Hyperbaric therapy is a means to enhance oxygen delivery to ischemic tissues of the body. For details see Index to HBOT Files
Please understand that HBOT is a generic treatment procedure.
IT reduces tissue swelling (oedema)
The reduced swelling enables capillaries to open up to enhance microcirculation
It promotes many chemicals to be released (Angio-genetic factors) that enhance new capillary growth from normal areas towards ischemic zones
It acts like an "Internal Hydrogen-peroxide antiseptic" to kill microbes
It enhances the oxygen dissolved in tissue fluid that is the ONLY source of direct oxygen supply to any tissue of the body including brain, as per Henry's law of Physics that states that pressure exerted on a water body is directly proportional to the solubility of a gas in water. Thus, once the blood / tissue fluid gets oxygen enriched, simple laws of diffusin does the rest to carry it from "Normal" perfused tissues to "Ischemic" low perfused tissues
Hyperbaric Oxygen Therapy, in addition to its well understood role of enhancing solubility of gas (Oxygen) under increased pressure inside the chamber to enhance tissue oxygenation, edema reduction, inflammation reduction and recovery of ischemic penumbra zone of injury, has been shown to have the following beneficial enhanced effects :
Mobilization of Bone Marrow Stem Cells Thom, SR. Am J Physiol Heart Circ Physiol, 2006;290:1378-86.
Enhanced Neuro-Plasticity to allow unused areas of brain to take over function of fully damaged areas, and also normalisation of Metabolic Apoptosis & DNA signaling P Harch, Neural Repair & Neuro Rehabilitation Conf. (NR2CON), Ind. Inst. of Technology; Delhi; Sept. 2007
HBOT was first used about a few centuries ago, and virtually predates modern allopathic medicine (SURPRISED?????). Lack of placebo controlled double blind randomised clinical trials have upheld its progress.
Yes, it is costly. So which patient will pay the Rs.1.5 lakh to standard commercial hospitals if he is told that he may get actual HBOT or a sham treatment? Will you?
Regarding Autism:
It is a multigenetic disturbance syndrome and not "A Disease". Due to the multiplicity of genetic faults, there are various biochemical and neuro-hormonal pathways and physiological functions of the body that may go wrong in a particular person with autism. These include:
Abnormalities in the way immunity works. It starts attacking the patients own tissue including specific areas of brain (causing typical psychosocial-communication-behavioral issues that can be correlated to the Brain Scan picture in many cases) and gut (Gut Dysbiosys).
At UDAAN, we do a CT-cum-SPECT Fusion Scan of brain in children with CP or Autism who seek HBOT. We are reasonably accurate in telling from the scan, without first seeing the child, what problems the child has, though we still need to go some distance to achieve perfection.
Routine CECT and MRI are anatomical scans and are inadequate for our purpose of correlation of "Function" to scan result assessment. If the problem areas show that the brain is edematous and inflamed (Ischemic penumbra) but not totally dysfunctional (dead), THEN ONLY do we advise HBOT, based on our experience of last nine years in this field.
CP, Autism, Down Syndrome, severe Mitochondrial Disorder: four totally different disabilities with different causes. But, at the end of the day, the CT-cum-SPECT Fusion Scans are very similar, and all of them respond to HBOT in VERY CAREFULLY ASSESSED AND SELECTED CASES, something that comes from long experience and a full team of experts in all related fields (OT + PT + Speech Therapist + Special Educator + Physicians team who understands what is going on and also can analyse the CT-cum-SPECT Fusion Scans in a functional manner and not just an anatomical manner the way ALL radiologists give their report + who has experience and knowledge about HBOT and the multiple physiological changes it can produce).
To give an example: ibuoprofen works as a pain and inflammation remover in cases of Arthritis and traumatic pain in leg of a football player, as per a clinical study done. Do you still need a study to prove that it will also work in relieving inflammation and pain in a traumatic injury of the right elbow, and another one for the left elbow and another one for the back bone.......????
If you want our opinion on your child
We at UDAAN-INDIRA are a team of doctors, therapists and psychologists who will work with the child for a week, assessing him using diagnostic and well as PROGNOSTIC scales. The medical wing will assess his physiology and biochemical parameters, micronutrient levels, allergy and toxicology profile, blood metal profiles, serum vitamin levels, and then guide the dietician to plan out a well balanced allergen free non toxic diet suitable for a normal child of his sex, weight and age (DAN Protocol based). Certain specific genetic parameters will also need testing and remedial medical means adopted. All of these will be evidence based approach to the limit possible in India. After three months or more of this process, we will do a CT-cum-SPECT Fusion Scan of brain using dyes at an appropriate dose for small children. After analysing that scan, we suggest what degree of benefit may accrue from HBOT.
However, just as in any class of 50 normal kids, someone becomes a lower division clerk while another becomes an IAS or very high ranking professional, similarly, different children will respond differently. About 15% or so improve remarkably, about 35% show good improvement, and another 15 % will show minor improvements, while the balance 35% will not show a statistically significant improvement.
The Times of India Mumbai Edition, September 21, 2009; Section: Times City; page 7, recently had an article on HBOT usage in Autism, and had quoted a pediatric neurologist who said that a study showed that HBOT does not work in CP. He comment is based on erroneaous interpretation of that study.
The rate of neurodevelopment of motor activity in a CP child is measured by changes in the GMFM Scale, best assessed using a GMAE Estimator software, which is rarely found anywhere in India (UDAAN has been using it for last seven years). This was the main tool used in the Collet study from Canada the doctor was referring to, as published in the Lancet in 2001. That study clearly showed that when CP children are NOT TREATED, their GMFM score spontaneously improved at a rate of 0.1 per month, whereas when either HBOT at 1.75 Atmospheric pressure (ATA) with 100% oxygen was used or 1.3 Atmospheric pressure with ambient air was used, the GMFM change JUMPED to 1.0 or more per month: that is, a TEN FOLD Spontaneous jump. Is that a joke?
But that pediatric neorologist, not knowing the implications of GMAE and GMFM, could not appreciate that and only went by the version repeated ad-nauseaum at every forum by Collet, who is neither a qualified doctor nor a HBOT therapist, but only a Government employed Pharmacist who used to do drug trials, who was thrust upon the team of genuine doctors, pediatricians and HBOT Therapists lead by Pierre Marois, to discredit the study so that Government would not have to re-imburse the money for HBOT in CP. Now that this trickery has been exposed, the state of Quebec in Canada, where the study took place, has accorded recognition to HBOT as a reimbursible treatment for CP as have more than 16 states in USA.. I wonder how many in India are aware of this.
Dr. Wassman et al from Munster, Germany did a physiological study of Intracranial pressure, intracerebral lactate levels, intracranial blood flow and alpha wave pattern in brain when brain damaged persons were given 100% oxygen using Hyperbaric pressures that were slowly increased from 0 above atmospheric pressure to 2.5 times atmospheric pressure (ATA). His study showed that the beneficial effects of HBOT on all four parametrers of measurement as mentioned above, peak at 1.5 ATA, with both 1.3 and 1.75 ATA slightly lower on either side of the bell shaped curve and at the same level. This is what the Collet study also showed.
We at UDAAN are doing an ongoing observational controlled open study of CP children using 1.75 ATA with 100% Oxygen, 1.5 ATA with 100% Oxygen, 1.3 ATA with 21% Oxygen (room air) or NO Hyperbarics, with all children given two hours of daily OT, PT, Speech, Spl. Edu, half an hour each. Our results have also shown similar benefits of PRESSURE and not Oxygen. Our results were invited to be presented at recent conferences in USA (Am. College for Advancement of Medicine, Internat. Coll. for Integrative Medicine, 6th Int. Symposium on HBOT and the Brain Injured Child, etc. Incidentally, all three lecutes were Accredited CME lectures in USA).
We have not published our paper in India, because India is still in the stone age of civilian sector HBOT, with only about 50 attendees in the just concluded 5th Annual Asian Hyperbaric and Diving Medical Association Conference at Goa.
Did you know that India has a total of only about 2 dozen HBOT chambers in the civilian sector versus about four thousand chambers in China, what to speak of USA?