Chronic

Non-Healing

Hyperbaric Oxygen Therapy

Wounds

"Treating the 14 conditions covered by OHIP"

Ontario HBOT

What are Chronic Non-Healing Wounds?
Anemia is a condition characterized by a decrease in the concentration of hemoglobin in the blood. Hemoglobin is necessary for transporting oxygen to tissues and organs in the body. The reduction in oxygen available to organs and tissues when hemoglobin levels are low is responsible for many of the symptoms experienced by anemic people. The consequences of anemia include general body weakness, frequent tiredness, and lowered resistance to disease.
 
Anemia can be a particularly serious problem for pregnant women, leading to premature delivery and low birth weight. It is of concern in children since anemia is associated with impaired mental and physical development. Overall, morbidity and mortality risks increase for individuals suffering from anemia
What is Chronic/Severe Anemia?
Patients who develop chronic/severe anemia have lost significant oxygen carrying capacity in the blood. These patients become candidates for hyperbaric oxygen therapy (HBOT) when they are unable to receive blood products because of religious or medical reasons. The major oxygen carrier in human blood is hemoglobin, transporting 1.34 mL of oxygen per gram.
Grade 1, considered mild anemia, is Hb from 10 g/dL to the lower limit of normal; grade 2 anemia, or moderate anemia, is Hb from 8 to less than 10 g/dL; grade 3, or severe anemia, is below 8 g/dL
What Red Bloods Cells do...

Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot and red blood cells to carry oxygen throughout your body.

Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red colour. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Treatment with HBOT

The body generally uses 5-6 vol% (mL of O2 per 100 mL of blood); under 3 ATA, 6 vol% of molecular oxygen can be dissolved into the plasma. The CNS and cardiovascular systems are the two most oxygen-sensitive systems in the human body. Oxygen debt is one way of determining a patient’s need to start or continue HBOT. A cumulative oxygen debt is the time integral of the volume of oxygen consumption (VO2) measured during and after shock insult minus the baseline VO2 required during the same time interval. Patients who have a debt >33 L/m2 do not survive, whereas patients with debts ≤9 usually recover.

HBOT is administered at 2-3 ATA for periods of up to four hours per treatment. As many as 3-4 sessions a day may be necessary, depending on a patient’s clinical picture. Treatments should continue until the patient can receive blood products, no longer demonstrates end stage organ failure, or no longer has a calculated oxygen debt.

How do I Qualify for OHIP Coverage?

In order to qualify for OHIP covered hyperbaric oxygen therapy for Chronic/Severe Anemia, ones' hemoglobin must be below 8 g/dL (grams per decilitre) or 80 mg/dl (milligrams per decilitre). A referral from a physician or specialist is preferred, however it is not absolutely necessary. Our medical director will look over all supporting documentation, and make the ultimate decision for qualification.

Additional Literature
The following documents are sourced from respected medical journals regarding Chronic/Sever Anemia and Hyperbaric Oxygen Therapy (HBOT). 
Please click on the icon to open the PDF in your browser window. If you would like to download the PDF to your computer, right click on the icon and select "save linked file as". 
Annals of the American Thoracic Society
Volume 14, Issue 7, Pages 1216-1220
Published: July 2017
Journal of American Anestesiologists
Volume 93, Issue 4, Pages 1049–1052
Published: October 2000
Journal of the Undersea and Hyperbaric Medical Society
Volume 39, Issue 5, Pages 937-942
Published: May 2012

ONTARIO 

HBOT

 136B Cartwright Avenue

Toronto, Ontario M6A1V2

Phone: 416.789.HBOT (4268)

Fax: 416.781.HBOT (4268)

Toll-Free: 1.877.297.9931

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