Top Ten Things You Need to Know About HBOT #9: Oxygen’s Life-Giving Qualities

Hyperbaric oxygen therapy (HBOT) is an accepted therapeutic modality for use in several medical conditions including problem wounds. HBOT enhances oxygen supply to hypoxic tissues and increases wound healing and tissue remodeling capacity. Currently, HBOT therapy is applied in a wide range of clinical conditions.
 
In the second in a series of articles, these authors continue counting down the top ten things you need to know about HBOT. 

9

Did you know that life can exist without blood?

In 1960, Dr. Ite Boerema, a Dutch surgeon, conducted a series of experiments that came to be known as “Life without blood.” Dr. Boerema lived in a world where heart bypass machines were not widely available.
 
Initially, Dr. Boerema had been searching for a way to reduce the metabolic rate so that the cardiac output could be arrested long enough for open-heart surgery. In an animal model, he deduced that when the core temperature was reduced the heart could survive cardiac arrest twice as long. In a quest to continue to find alternatives to prolonging permissible cardiac standstill, his research in hyperbaric oxygenation therapy was initiated.¹ Dr. Boerema and his team took healthy pigs as subjects and essentially exsanguinated them to remove all erythrocytes. They then replaced the blood volume with a plasma-like solution which resulted in a hemoglobin concentration of 0.4g/dL, which is incompatible with life.²
 
Dr. Boerema then exposed them to 3 ATM of HBOT in hyperbaric chambers. The swine were noted to have sufficient oxygen in the plasma to sustain life when they were given HBO at 3 ATA for 45 minutes.³
 
The animals survived despite having virtually no hemoglobin circulating in their system! They recovered uneventfully once they were reinfused with normal blood and lived happily thereafter. And that is how Dr. Boerema used pigs to demonstrate the principle of using plasma dissolved oxygen to sustain life in the absence of hemoglobin.
 
Dr. Boerema is now recognized by many as the father of hyperbaric medicine.                                                 
 
Denise Nemeth is a first-year medical student at the University of the Incarnate Word School of Osteopathic Medicine in San Antonio, TX. Formerly a general and vascular surgery PA in a rural community, Ms. Nemeth aspires to become a general surgeon. She is certified wound specialist with the American Board of Wound Management. Her interests include rural health, wound healing, colorectal surgery, and minimally invasive surgery.

Jayesh B. Shah is Immediate Past president of the American College of Hyperbaric Medicine and serves as medical director for two wound centers based in San Antonio, TX. In addition, he is president of South Texas Wound Associates, San Antonio. He is also the past president of both the American Association of Physicians of Indian Origin and the Bexar County Medical Society and Current of Board of Trustees of Texas Medical Association.      

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References
 
1. Leopardi LN, Metcalfe MS, Maddern GJ. Ite Boerema—surgeon and engineer with a double-dutch legacy to medical technology. Surgery. 2004;135(1):99-103. doi: 10.1016/j.surg.2003.08.022.
2. Johnson-Arbor K. Hyperbaric oxygen therapy. MedStar Health. Accessed March 6, 2022.
3. Crowe DT. Hyperbaric oxygen therapy: The history. DVM 360. Accessed March 6, 2022.