Hyperbaric Chambers, life-saving devices or killer machines?

With the reopening of the South Florida clinic where a hyperbaric chamber exploded killing a woman and her grandson from Italy, the debate over the dependability of these medical devices has risen again.

The Hyperbaric Chamber is used in oxygen therapy to treat decompression sickness, gas embolism, carbon monoxide poisoning, gas gangrene resulting from infection by anaerobic bacteria, tissue injury arising from radiation therapy for cancer, and wounds that are difficult to heal. The medical use of oxygen at a level higher than atmospheric pressure is known as Hyperbaric Oxygen Therapy (HBOT).

Hyperbaric Chambers first jumped to popularity when the controversial and yet widely loved pop star Michael Jackson was pictured in one of them. Rumors were rampant that he was undergoing hyperbaric therapy to keep his youthful appearance. The chambers, therefore, soon came to be seen as these space-age anti-aging devices.

The hyperbaric chambers landed in the negative light on May 1, 2009, when Francesco Martinisi, 4, and his grandmother, Vincenza Pesce, 62, died days after an explosion inside a hyperbaric chamber at Neubauer Hyperbaric Neurologic Center.

In January 2011, the clinic reopened and also resumed offering hyperbaric treatment.

The widow of the clinic's late founder, Dr. Richard Neubauer, Winnie Neubauer, 85, said that the clinic, which still faces negligence lawsuits, decided to continue the hyperbaric treatment as it was Dr. Neubauer's lifelong mission of using hyperbaric oxygen for those in need.

We knew we were helping people. We're so happy to be open, she is quoted as saying in media reports.

Neubauer Hyperbaric Neurologic Center, previously known as Ocean Hyperbaric Neurologic Center, has been under controversy due to its firm stance supporting the hyperbaric treatment. Although not scientifically proven, the clinic advertises that hyperbaric oxygen helps treat certain illnesses, such as multiple sclerosis, autism and cerebral palsy. U.S. Food and Drug Administration (FDA), on the other hand, states hyperbaric chambers can treat 13 listed conditions, such as decompression sickness, air or gas embolism, and crush injuries.

In September 2009, the agency ordered the clinic to remove the claims from its website as it was promoting the devices for unlisted conditions, and in turn violating federal law. The clinic complied and removed any brand names of hyperbaric chambers. It also added on its website a disclaimer that the FDA regulates medical devices.

In the wake of the news of the clinic reopening after two years, reports of how the hyperbaric chamber saved two little lives have also emerged. A report in Peoria Journal Star narrates a story on how the hyperbaric chambers could be life savers and not killer machines.

Austin and Sydney Williams, now 10 and 8, who often fell sick, baffled the doctors. Austin was just a year old when it all began. Both the children regressed physically and academically. They were both finally diagnosed with mitochondrial disease.Mitochondiral disease prevents cells from using food to generate energy for living. Children diagnosed with this disease mostly don't live past the age of ten. Austin was diagnosed with autism as well.

The mother, who quit her job to take care of her children, continued to do research on the internet to find a way to help her children. She found a glimmer of hope in the form of hyperbaric treatments. After more than three sessions of hyperbaric treatment, the children began to turn to normalcy. They began to eat and play like normal children.

They have been weaned from most medications. Their physician at Cleveland Clinic expects their progress will continue, the report added.

Research studies on the effectiveness and safety of hyperbaric treatment have largely been either inconclusive or have shown mixed results. The observations in the 2004 systematic review of HBOT in traumatic brain injury were weak. A 2005 review of the evidence for HBOT in the treatment of stroke showed no benefit to the treatment. In a 2007 review of HBOT for cerebral palsy, there were no neuropsychological or behavioral changes worth noting. While there were improvements reported in motor function, children undergoing HBOT experienced seizures. In case of multiple sclerosis, there has been no clinically significant benefit from HBOT found.

While European and Scandinavian countries have approved a wider use of the hyperbaric chamber, in the United States, hyperbaric chamber treatments are recognized as safe and effective only for a few medical conditions. Hyperbaric treatment is also expensive and in some cases the patient may require over a dozen sessions.