What is hyperbaric (high-pressure) oxygen therapy?

From the Guidelines

Hyperbaric oxygen therapy is a medical treatment that involves breathing pure oxygen in a pressurized chamber, primarily used to treat conditions like decompression sickness, severe infections, and carbon monoxide poisoning, with the goal of improving neurological outcomes and reducing morbidity and mortality. The therapy works by increasing oxygen concentration in the blood, which promotes healing by stimulating the release of growth factors and stem cells, enhancing white blood cell function, and reducing inflammation 1. According to the American College of Emergency Physicians and the Cochrane Review, hyperbaric oxygen therapy may be beneficial in treating carbon monoxide poisoning, especially in patients with severe toxicity, with some studies suggesting improved neurological outcomes 1. Key benefits of hyperbaric oxygen therapy include:

• Improved neurological outcomes in patients with carbon monoxide poisoning
• Reduced morbidity and mortality in patients with severe infections and decompression sickness
• Enhanced wound healing in patients with diabetes or radiation injury
• Low incidence of severe side effects, making it a relatively safe treatment option 1. However, the optimal dose and frequency of hyperbaric oxygen treatments for acute carbon monoxide poisoning remain unknown, and treatment decisions should be made on a case-by-case basis, taking into account the patient's condition, logistical considerations, and potential risks and benefits 1. In general, hyperbaric oxygen therapy is considered a valuable treatment option for patients with severe carbon monoxide poisoning, and its use should be considered in all cases of serious acute CO poisoning, with the goal of preventing long-term and permanent neurocognitive dysfunction 1.

From the Research

Definition and Principles of Hyperbaric Oxygen Therapy

• Hyperbaric oxygen therapy (HBO) is defined as a treatment in which a patient breathes 100% oxygen in a pressurized environment of at least 1.4 absolute atmospheres 2.
• The therapy is grounded in three gas laws: Henry's Law, Dalton's Law, and Boyle's Law 2.
• The beneficial effects of HBO include wound healing enhancement, increased neutrophil bactericidal capacity, and direct toxic effect against some microorganisms 2.

Clinical Applications of Hyperbaric Oxygen Therapy

• HBO has been shown to be effective in treating several surgical conditions, including gas gangrene, crush injuries, and compartment syndromes 3.
• It is also used to treat decompression sickness, arterial gas embolism, and acute carbon monoxide poisoning 4.
• Additionally, HBO has been used to treat severe infections, non-healing wounds, and COVID-19 5.
• The therapy has been shown to enhance tissue oxygenation, reduce inflammation, and modulate oxidative stress, thereby improving clinical outcomes in patients with severe COVID-19 5.

Therapeutic Effects and Indications of Hyperbaric Oxygen Therapy

• Hyperbaric oxygen therapy has a therapeutic effect in numerous pathological conditions, including decompression sickness, arterial gas embolism, carbon monoxide poisoning, and wound healing 6.
• The therapy is used for treating underlying hypoxia and has been shown to have a therapeutic effect in osteomyelitis, osteoradionecrosis, and smoke inhalation 6.
• The current indications and contraindications of hyperbaric oxygen therapy are well-established, and the therapy has been shown to be safe and effective when used properly 2, 3, 6.