Initially, HBOT was developed as a treatment for diving disorders involving bubbles of gas in the tissues, such as decompression sickness and gas embolism, It is still considered the definitive treatment for these conditions. The chamber treats decompression sickness and gas embolism by increasing pressure, reducing the size of the gas bubbles and improving the transport of blood to downstream tissues. After elimination of bubbles, the pressure is gradually reduced back to atmospheric levels.<unk>  chambers are also used for animals, especially race horses where a recovery is worth a great deal to their owners. It is also used to treat dogs and cats in pre- and post-surgery treatment to strengthen their systems prior to surgery and then accelerate healing post surgery. Protocol Emergency HBOT for decompression illness follows treatment schedules laid out in treatment tables. Most cases employ a recompression to absolute, the equivalent of of water, for 4.5 to 5.5 hours with the casualty breathing pure oxygen, but taking air breaks every 20 minutes to reduce oxygen toxicity. For extremely serious cases resulting from very deep dives, the treatment may require a chamber capable of a maximum pressure of , the equivalent of of water, and the ability to supply heliox as a breathing gas. U.S. Navy treatment charts are used in Canada and the United States to determine the duration, pressure, and breathing gas of the therapy. The most frequently used tables are Table 5 and Table 6. In the UK the Royal Navy 62 and 67 tables are used. The Undersea and<unk>  Medical Society (UHMS) publishes a report that compiles the latest research findings and contains information regarding the recommended duration and pressure of the longer-term conditions. Home and out-patient clinic treatment An example of mild portable<unk>  chamber. This chamber is one of the larger chambers available for home. There are several sizes of portable chambers, which are used for home treatment. These are usually referred to as "mild personal<unk>  chambers", which is a reference to the lower pressure (compared to hard chambers) of soft-sided chambers. In the US, these "mild personal<unk>  chambers" are categorized by the FDA as CLASS II medical devices and requires a prescription in order to purchase one or take treatments. The most common option (but not approved by FDA) some patients choose is to acquire an oxygen concentrator which typically delivers 85–96% oxygen as the breathing gas. Oxygen is never fed directly into soft chambers but is rather introduced via a line and mask directly to the patient. FDA approved oxygen concentrators for human consumption in confined areas used for HBOT are regularly monitored for purity (+/- 1%) and flow (10 to 15 liters per minute outflow pressure). An audible alarm will sound if the purity ever drops below 80%. Personal<unk>  chambers use 120 volt or 220 volt outlets. Possible complications and concerns There are risks associated with HBOT, similar to some diving disorders. Pressure changes can cause a "squeeze" or barotrauma in the tissues surrounding trapped air inside the body, such as the lungs, behind the eardrum, inside paranasal sinuses, or trapped underneath dental fillings. Breathing high-pressure oxygen may cause oxygen toxicity. Temporarily blurred vision can be caused by swelling of the lens, which usually resolves in two to four weeks. There are reports that cataract may progress following HBOT. Effects of pressure Patients inside the chamber may notice discomfort inside their ears as a pressure difference develops between their middle ear and the chamber atmosphere. This can be relieved by ear clearing using the Valsalva maneuver or other techniques. Continued increase of pressure without equalising may cause ear drums to rupture, resulting in severe pain. As the pressure in the chamber increases further, the air may become warm. To reduce the pressure, a valve is opened to allow air out of the chamber. As the pressure falls, the patient's ears may "squeak" as the pressure inside the ear equalizes with the chamber. The temperature in the chamber will fall. The speed of pressurization and de-pressurization can be adjusted to each patient's needs.
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