Most laypeople know the use of HBOT through use by the Navy in treating decompression sickness with high-pressure oxygen. In the years since, thousands of published experiments and clinical trials have established a body of knowledge about the physiological and mechanical effects of Hyperbaric Oxygen Therapy.
In 1977, the Undersea and Hyperbaric Medical Society (UHMS) created the Hyperbaric Oxygenation Therapy Committee to review and evaluate current and potential uses for HBOT. This Committee publishes an HBO indications document every 5 years. Currently the UHMS lists 14 indications and the scientific knowledge for each diagnosis.
Air or Gas Embolism
As the primary treatment for embolism, HBOT decreases bubble size, reduces mortality/morbidity and the development of permanent neurological damage. At the present time there is no alternative therapy.
Decompression Sickness (The Bends)
As the primary treatment, HBOT rapidly clears inert gas bubbles and provides oxygenation to ischemic and hypoxic tissues. No alternative therapy is currently available.
Carbon Monoxide Poisoning and Smoke Inhalation
Considered mandatory for severe CO poisoning, HBOT mitigates tissue poisoning and significantly reduces permanent neurologic damage. HBOT also has a direct effect in reducing the toxicity of cyanide.
When used in conjunction with surgery and antibiotics, HBOT significantly reduces morbidity and mortality. HBOT inhibits the production of lethal alpha-toxin produced by Clostridium perfringens.
Crush Injury and Traumatic Wounds
HBOT increases tissue oxygen levels by increasing oxygen delivery, and significantly reduces tissue edema through its vasoconstrictive effect.
HBOT causes a 10-15 fold increase in plasma oxygen and a 2-3 fold increase in oxygen diffusion distance. This restores a favorable cellular environment, stimulates fibroblasts to form adequate collagen, increases neovascularization by 20% and enhances leukocyte activity. HBOT has been proven effective in promoting faster, more thorough healing of problem wounds. *Acute Traumatic Peripheral Ischemia and Acute peripheral arterial insufficiency are two such indications.
Compromised Skin Grafts, Flaps and Replants
Following ischemia or vascular repair where there has been a decrease in microcirculation or tissue hypoxia, HBOT improves outcome by decreasing edema and increasing tissue oxygenation.
Necrotizing Soft Tissue Infections
Used as adjunct therapy to debridement and systemic antibiotics, HBOT reduces anaerobic bacterial growth and increases leukocyte activity. Studies indicate it can decrease mortality by two-thirds.
Effective in bone infections and in the presence of localized or systemic host compromise, HBOT is used in cases of chronic osteomyelitis as adjunct therapy to antibiotics, debridement, nutritional support and reconstructive surgery.
Radiation Tissue Damage
In conjunction with surgical treatment, HBOT stimulates function capillary growth, fibroblastic proliferation and collagen synthesis in radiated bone and soft tissue. HBOT allows grafting of soft tissue or bone in previously irradiated tissue.
As adjunct to standard burn treatment, HBOT helps maintain microvascular integrity, minimizes edema and provides the substrate necessary to maintain viability. With HBOT, mortality, hospital stay and grafting need are markedly reduced.
Exceptional Blood Loss Anemia
When transfusion is refused by the patient, HBOT dissolves enough oxygen in the plasma of severely anemic patients to support basic metabolic needs until RBCs can be restored.
Adjunctive Hyperbaric Oxygen in Intracranial Abscess
Current literature has shown that the mortality rate in Pediatric and ICA patients can be reduced from 17% to 0% using HBOT.
Diabetic Wounds of the Lower Extremity
As an adjunct to convention wound therapy, HBOT helps with angiogenesis.
Idiopathic Sudden Sensorineural Hearing Loss