What is the best Hyperbaric HBOT protocol and what should be done after the initial 40 treatments?

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"Answer: No one knows for sure, but in Dr. Neubauer's 26 years of experience and my 9, forty treatments seems to be the best start. Permanence to most of the effect occurs around 30 to 35 treatments at 1.5 ATA. These 40 can be delivered once or twice a day, maximum 5 days per week. When we first started, treatment was once a day, 6 days a week.

With time and closing of the facility on Saturdays, this evolved to be a twice-a-day, 5 days per week on a two times per day schedule. We take a four-hour break between treatments out of habit and convention with standard HBOT wound treatment, but others have had success with only one to two hour breaks.

Beyond forty treatments, the protocol is more variable, depending on the initial dose of HBOT in the first 40. If HBOT was given only once a day, five days per week in the first 40, you may be able to continue on that schedule without break to 60, 80, or more treatments without a problem.

However, I have found that a four-week break at forty treatments works well to give any effect too much oxygen or physical fatigue time to wear off. The second 40 treatments evolved when our first 18-20 chronic brain injured patients all experienced some degree of improvement by 40 and elected to have more. In the children with CP, there seems to be some additional improvement and often those with minimal or no improvement in the first 40 show an improvement in the next 40.

This is where our first child with hypotonia began to walk. The overall effect of HBOT in chronic brain injury is one of HBOT and time; the relative contributions of each have not been sorted out. Beyond 80 treatments the protocol is more empirical, like any drug, and dosing is dictated by response.

My habit has been 5 to 15 treatment blocks every four to eight weeks, but this is by no means fixed in stone. Above all, remember that each brain injury is idiosyncratic, HBOT is a drug, and ultimately the drug dosage must be individualized. www.hbot.com

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