Hyperbaric Medicine Center

The entrance to the Center

The Head of the Hyperbaric Medicine Center, leading vascular surgeon Dr. Eyal Avraham, and senior nurse Gali Sharon respond to the questions of our editorial team.

Dr. Avraham: Hyperbaric chambers are used in the treatment of a variety of conditions, including hard-to-heal wounds, decompression sickness, smoke inhalation poisoning, and many others. The treatment involves placing the patient in a special chamber where they breathe 100% oxygen at a pressure of 2-3 atmospheres. This way, we provide the body with a high dose of oxygen, which it uses to treat various conditions.

Interviewer: Gali, do you hold the position of the head nurse at the Center?

Gali: Yes, I am responsible for patient care at the center, while Dr. Avraham handles the medical aspect. In our center, we receive a wide range of patients, including those receiving outpatient treatment, those hospitalized in the clinic, patients referred from other medical centers, nursing homes, brought in by emergency services, from different departments, and various institutions. Typically, patients come with a referral specifying why they were transferred here. First and foremost, we conduct a series of assessments to ensure that the patient has no contraindications for hyperbaric chamber treatment. This includes both chronic and temporary factors. We check that there are no devices on or inside the patient that could interfere with the chamber’s operation and that the patient is in a physical condition that allows them to undergo this procedure. Let me provide an example to clarify what I’ve said. We frequently receive patients with diabetes, whether it’s type 1 or type 2. Hyperbaric chambers affect patients in a way that lowers their blood sugar levels. Diabetics who take insulin or other medications that can cause hypoglycemia (low blood glucose concentration) may experience a state of increased hypoglycemia. To prevent this condition, we monitor the patient’s blood sugar levels before and after therapy. A patient is considered ready for hyperbaric oxygen therapy if their blood sugar level falls between 150 and 250 milligrams per deciliter. In everyday life, this is a high level, but for us, it’s an indicator of the feasibility of the therapy.

The entrance to the hyperbaric chamber

We monitor the patient’s condition both inside and outside the chamber, ensuring that no emergency situations arise, either due to their underlying condition or as a result of the therapy. We assist in fitting oxygen masks and monitor oxygen levels to ensure they stay within acceptable limits, although this is practically impossible due to the excellent safety system in place. We also provide psychological support, as it’s not easy for everyone to spend extended periods of time inside the chamber. This therapy lasts for 2.5 hours over several weeks, in addition to the time required for pre- and post-treatment assessments. It can be quite challenging for some patients.

Interviewer: Dr. Avraham, what are the advantages of this therapy? Why, under certain circumstances, do patients undergo hyperbaric chamber treatment instead of some other method?

Dr. Avraham: The advantage of this therapy isn’t necessarily about pros and cons; it’s about different aspects of the treatment process. For instance, when dealing with patients with compromised blood flow, hyperbaric oxygen therapy doesn’t replace the surgery performed by a vascular surgeon. However, it can aid in scar tissue healing after surgery. Of course, we strive to maintain proper blood circulation in the scar area using advanced bandaging techniques. Nonetheless, scars tend to heal much better with the application of the chamber. Blood circulation, bandaging, and the chamber all work together synergistically.

Interviewer: Your center at Israel’s Leading University Hospital was recently opened, and it’s likely equipped with state-of-the-art equipment and utilizes innovative techniques. Can you please tell us more about this?

Dr. Avraham: We operate according to the highest international standards. Before therapy, each patient undergoes thorough assessments, such as measuring oxygen levels in various tissues of the body. We employ individually tailored treatment protocols.

Interviewer: Does the center treat any health issues that you haven’t mentioned, and for which the benefits of hyperbaric oxygen therapy have not been proven yet? For example, in the context of clinical trials. Does the center conduct clinical research to explore new applications for the chamber?

Dr. Avraham: We have a list of indications for using the chamber that have already been researched and confirmed. However, research is also conducted to identify diseases where the chamber can be effective. For example, various types of nerve injuries, treatment of chronic pain syndrome, and treatment of various inflammations. Research in this area is conducted both at Israel’s Leading University Hospital and in other clinics.

Interviewer: Is the chamber used in the treatment of patients with oncological diseases? For instance, to alleviate pain or improve the patient’s overall condition?

Dr. Avraham: Definitely not. Treating patients with cancer is a very complex process. Patients who have had or are currently undergoing cancer treatment don’t use the chamber during the actual cancer treatment, and it’s important to emphasize this. However, the chamber can indeed be helpful for those suffering from side effects of cancer treatment. For example, patients with side effects after radiotherapy, such as damage to the urogenital or digestive system or skin issues, can benefit from it. We do treat such patients. In any case, if a patient has or had cancer, we consult with oncologists to ensure that the treatment won’t harm them.

The technician constantly monitors the chamber

Interviewer: Gali, a question for you: can foreign patients receive this treatment? How long does it take, and how long do they need to stay in Israel? What can foreign patients expect at the Center?

Gali: First, let’s talk a bit more about the types of patients we receive at the Center. We have several directions here. One of them is emergency therapy when it’s a matter of saving a life. In such cases, we deal with hospitalized patients who receive all the necessary care. When is emergency therapy used? For example, in cases of smoke inhalation, like we had just yesterday, or problems following deep-sea diving. However, the majority of patients come to the Center with chronic pathologies. Foreign patients will require a range of services and will need to come here every day. Some patients require staff assistance, such as those with non-healing wounds. Some of these patients need significant care, including individuals who have difficulty walking or who lack limbs. Someone should accompany these patients, and it’s better if they live nearby. We have invested a lot in making our Center accessible to people with limited mobility. These are all organizational matters. From a general perspective, foreign patients will receive the same level of care as Israeli patients. We will also address and meet all their daily needs. We don’t see a difference between Israeli and foreign patients, and we will provide the best possible service to both.

Interviewer: Gali, could you please tell us what this room is for and what activities take place here?

Gali: Israel’s Leading University Hospital is a medical center that follows a holistic approach. We understand that emergencies can happen anytime, at any stage. Under certain circumstances, hyperbaric oxygenation can either worsen a patient’s condition or have no connection to it; it’s just that the person happened to be in the right place at the right time. Any reaction can occur: chest pain, breathing problems, anything. That’s when we transfer the patient here. Everything is ready here to address any possible medical issue. Essentially, this is an intensive care unit, and it doesn’t matter whether the issue was caused by the chamber or not. The patient’s condition will be rapidly stabilized here, and then they will be transferred to the reception area, the operating room, the vascular surgery department, or wherever is needed. Here, we can support the body’s vital functions in the early stages after a crisis. If a deterioration occurs in the chamber, we promptly transfer the patient here and do everything possible within half an hour to an hour. After that, the patient is transferred to another department in stable condition.

If I were asked to come up with a slogan, something that could be written on a banner to explain the principles of this Center as part of Israel’s Leading University Hospital, I would say this: Israel’s Leading University Hospital pays special attention to patient care. We view each patient as a whole and provide holistic service. We strive to provide service at the highest professional and compassionate level possible. Compassion, attention to the patient and their family – these are our guiding principles. And from this perspective, we are not just another department of the clinic. We have a special position; we combine outpatient care and hospitalization and aim to provide patients with the very best. Everything here is synchronized to the maximum and meets ‘gold standards.’ We give everything to the fullest extent: care, attention to caregivers, guidance, social and psychological support, organization of consultations with the necessary specialists. We have a clinic for scar treatment. A clinic for wound healing and bandaging. Monitoring and communication with various clinics and departments are well established. We are currently at the beginning of our journey, and we will constantly develop and improve to reach the highest standards. But the patient and their family will always be at the center of our attention. And, of course, the desire to be the best.

You can see special chairs in which patients who can sit undergo the procedure. In this large chamber called the ‘multiplace,’ up to 16 patients can be accommodated. There is also one lying position available. Patients with complex illnesses, including those connected to artificial respiration, are placed here. For such patients, we have a specialized hyperbaric life support and artificial respiration system. Inside the chamber, there are many devices and equipment specially adapted for the conditions created within.

Transparent partitions separate patients from each other. Everything here undergoes sterilization to prevent infections. During the procedure, patients can watch movies, news, or use the audio system. Oxygen masks are connected to these openings, and we put them on each patient. Patients breathe normally, receiving 100% purified medical oxygen. There is also a special screen in the chamber on which patients can see data about the progress of the procedure. The screen is currently inactive because we are not undergoing the procedure, but even now, you can see that it displays pressure and temperature. This temperature changes during the chamber’s pressurization and depressurization. It also shows the time remaining until the procedure is completed; the countdown starts from the top and then counts down. This way, patients know how much time is left until the procedure ends and when it finishes.

Behind you, you can see the transition lock. There is always someone from the staff inside the chamber, but if something unforeseen happens inside, we can provide assistance from the outside. Support comes through the lock. The external door is closed, the chamber’s pressure is equalized with the lock, and then the internal door is opened.

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