HBOT Training Programs for Technicians Compared

Last updated: April 2026

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Quick Answer

The Undersea & Hyperbaric Medical Society (UHMS) has published 14 editions of its Hyperbaric Oxygen Therapy Indications, with the 13th edition released in 2013.
UHMS offers "Introductory 40-Hour Training Courses" for those entering the field, accessible through their featured education portal.
Gas embolism from IV oxygen infusion caused symptoms at 20 mL/min in humans, but 10 mL/min was tolerated.
The FDA recommends UHMS-accredited hyperbaric facilities for treating specific illnesses, highlighting the importance of standardized care.

Hyperbaric oxygen therapy (HBOT) requires specialized knowledge and skilled technicians to ensure patient safety and effective treatment. Training programs for these professionals are crucial, laying the groundwork for understanding the complex physics and physiology involved in delivering oxygen at increased atmospheric pressures. The Undersea & Hyperbaric Medical Society (UHMS) plays a central role in defining the standards and indications for HBOT, having published its Hyperbaric Oxygen Therapy Indications in 14 editions. This comprehensive guide helps to standardize practices across facilities. For instance, the 14th edition lists "Hyperbaric Treatment of Air or Gas Embolism" on page 1 and "Adjunctive Hyperbaric Oxygen Therapy in the Treatment of Thermal Burns" on page 301, demonstrating the breadth of conditions treated. Aspiring HBOT professionals can find foundational education through UHMS, which provides "Introductory 40-Hour Training Courses" as part of its educational offerings. These courses are essential for technicians to grasp the fundamentals before moving into clinical practice where precision is paramount, especially given that conditions like gas embolism can arise from various medical procedures, with continuous intravenous oxygen infusion at 20 mL/min causing symptoms in humans, while 10 mL/min was tolerated.

What is Hyperbaric Oxygen Therapy (HBOT)?

Hyperbaric oxygen therapy, known as HBOT, is a medical treatment that involves breathing 100% oxygen inside a pressurized chamber. This method increases the amount of oxygen dissolved in the blood, which can help heal various conditions. The Undersea & Hyperbaric Medical Society (UHMS) is a leading authority that defines and lists the accepted medical indications for HBOT. Their detailed publications guide medical professionals on when and how to use this therapy effectively.

Defining HBOT and Its Core Principles

HBOT works by increasing the partial pressure of oxygen in the body's tissues. When a patient breathes pure oxygen in a chamber where the atmospheric pressure is greater than sea level, more oxygen can dissolve into the plasma, red blood cells, and other body fluids. This elevated oxygen level can reach areas with compromised blood flow, promoting healing, reducing inflammation, and fighting certain types of infections. The UHMS clearly defines hyperbaric oxygen therapy as a key component of its comprehensive reference materials, ensuring a consistent understanding across the medical community. This definition is fundamental for any technician training program, as it sets the stage for understanding the physiological effects and therapeutic goals of HBOT. Without a clear definition and understanding of these core principles, technicians would struggle to grasp the 'why' behind the procedures they perform, making their work less effective and potentially less safe for patients.

UHMS Indications: A Comprehensive Guide

The Undersea & Hyperbaric Medical Society (UHMS) publishes a crucial document titled "Hyperbaric Oxygen Therapy Indications." This document serves as the authoritative source for approved uses of HBOT. The UHMS has released this guide in multiple editions, with the 14th edition being a recent compilation of current recommendations. We know the 13th edition was also available, as its front matter and references are accessible. These editions are vital for practitioners because they detail specific medical conditions where HBOT has demonstrated therapeutic benefit. For example, the 14th edition of the UHMS Hyperbaric Oxygen Therapy Indications lists 14 primary indications. These include critical conditions such as "Hyperbaric Treatment of Air or Gas Embolism" on page 1 and "Adjunctive Hyperbaric Oxygen Therapy in the Treatment of Thermal Burns" on page 301.

The scope of these indications is broad, encompassing a range of complex medical challenges. The 13th edition of the UHMS Indications, for instance, also covers "Air or Gas Embolism" on page 1 and "Enhancement of Healing in Selected Problem Wounds" on page 25. These specific page references highlight the detailed nature of the UHMS guidelines, providing precise guidance for clinicians. Understanding these indications is a cornerstone of HBOT technician training, as technicians must be aware of the conditions their patients are being treated for to provide appropriate care and monitor for specific side effects. The indications also provide a framework for quality assurance and facility accreditation, ensuring that HBOT is administered only for conditions where its efficacy is well-established. This structured approach helps prevent the misuse of HBOT and ensures that patients receive evidence-based care. The UHMS's commitment to regularly updating these indications, as evidenced by the progression from the 13th to the 14th edition, reflects the dynamic nature of medical research and the ongoing evaluation of HBOT's therapeutic potential.

Why is UHMS Accreditation Important for HBOT Facilities?

UHMS accreditation is crucial for hyperbaric oxygen therapy facilities because it signifies adherence to high standards of patient safety and quality of care. The Food and Drug Administration (FDA) itself recommends UHMS-accredited hyperbaric facilities for treating specific illnesses, underscoring the importance of this recognition. This recommendation from a federal regulatory body highlights the value of the UHMS's rigorous evaluation process.

Ensuring Patient Safety Through Accreditation

Accreditation by the Undersea & Hyperbaric Medical Society (UHMS) provides a robust framework for ensuring patient safety within hyperbaric facilities. The UHMS Hyperbaric Facility Accreditation Program evaluates facilities based on a comprehensive set of criteria, including equipment maintenance, staff qualifications, emergency procedures, and adherence to established treatment protocols. When a facility achieves UHMS accreditation, it signals to patients, referring physicians, and regulatory bodies that the facility meets or exceeds nationally recognized standards for hyperbaric medicine. This commitment to safety is paramount in HBOT, where patients are exposed to altered atmospheric pressures and high concentrations of oxygen.

The accreditation process involves a thorough review of a facility's operations. This includes examining the qualifications of the medical director, hyperbaric physicians, and the technical staff, including HBOT technicians. It also scrutinizes the maintenance records of hyperbaric chambers, ensuring they are safe and functioning correctly. For example, the proper operation of hyperbaric chambers is critical, as discussed by Hyperbaric Medical Solutions, which outlines different types of chambers. Maintaining these chambers according to strict guidelines is a key component of accreditation. Without such rigorous oversight, there would be a greater risk of equipment malfunction or operational errors, which could have serious consequences for patient health. The UHMS accreditation program is designed to minimize these risks by promoting best practices and continuous quality improvement.

FDA's Endorsement of UHMS Standards

The Food and Drug Administration (FDA) plays a vital role in regulating medical devices and therapies in the United States. Its recommendation for UHMS-accredited hyperbaric facilities for treating specific illnesses is a significant endorsement of the UHMS's standards and expertise. This recommendation can be found on the UHMS website, emphasizing the synergy between regulatory guidance and professional society standards FDA Recommendation for UHMS-Accredited Facilities. The FDA's stance provides an additional layer of credibility to UHMS accreditation, suggesting that facilities meeting these standards are better equipped to deliver safe and effective care. This is particularly important because while hyperbaric chambers themselves are FDA-cleared medical devices (for example, a 510(k) Premarket Notification for a hyperbaric chamber can be found via the FDA's database), the practice of hyperbaric medicine requires careful oversight.

The FDA's recommendation helps guide healthcare providers and patients toward facilities that adhere to recognized best practices. It reinforces the idea that HBOT, when used for approved indications, should be delivered in an environment that prioritizes patient well-being and clinical efficacy. For HBOT technicians, working in a UHMS-accredited facility means operating within a system that values ongoing education, adherence to protocols, and a culture of safety. This environment is crucial for professional development and for maintaining the highest level of patient care. The emphasis on accreditation also indirectly influences technician training programs. These programs often align their curricula with UHMS guidelines, preparing students to work effectively in accredited settings. This creates a virtuous cycle where training, accreditation, and regulatory recommendations all contribute to elevating the standard of hyperbaric medicine.

What Training Does UHMS Offer for HBOT Professionals?

The Undersea & Hyperbaric Medical Society (UHMS) provides structured educational opportunities specifically designed for professionals entering or advancing in the field of hyperbaric medicine. These offerings are essential for developing a skilled workforce capable of safely and effectively administering hyperbaric oxygen therapy. The UHMS aims to standardize knowledge and practice through its educational initiatives.

Introductory Courses for New Technicians

For individuals new to the field of hyperbaric medicine, the UHMS offers "Introductory 40-Hour Training Courses." These courses are a fundamental starting point for aspiring HBOT technicians and other hyperbaric professionals. They are designed to provide a comprehensive overview of hyperbaric principles, safety protocols, equipment operation, and patient care considerations. These introductory courses are part of the UHMS's featured education initiatives, highlighting their importance in professional development. Access to information about these courses is available through the UHMS's online education portal.

The 40-hour format suggests a concentrated period of learning, covering essential topics that a technician needs before beginning supervised clinical practice. This foundational training typically includes subjects such as the physics of gases, decompression sickness, air or gas embolism, carbon monoxide poisoning, and wound healing principles, all of which are recognized indications for HBOT by the UHMS. For example, understanding air or gas embolism, which can result from breath holding during ascent as little as one meter, is critical for technician safety and patient monitoring. The courses also likely delve into the operational aspects of hyperbaric chambers, emergency procedures, and patient assessment. This initial training is crucial because HBOT involves complex physiological changes and potentially hazardous environments. A solid understanding of the basics ensures that technicians can assist patients safely and effectively under the supervision of qualified medical personnel.

Continuing Education and Professional Development

Beyond introductory training, the UHMS also supports ongoing professional development for experienced HBOT professionals. They provide an "Online Continuing Education Portal" which offers various resources for maintaining and enhancing knowledge and skills in hyperbaric medicine. This portal is a valuable tool for technicians, nurses, physicians, and other healthcare providers to stay current with the latest research, best practices, and advancements in the field. Continuous learning is especially important in a medical specialty like HBOT, where new research and clinical applications may emerge.

Continuing education typically includes modules on advanced topics, updates to UHMS indications, case studies, and discussions on emerging technologies or techniques. For example, understanding the nuances of treating complex conditions like compromised grafts and flaps or severe anemia, both UHMS indications, might be covered in advanced modules. The portal allows professionals to access educational content conveniently, often on demand, which supports flexible learning schedules. This commitment to continuing education helps ensure that HBOT professionals maintain a high level of competency throughout their careers. It also plays a role in satisfying requirements for re-certification or license renewal, which often mandate a certain number of continuing education hours. By offering both foundational and ongoing education, the UHMS plays a pivotal role in fostering a well-trained and knowledgeable workforce in hyperbaric medicine, ultimately benefiting patient care and safety. See the severe anemia evidence atlas for the full study-by-study evidence breakdown.

What are the Approved Indications for HBOT Treatment?

The Undersea & Hyperbaric Medical Society (UHMS) meticulously lists specific conditions for which hyperbaric oxygen therapy (HBOT) is an approved treatment. These indications are based on scientific evidence and clinical experience, ensuring that HBOT is used appropriately and effectively. The UHMS's comprehensive "Hyperbaric Oxygen Therapy Indications" document is the primary reference for these approved uses.

Overview of UHMS-Approved Conditions

The UHMS identifies a range of medical conditions where HBOT is considered a beneficial and sometimes life-saving intervention. These indications span various medical specialties and address diverse physiological problems. The 14th edition of the UHMS Indications provides a detailed list of these conditions. For instance, it covers "Central Retinal Artery Occlusion" on page 15, a condition affecting vision. Another critical indication is "Clostridial Myonecrosis (Gas Gangrene)" on page 105, a severe bacterial infection. "Delayed Radiation Injuries (Soft Tissue and Bony Necrosis) and Potential for Future Research" is also listed on page 163, highlighting HBOT's role in addressing long-term effects of radiation therapy. Furthermore, "Sudden Sensorineural Hearing Loss" on page 203 and "Intracranial Abscess" on page 231 are among the other conditions for which HBOT is indicated. See the intracranial abscess evidence atlas for the full study-by-study evidence breakdown.

These indications are not merely suggestions but are backed by a consensus of expert opinion and available research. The UHMS committee, including experts like Lindell K. Weaver MD, Chair and Editor of the 13th edition, carefully reviews and updates these indications. The comprehensive nature of these lists provides clear guidance for healthcare providers and facilities. For HBOT technicians, understanding these indications is fundamental to their role. They must be familiar with the types of patients they will be treating, the expected outcomes, and potential complications associated with each condition. This knowledge allows technicians to better monitor patients during treatment and respond effectively to their specific needs.

Air or Gas Embolism: A Key Indication

One of the most critical indications for HBOT is air or gas embolism. This condition occurs when gas bubbles enter arteries or veins, potentially blocking blood flow and causing severe damage. Richard E. Moon, in the "Hyperbaric Oxygen Therapy Indications: Air or Gas Embolism" section, explains that arterial gas embolism (AGE) was historically linked to submarine escape training where pulmonary barotrauma occurred during rapid ascents after breathing compressed gas at depth Undersea & Hyperbaric Medical Society HBO Indications. Pulmonary barotrauma and gas embolism due to breath holding can occur after an ascent of as little as one meter, demonstrating how quickly this condition can develop.

Beyond diving, gas embolism can arise from numerous medical and accidental causes. Venous gas embolism (VGE) is common after compressed gas diving, though normally bubbles are trapped in pulmonary capillaries without symptoms. However, large volumes of VGE can cause cough, dyspnea, and pulmonary edema, and may even overwhelm the pulmonary capillary network, allowing bubbles into the arterial circulation. VGE can also enter the left heart directly through a patent foramen ovale or an atrial septal defect. Causes outside of diving include accidental intravenous air injection, cardiopulmonary bypass accidents, needle biopsy of the lung, hemodialysis, central venous catheter placement or disconnection, and gastrointestinal endoscopy. Even unusual causes like hydrogen peroxide irrigation or ingestion, arthroscopy, cardiopulmonary resuscitation, percutaneous hepatic puncture, blowing air into the vagina during orogenital sex, and sexual intercourse after childbirth have been linked to air embolism. For more details, see UHMS 14th Edition Indications Reference Material.

Air embolism can also occur during surgical procedures where the site is under pressure, such as laparoscopy, transurethral surgery, vitrectomy, endoscopic vein harvesting, and hysteroscopy. Massive VGE can result from passive entry of air into surgical wounds elevated above the heart, creating subatmospheric pressure in adjacent veins. This has been noted in sitting craniotomy, cesarean section, prostatectomy, spine surgery, hip replacement, liver resection, liver transplantation, and insertion of dental implants. The wide array of causes underscores the importance of HBOT as a treatment. Small volumes of air injected intra-arterially can cause clinical deficits, while intravenous injection is often asymptomatic. In experimental animals, injection of up to 0.5-1 mL/kg of intravenous air has been tolerated. In humans, a continuous IV infusion of oxygen at 10 mL/min was tolerated, but 20 mL/min caused symptoms. This highlights the delicate balance and potential dangers associated with gas in the circulatory system, making HBOT a crucial therapy for removing these harmful bubbles.

How Do Hyperbaric Chambers Work?

Hyperbaric chambers are specialized medical devices designed to deliver oxygen at pressures greater than the normal atmospheric pressure found at sea level. This unique environment is what makes hyperbaric oxygen therapy (HBOT) possible, enabling the body to absorb significantly more oxygen than it would under regular conditions. Understanding the mechanics of these chambers is fundamental for HBOT technicians.

The Physics Behind Pressurization and Oxygen Delivery

The core principle behind how hyperbaric chambers work lies in the physics of gases, specifically Henry's Law, which states that the amount of gas dissolved in a liquid is directly proportional to the partial pressure of that gas above the liquid. In the context of HBOT, this means that by increasing the ambient pressure inside the chamber and having the patient breathe 100% oxygen, a much greater volume of oxygen dissolves into the patient's blood plasma and other body fluids. Normally, oxygen is primarily carried by hemoglobin in red blood cells. However, under hyperbaric conditions, the dissolved oxygen becomes a significant source of oxygen delivery to tissues.

Hyperbaric chambers achieve increased pressure by pumping compressed air into the sealed vessel. Once the desired pressure is reached, which is typically 2 to 3 times greater than sea level pressure, the patient breathes pure oxygen through a mask or hood. This combination of increased pressure and high oxygen concentration creates a powerful therapeutic effect. The oxygen-rich plasma can then penetrate areas that have reduced blood flow, such as compromised tissues in problem wounds, or help to reduce the size of gas bubbles in conditions like air embolism. The mechanical operation of these chambers, including controlling pressure, monitoring oxygen levels, and ensuring airtight seals, is a primary responsibility for HBOT technicians. They must be intimately familiar with the chamber's control panel, safety mechanisms, and emergency protocols, ensuring precise and safe operation throughout the treatment session.

Types of Hyperbaric Chambers

There are generally two main types of hyperbaric chambers: monoplace chambers and multiplace chambers. Both types achieve the same therapeutic goal of delivering hyperbaric oxygen, but they differ in design, capacity, and operational characteristics. Hyperbaric Medical Solutions discusses the different types of hyperbaric chambers, providing insight into their varied applications. Understanding these differences is important for technicians, as their operational procedures and patient management strategies may vary depending on the chamber type.

Monoplace chambers are designed for a single patient. These chambers are typically made of clear acrylic, allowing the patient to see outside and providing a sense of openness despite being enclosed. The entire chamber is pressurized with 100% oxygen, which the patient breathes directly. This design simplifies oxygen delivery, as no separate breathing apparatus is needed inside the chamber for oxygen. However, it means that support staff cannot be inside the chamber with the patient during treatment, requiring constant monitoring through observation windows and communication systems.

Multiplace chambers, on the other hand, are larger and can accommodate multiple patients simultaneously, along with medical staff. In a multiplace chamber, the interior is pressurized with compressed air, and patients breathe 100% oxygen through individual masks or hoods. This allows medical personnel, such as HBOT technicians or nurses, to be inside the chamber with the patients, providing direct care, monitoring, and intervention if necessary. This can be particularly advantageous for critically ill or anxious patients. Multiplace chambers are more complex to operate due to the need for internal oxygen delivery systems and the management of multiple individuals within a pressurized environment. Regardless of the type, the goal remains consistent: to safely and effectively deliver oxygen at increased pressure to promote healing and address specific medical conditions, always under the careful supervision of trained HBOT professionals.

Can Hyperbaric Oxygen Therapy Cause Complications?

While hyperbaric oxygen therapy (HBOT) is a powerful treatment for many conditions, like any medical intervention, it carries potential risks and can sometimes lead to complications. Understanding these potential complications is a critical part of HBOT technician training, as technicians play a vital role in monitoring patients and recognizing early signs of adverse events. Many of the complications are related to pressure changes or oxygen toxicity.

Understanding Gas Embolism Risks

One significant complication that HBOT can both treat and, in rare circumstances, be associated with is gas embolism. Gas embolism occurs when gas bubbles enter arteries or veins, obstructing blood flow. While HBOT is the primary treatment for conditions like arterial gas embolism (AGE) and severe venous gas embolism (VGE), it's important to recognize that various medical procedures and even accidental events can cause gas embolism. For instance, accidental intravenous air injection is a known cause of gas embolism, as documented in medical literature. This highlights the delicate balance involved in managing gas within the body's circulatory system.

The "Hyperbaric Oxygen Therapy Indications: Air or Gas Embolism" document details numerous ways gas embolism can occur. Beyond diving-related incidents, such as pulmonary barotrauma from breath holding during ascent, medical procedures are frequently implicated. These include cardiopulmonary bypass accidents, needle biopsy of the lung, hemodialysis, central venous catheter placement or disconnection, and even gastrointestinal endoscopy. Surgical procedures where the site is under pressure, like laparoscopy, transurethral surgery, vitrectomy, endoscopic vein harvesting, and hysteroscopy, can also lead to air embolism. In some cases, massive VGE can occur due to passive entry of air into surgical wounds that are elevated above the level of the heart, creating subatmospheric pressure in adjacent veins. This has been classically described in sitting craniotomy but has also occurred during other major surgeries such as cesarean section, prostatectomy, spine surgery, hip replacement, liver resection, liver transplantation, and insertion of dental implants.

The severity of gas embolism depends on the volume and location of the gas. Clinical deficits can occur after intra-arterial injection of only small volumes of air. In contrast, intravenous injection is often asymptomatic, especially with small amounts. Experimental animals have tolerated intravenous injections of air up to 0.5-1 mL/kg. In human studies, a continuous IV infusion of oxygen at 10 mL/min was reported as well tolerated, but a rate of 20 mL/min caused symptoms. This data underscores the critical difference between arterial and venous entry of gas, and the volume thresholds at which symptoms manifest. For HBOT technicians, recognizing the potential for gas embolism in patients undergoing various medical procedures, even those unrelated to HBOT, is crucial for comprehensive patient assessment and safety protocols.

Other Potential HBOT Side Effects and Mitigation

Beyond gas embolism, other potential complications of HBOT primarily stem from the effects of pressure and high oxygen concentrations. Barotrauma, or injury caused by pressure changes, is a common concern. This can affect air-filled cavities in the body, such as the ears (ear squeeze), sinuses (sinus squeeze), or lungs (pulmonary barotrauma). Technicians are trained to instruct patients on proper ear clearing techniques to mitigate ear barotrauma. Pulmonary barotrauma is a more serious concern, especially if a patient holds their breath during decompression. This is why careful patient education and monitoring are paramount.

Oxygen toxicity is another potential complication, resulting from prolonged exposure to high concentrations of oxygen. This can manifest in two main forms: central nervous system (CNS) oxygen toxicity, which can cause seizures, and pulmonary oxygen toxicity, which affects the lungs. The risk of CNS oxygen toxicity is generally low with standard HBOT protocols but can increase with higher pressures or longer exposure times. Pulmonary oxygen toxicity typically requires longer exposures than a single HBOT treatment, but cumulative exposure over many sessions is a consideration. Technicians monitor patients for any signs or symptoms of oxygen toxicity, such as visual changes, ear ringing, nausea, muscle twitching, or seizures. Treatment protocols, including air breaks during oxygen breathing, are designed to minimize these risks. As Lindell K. Weaver MD, Chair and Editor of the 13th edition of the UHMS Indications, stated, "No responsibility is assumed by the Publisher or Editor for any injury and or damage to persons or property as a matter of product liability, negligence or otherwise, or from any use or operation of any methods, product, instructions, or ideas contained in the material herein." This emphasizes the importance of clinical judgment and adherence to verified protocols. Proper training ensures that technicians understand these risks, how to identify them, and how to respond in an emergency, thus enhancing patient safety during HBOT.

Frequently Asked Questions

What is the Undersea & Hyperbaric Medical Society (UHMS)?

The Undersea & Hyperbaric Medical Society (UHMS) is a non-profit organization focused on hyperbaric and diving medicine. It serves as a leading authority for hyperbaric oxygen therapy, publishing extensive guidelines and indications. The UHMS, for example, has produced the 14th edition of its "Hyperbaric Oxygen Therapy Indications," which includes topics like "Hyperbaric Treatment of Air or Gas Embolism" on page 1. The society also offers educational programs and facility accreditation.

What are the primary indications for HBOT according to UHMS?

The UHMS lists several primary indications for HBOT, which are conditions where the therapy has proven benefits. These include, but are not limited to, air or gas embolism, carbon monoxide poisoning, clostridial myonecrosis (gas gangrene), and compromised grafts and flaps. The 14th edition of the UHMS Indications details 14 primary indications, ranging from "Central Retinal Artery Occlusion" on page 15 to "Adjunctive Hyperbaric Oxygen Therapy in the Treatment of Thermal Burns" on page 301.

Does the FDA regulate hyperbaric oxygen therapy?

The FDA regulates hyperbaric chambers as medical devices and provides guidance on the use of hyperbaric oxygen therapy. The FDA recommends UHMS-accredited hyperbaric facilities for treating specific illnesses, indicating their reliance on the UHMS's standards for quality and safety. This recommendation helps ensure that patients receive HBOT in environments that meet rigorous professional standards.

What kind of training is needed to become an HBOT technician?

To become an HBOT technician, foundational training is essential. The UHMS offers "Introductory 40-Hour Training Courses" as part of its featured education initiatives. These courses cover the basics of hyperbaric medicine, including chamber operation, patient safety, and an understanding of the conditions treated. Continuous learning is also supported through the UHMS's "Online Continuing Education Portal" for ongoing professional development.

What is gas embolism and how is it related to HBOT?

Gas embolism occurs when gas bubbles enter arteries or veins, which can block blood flow and cause serious medical issues. HBOT is a primary treatment for gas embolism because the increased pressure helps to reduce the size of the gas bubbles, allowing them to be reabsorbed by the body. Gas embolism can be caused by various factors, including medical procedures, diving incidents, and even accidental intravenous air injection, with continuous IV oxygen infusion at 20 mL/min causing symptoms in humans, while 10 mL/min was tolerated.