporary, while serious complications are uncommon.
The key to safe treatment is proper medical screening, appropriate treatment pressure and duration, careful monitoring, and a team experienced in hyperbaric medicine.
Patients considering HBOT should feel comfortable asking questions about safety, chamber type, medical supervision, and what precautions are used before beginning treatment.