The Facility and Clinical Program
The Center for Hyperbaric Medicine and Environmental Physiology is a multidisciplinary organization involved in clinically treating patients with hyperbaric oxygen; researching in the fields of oxygen biology and environmental physiology (especially diving and altitude physiology); and providing information and medical services for recreational divers. (Visit the Center for Hyperbaric Medicine Website.)
The facility contains a seven-chamber, 254 cubic meter complex supplied by a 5,660 cubic meter compressed air storage field; three air compressors; a 2,633 cubic meter liquid oxygen system; two vacuum pumps; and a complete gas mixing facility. The chambers were designed to simulate environments ranging from an altitude of 47,000 m (155,000 feet, 1/600th of an atmosphere) to a depth of 1,100 m of sea water (3,600 ft, 110 atmospheres). An electronics shop and machine shop provide in-house design and construction facilities.
Up to 14 patients can be treated at one time in the clinical chambers. Both non-invasive and invasive monitoring and blood gas measurement at pressure. General anesthesia can be provided for patients requiring therapeutic lung lavage. The chambers are outfitted with environmental control units that regulate temperature, humidity, and CO2 accumulation.
Twenty-four hour coverage is provided for hyperbaric emergencies and elective treatment of patients with hyperbaric oxygen. The call team consists of an intern, resident, or fellow, an attending physician, a nurse, and a chamber operator. “Hotline” coverage is provided for emergency diving calls from throughout the world.
Hyperbaric oxygen therapy is provided for conditions such as decompression sickness, air embolism, carbon monoxide poisoning, necrotizing soft tissue infections, refractory osteomyelitis, threatened flaps, radiation necrosis, and selected ischemic problem wounds.
Therapeutic lung lavages for patients with pulmonary alveolar proteinosis are carried out under general anesthesia inside “C” chamber. Hyperbaric oxygen provides a mechanism for treating hypoxemia during the procedure.
Fitness-to-dive consultations are provided for recreational, scientific and commercial divers. All patient data are maintained on a computerized database, which is accessible from anywhere within the Medical Center.
The Center runs an ACGME approved fellowship program in Undersea and Hyperbaric Medicine. Anesthesia interns regularly rotate onto the Hyperbaric Service, as do fellows in critical care and numerous medical students. The Center remains a popular site for medical students to fulfill their third year research requirement. An annual 37-hour-long graduate and medical school level course is taught: The Physiology of Extreme Environments.
Experimental studies can be performed at simulated depth or altitude, and in water immersion, with invasive measurement of arterial and pulmonary arterial pressures, transcranial Doppler blood velocity, precordial doppler monitoring for vascular bubbles, and in vivo near infrared spectroscopy of tissue oxygenation. A human physiology laboratory is available for studies at 1 ATA.
Richard E. Moon, MD, CM, M.Sc., FRCPC, FACP, FCCP
Medical Director, Center for Hyperbaric Medicine and Environmental Physiology
Guy de Lisle Dear, MB (Anesthesiology)
Anna Grodecki, MD
Barry Allen, PhD
Kevin Kraft, RN (Nurse Manager)