What are the uses of Hyperbaric Oxygen (HBO) therapy?

From the Guidelines

Hyperbaric oxygen therapy (HBOT) should be used to treat conditions such as carbon monoxide poisoning, gas gangrene, and stubborn wounds like diabetic foot ulcers, as it has been shown to improve outcomes in these cases. The use of HBOT in carbon monoxide poisoning has been associated with a 21% absolute reduction in the rate of neurologic sequelae, as reported in a 2002 Class II study by Weaver et al 1. Additionally, a 2024 study on the use of HBOT in diabetic foot ulcers found that the evidence is conflicting, but the studies with the lowest risk of bias suggest that there may be some benefit for its use in improving wound healing 1.

Key Uses of HBOT

• Carbon monoxide poisoning: HBOT has been shown to reduce the rate of neurologic sequelae in patients with carbon monoxide poisoning, with a study by Thom et al reporting a 23% absolute reduction in the rate of neurologic sequelae 1.
• Gas gangrene: HBOT is used to treat gas gangrene, a serious infection that can occur when bacteria infect wounds.
• Diabetic foot ulcers: HBOT may be beneficial in improving wound healing in patients with diabetic foot ulcers, although the evidence is conflicting 1.
• Radiation injuries: HBOT is used to treat radiation injuries, which can occur after exposure to high levels of radiation.
• Severe anemia: HBOT can be used to treat severe anemia, which can occur when the body does not have enough red blood cells.
• Burns: HBOT can be used to treat burns, which can help promote healing and reduce the risk of infection.
• Sudden deafness: HBOT can be used to treat sudden deafness, which can occur when the inner ear is damaged.
• Certain infections: HBOT can be used to treat certain infections, such as necrotizing fasciitis, which can occur when bacteria infect the skin and underlying tissue.

How HBOT Works

HBOT works by increasing oxygen concentration in tissues, enhancing white blood cell function, promoting new blood vessel formation, and reducing swelling in damaged tissues. During treatment, patients breathe pure oxygen in a pressurized chamber where atmospheric pressure is increased to 2-3 times normal levels. This allows the lungs to gather more oxygen than would be possible at normal air pressure, helping blood carry this extra oxygen throughout the body to fight bacteria and stimulate healing factors.

Potential Side Effects

While generally safe, potential side effects of HBOT include temporary nearsightedness, middle ear injuries, sinus pain, and rarely oxygen toxicity. It is essential to weigh the potential benefits and risks of HBOT when considering its use in clinical practice.

From the Research

Hyperbaric Oxygen Therapy Uses

• Hyperbaric oxygen therapy (HBOT) is used to treat a variety of medical conditions, including:
  • Severe infections 2
  • Non-healing wounds 3, 4
  • Decompression sickness 5, 6
  • Arterial gas embolism 6
  • Clostridial gas gangrene 6
  • Necrotizing fasciitis 6
  • Acute crush injury 6
  • COVID-19 2, 4
• HBOT has been shown to enhance tissue oxygenation, reduce inflammation, and modulate oxidative stress, thereby improving clinical outcomes in patients with severe conditions 2, 5
• The therapy's ability to increase dissolved oxygen levels in blood and tissues makes it particularly beneficial in conditions where hypoxemia and inflammation are prominent 2, 4

Specific Applications

• Wound care: HBOT can be used as an adjunctive therapy to improve oxygenation and neovascularization, and decrease inflammation in chronic wounds 3
• Neurotherapeutics: HBOT has been shown to have a positive effect on brain repair and may be used to treat conditions such as brain injury and stroke 5
• Critical care: HBOT can be used to treat critically ill patients with conditions such as acute carbon monoxide poisoning, arterial gas embolism, and severe decompression sickness 6