Therapy

High Dosage Oxygen Therapy (HDOT)

Why is HDOT medically useful?

Changes in atmospheric pressure are responsible for the weather and the concentration of the oxygen in the atmosphere. Atmospheric pressure determines the amount of oxygen dissolved in our blood plasma. A low pressure weather front can reduce the oxygen concentration in the air we breathe by as much as 10% in a day. This could be critically important to a patient in an intensive care unit but without a pressure chamber cannot be avoided.

Barometric pressure falls as altitude rises. This means that an aircraft flying above 10,000 feet must be pressurised to prevent serious oxygen deficiency. Lack of oxygen is important in a wide variety of diseases and the latest research has shown that blood flow and platelet stickiness are both controlled by the oxygen concentration in the blood. It has been common practice for many years to use positive pressure in surgical operating theatres and infectious disease units are now constructed to use negative pressure for the containment of dangerous micro organisms.

What is the history of HDOT in the UK?

Pressure chambers for high dose oxygen therapy (HDOT) have been in use in the community in the UK and Ireland for over 20 years. They were set up after consultations with the UK Department of Health by multiple sclerosis self help groups following the publication of trials indicating symptomatic improvements in patients with long standing diseases. In 1994 Linda Scotson commenced investigations into the use of hyperbaric oxygen for children with cerebral palsy and other neurological injuries. After a successful pilot study she set up the Charity “The Hyperbaric Oxygen Trust” which encouraged the use of HDOT for children with cerebral palsy all over the world. In 2005 the Advance Centre’s HDOT facility was registered with the Government Healthcare Commission.

Studies have shown that children with chronic cerebral palsy receive clearly evidenced benefit from HDOT. The UK HDOT facilities have a unique safety record with over 1.6 million sessions completed without a significant incident.

How does HDOT help children with brain injuries?

HDOT also assists children with cerebral palsy on The Scotson Technique (TST) physical programme to help improve oxygenation of cerebral tissue and to help improve their ability to develop a more flexible and responsive breathing pattern. Normal breathing changes in response to changes in atmospheric pressure and variations in the content of the air breathed.

Fatigue can be experienced on low pressure days even sometimes aches, pain and other discomforts that seem to appear for no apparent reason. Fatigue is also felt as a result of a stuffy atmosphere. In both cases less atmospheric oxygen is available and compensatory changes in breathing pattern are required.

A child with cerebral palsy has underdeveloped respiratory muscles which reduce the flexible response to atmospheric changes.

Breathing is central to life and it has long been known that breathing changes in response to varying metabolic demands. If the demand for oxygen is too great activity has to be reduced. A tired person sits down and rests, he does not stop breathing! So it is with children with cerebral palsy. Their poor respiratory flexibility is not obviously evident because they continue to breathe. However, their ability to do other things as well as breathe becomes limited. Extra height and weight increase respiratory load and so respiratory demand and so increase the problem.

The The Scotson Technique (TST) physical programme strengthens weak underdeveloped respiratory muscles, creates new core strength in the connective tissues between the bones, improves the nervous connection between the muscular skeletal system and the brain and improves understanding and intellectual development.

The Scotson Technique HDOT programme supports this approach by helping to improve the cerebral metabolism and encourage a more flexible and responsive use of the respiratory muscles.

Literature references available on request

Therapy