Q J Med 2004; 97: 385-395
QJM vol. 97 no. 7 © Association of Physicians 2004; all rights reserved.
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Hyperbaric oxygen: its uses, mechanisms of action and outcomes
From the University of Bristol, and 1Division of Oral & Maxillo-Facial Surgery, Bristol Dental Hospital, Bristol, UK
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Introduction |
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Hyperbaric oxygen therapy (HBO) is increasingly used in a number of areas of medical practice. It is a unique intervention whose method of action is not well understood. Clinicians may request its use for their patients, but often will not fully understand its mechanisms. It is hoped that this review and discussion of HBO and the literature surrounding its use may be useful to clinicians who are unsure whether their patients will benefit from this exciting intervention.
Hyperbaric oxygen therapy is defined by the Undersea and Hyperbaric Medical Society (UHMS) as a treatment in which a patient intermittently breathes 100% oxygen while the treatment chamber is pressurized to a pressure greater than sea level (1 atmosphere absolute, ATA).1 The pressure increase must be systemic, and may be applied in monoplace (single person) or multiplace chambers. Multiplace chambers are pressurized with air, with oxygen given via face-mask, hood tent or endotracheal
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History of hyperbaric medicine |
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Physiological basis of hyperbaric oxygen therapy |
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Indications and uses for hyperbaric oxygen therapy |
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Arterial gas embolism
Carbon monoxide poisoning
Clostridial myostitis and myonecrosis (gas gangrene)
Crush injuries, compartment syndromes and other acute traumatic peripheral ischaemias
Decompression sickness
Enhancement of healing in selected problem wounds
Exceptional blood loss anaemia
Intracranial abscess
Necrotising soft tissue infections
Refractory osteomyelitis
Delayed radiation injury (soft tissue and bony necrosis)
Skin flaps and grafts (compromised)
Thermal burns
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Complications and contraindications |
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Conclusions |
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Address correspondence to Dr C.N.A. Bell, Division of Oral & Maxillo-Facial Surgery, Bristol Dental Hospital, Lower Maudlin Street, Bristol BS1 2LY. e-mail: chris.bell@bristol.ac.uk
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