From the Guidelines
Hyperbaric oxygen therapy (HBOT) is primarily used to treat decompression sickness, serious infections, wounds that won't heal, and injuries from radiation, with specific approved medical uses including carbon monoxide poisoning, gas gangrene, necrotizing soft tissue infections, diabetic foot ulcers, compromised skin grafts, crush injuries, and radiation injuries. The uses of hyperbaric oxygen therapy can be summarized as follows:
- Treating decompression sickness
- Treating serious infections such as gas gangrene and necrotizing soft tissue infections
- Enhancing wound healing in diabetic foot ulcers and other wounds that won't heal
- Treating injuries from radiation
- Treating carbon monoxide poisoning
- Treating compromised skin grafts and crush injuries
HBOT 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. A typical treatment session lasts 1-2 hours, with patients usually requiring multiple sessions depending on their condition 1. While generally safe, potential side effects include ear and sinus pain, temporary nearsightedness, claustrophobia, and rarely oxygen toxicity 1. HBOT should only be administered under medical supervision as it's not appropriate for all patients, particularly those with certain lung conditions or who have recently had ear surgery 1.
The most recent and highest quality study on the use of HBOT for diabetic foot ulcers was published in 2024 and found that the evidence for its use is limited, but it may be beneficial in improving wound healing and reducing amputation rates 1. However, the study also noted that the use of HBOT is not without risks and should be carefully considered on a case-by-case basis, taking into account the patient's overall health and medical history 1.
In the case of carbon monoxide poisoning, HBOT has been shown to be effective in reducing the risk of neurologic sequelae and improving outcomes 1. The use of HBOT for other conditions, such as gas gangrene and necrotizing soft tissue infections, is also supported by the evidence, although the quality of the studies is variable 1.
In summary, HBOT is a valuable treatment option for a range of medical conditions, including decompression sickness, serious infections, wounds that won't heal, and injuries from radiation. However, its use should be carefully considered on a case-by-case basis, taking into account the patient's overall health and medical history, as well as the potential risks and benefits of treatment 1.
From the Research
Uses of Hyperbaric Oxygen Therapy
The uses of hyperbaric oxygen therapy include:
- Treatment of carbon monoxide poisoning, as it enhances CO elimination and reduces the incidence of neurological sequelae 2, 3, 4, 5
- Management of decompression sickness and arterial gas embolism 3
- Treatment of central retinal artery occlusion, crush injury, necrotizing soft tissue infection, and symptomatic anemia 3
- Potential treatment for osteoradionecrosis, burns, and skin grafts, although the evidence is limited 6
- Treatment of conditions involving hypoxia, as hyperbaric oxygen therapy can improve energy metabolism, prevent lipid peroxidation, and decrease neutrophil adherence 2, 5
Conditions that May Benefit from Hyperbaric Oxygen Therapy
The following conditions may benefit from hyperbaric oxygen therapy:
- Carbon monoxide poisoning complicated by cyanide poisoning, often concomitantly with smoke inhalation 5
- Acute symptomatic CO poisoning, as hyperbaric oxygen hastens COHb elimination and favorably modulates inflammatory processes 5
- Conditions involving hypoxia, as hyperbaric oxygen therapy can improve mitochondrial function and reduce brain inflammation 2, 5