From 1770 to 2007The medical use of pressurized oxygen predates the element’s discovery and recognition of its role in metabolism by European scientists in the 1770s. An English pastor and physician, the Rev. Henshaw, reportedly treated patients in a compressed air chamber as early as 1662, although his theory for such therapy is not recorded.
The French surgeon Fontaine built a pressurized operating room in 1879, and Dr. J. L. Corning introduced hyperbaric (high-pressure) treatment to the United States in 1891. After experimenting with hyperbaric oxygen to treat “Spanish Flu” victims at the end of World War I, Dr. Orville J. Cunningham constructed an 88-foot long chamber in Kansas City. He topped this in 1928 by building a 64-foot-diameter pressurized sphere containing six floors and 72 rooms.
These ambitious pioneers were hampered by a poor understanding of the actual physiological effects and benefits of hyperbaric oxygen (HBO2). Research was spurred in part by the spread of professional and recreational scuba diving after World War II, and a corresponding rise in cases of “decompression disease.” This condition results when divers ascend too quickly, causing saturated nitrogen in their blood to gasify and form bubbles. These usually collect in the joints and make movement painful -- hence the name “the bends.” Victims are treated by repressurizing them in a chamber, which is then slowly decompressed to dissolve the bubbles.
The benefits of hyperbaric oxygen treatments in promoting healing after radiation therapy were noted in the 1950s. It was observed that the therapy accelerated the growth of capillaries and veins in damaged tissues, thereby speeding healing. The first scientific congress on HBO2 medicine was held in 1963 and the Undersea Society developed the first board-certification standards and exams for HBO2 specialists in 1976. Blue Cross/Blue Shield approved insurance reimbursement for the treatments the following year.
From the North Sea to the Northwest
Exploitation of oil reserves discovered in the North Sea off Scotland and Norway in the late 1960s required extremely deep dives to build and maintain drilling platforms. Oil companies made funds available for new research into the physiology of such dives and potential health hazards and treatments for divers.
Seattle has long been a center for both hard-hat and scuba diving, due in large part to the richness of Puget Sound’s marine ecology and its active maritime industries. Spurred by Dr. Merrill Spencer, Virginia Mason Medical Center sought and received funding for hyperbaric research with diving mammals. Drs. Kent Smith and Brian D’Aoust continued research into deep diving with government, military, and corporate funding. These grants were augmented by substantial gifts from donors such as John Lindbergh, son of the famed aviator and a noted deep-sea diver in his own right. Formally organized in 1969, Virginia Mason's Center for Hyperbaric Medicine has also enjoyed active participation and support from the national Undersea and Hyperbaric Medicine Society, which has many members in Western Washington.
The Center began treating divers and other patients in a standard off-shore deck decompression chamber in 1969. In 1970, Virginia Mason added a four-patient chamber based on an off-shore saturation chamber design and built by Seattle Boiler Works. Rising demand led Virginia Mason to spend $7.1 million on the new Center, of which $4.5 million was raised through grants or donations. As of 2007, the Center operates the only multi-patient hyperbaric chambers north of Los Angeles and west of Denver.
We All Live in an Off-White Submarine
The new Center occupies 8,000 square feet in remodeled conference rooms and a former auditorium on the ground floor of Virginia Mason’s main hospital wing on Seattle’s First Hill. The spacious main room features comfortable waiting rooms for patients and family members, infirmaries, examination rooms, an impressive salt water aquarium, and a large control console resembling something one might find at Cape Kennedy. The main room is dominated by the large twin chambers, which form a cylinder 46 feet in overall length with an interior diameter of 10 feet, about the same size as a medium-sized airliner. Portholes and airlocks create the impression of a beached submarine or grounded spaceship.
The two main chambers can accommodate up to 16 seated patients (fewer on gurneys), plus two attendants. Patients typically sit in comfortable recliner chairs and breathe oxygen through clear plastic helmets, or “hoods,” during two-hour sessions called “dives.” The chambers can sustain maximum pressures equivalent to submerging 165 feet below sea level, or roughly five times the normal surface atmospheric pressure of about 15 pounds per square inch, although “dives” of 45 to 60 feet are the most common.
These pressures are generated by a complex system of compressors, tanks, and pipes in rooms adjacent to and below the chambers. It also features a fire suppression system that can flood the tanks in seconds. Because of the fire potential of the pure oxygen environment, special care is taken to exclude materials that might spark or fuel a fire. The chamber was designed and engineered by Reimer Systems of Springfield, Virginia, and the pressure vessels were fabricated locally by Seattle Boiler Works.
Hyperbaric treatments are currently (2007) supervised by a large team led by Dr. Neil Hampson and including physicians David Dabell, Tony Gerbino, Steven Kirtland, and Anne Mahoney. They are assisted by specially trained technicians and registered nurses, many of whom are divers. Douglas Ross, RN, provides advanced wound care to complement the treatments.
The Center is staffed 24 hours a day, 7 days a week to handle emergencies, and it routinely carries out 100 patient treatments a week. Its capacities were put to the test by severe local storms in December 2006, when it handled some 70 victims of carbon monoxide poisoning over a four-day period. These were chiefly newly arrived immigrants who had sought to stay warm during power outages and were unfamiliar with the dangers of using charcoal cookers and heaters in enclosed spaces. The incidents led to aggressive community education efforts.