Dr. Wing-Wa YAN
Hong Kong


The Essentials of Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is the treatment of medical condition(s) by breathing pure oxygen (100%) at pressures greater than 1 atmosphere absolute (ATA) in a pressure chamber. Hyperbaric treatments are typically delivered at pressures between 2.0 to 3.0 ATA.

HBOT is a well-recognized treatment modality for many medical conditions. Peer-reviewed research has indicated HBOT for the following conditions:
-  Air or Gas Embolism
-  Carbon Monoxide Poisoning
-  Clostridial Myositis and Myonecrosis (Gas Gangrene)
-  Crush injury, Compartment Syndrome and Other Traumatic types of Ischemia
-  Decompression Sickness
-  Arterial Insufficiencies (including diabetic foot ulcers & central retinal artery occlusion)
-  Severe Anemia
-  Intracranial Abscess
-  Necrotizing Soft Tissue Infections
-  Osteomyelitis (Refractory)
-  Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
-  Compromised Graft and Flaps
-  Acute Thermal Burn Injury
-  Idiopathic Sudden Sensorineural Hearing Loss

Before initiation of HBO therapy, a balanced assessment should be made regarding the potential benefits and risks, considering both the indications and contraindications. Known contraindications include:
-  Untreated pneumothorax (absolute)
-  Patients taking bleomycin, cisplatin or doxorubicin (absolute)
-  Asthma or COPD (relative)
-  Claustrophobia (relative)
-  Eustachian tube dysfunction or URTI (relative)
-  High fever (relative)
-  Seizure or epilepsy (relative)
-  HBO incompatible pacemakers (relative)
-  Congenital spherocytosis (relative)

Clinicians and patients should also be aware of potential complications related to HBOT, which include:
-  Barotrauma: middle ear, sinuses & pulmonary
-  Oxygen toxicity: brain & pulmonary
-  Decompression illness
-  Insert gas narcosis (rare)
-  Fire (rare)