Indications and contraindications of the hyperbaric chamber

Hyperbaric Oxygenation Treatment (HBOT) has a set of physiological effects that affect the patient who is subjected to a hyperbaric environment. The therapy provides a number of therapeutic effects based on the increase in plasma oxygen transport together with better tissue availability. The benefits are applicable in certain pathologies and their side effects are well defined. They are rare if the HBOT is applied by specialists at the right time.

For practical purposes the indications of HBOT can be classified into 3 groups:

1. Preferred indications

Diseases in which hyperbaric oxygenation is the only effective treatment, or has an essential effect, together with other therapeutic interventions:

• Gas embolism (EG)
• Decompression sickness (ED)
• Intrathoracic hyperpressure syndrome (SHI)
• Acute carbon monoxide poisoning (ICO)
• Myonecrosis clostridial-gas gangrene (GG)

2. Supplementary indications

Those diseases in which the application of HBOT is not essential, but has a highly beneficial action, well proven in clinical and experimental studies.

• Necrotizing infections of non-clostridial soft tissues
• Acute soft tissue trauma, crush syndrome and compartment syndromes
• Refractory chronic osteomyelitis (OMCR)
• Healing delays
• Radioinduced lesions of bone, soft tissues and mucous membranes

3. Experimental indications

Situations in which HBOT can have an acceptable or interesting therapeutic effect, in some aspect of the disease, based on a consistent therapeutic hypothesis, with a defined and applicable control and evaluation system of results, and within the context of controlled studies.

• Acute occlusive retinopathies (ROA)
• Sudden deafness (SS)
• Hypoxic-ischemic encephalopathy
• Multiple sclerosis (MS)
• Crohn’s disease

The number of indications is wide, and may experience important variations depending on local, technical, social and even geographical conditions.

There is no condition that strictly contraindicates the application of HBOT. Some situations require careful approaches and, as in any therapeutic modality, assess the cost-effect-benefit ratio.

The presence of pneumothorax with valvular mechanism, the existence of thoracotomies, the history of spontaneous pneumothorax, or hypersusceptibility to convulsive episodes, as well as infectious and catarrhal diseases of the upper respiratory tract, flatulent dyspepsia and acute or chronic septal syncope require a much more careful application of HBOT. However, in the most delicate indications of the hyperbaric chamber, adopting the necessary precautions, all these conditions have been overcome without major problems.

Source

Desolaa, A. Crespob, A. Garcíaa, A. Salinasc, J. Salaa and U. Sánchez; INDICATIONS AND CONTRAINDICATIONS OF HYPERBARIC OXYGEN THERAPY; Virtual Journal of Hyperbaric Medicine; 1998