OxyFile #139

Hyperbaric oxygen therapy 
JAMA - The Journal of the American Medical Association 
April 25, 1990 v263 n16 p2216(5) 
by Grim, Pamela S.;  Gottlieb, Lawrence J.;  Boddie,  Allyn;  Batson, 
Hyperbaric oxygen (HBO) therapy involves intermittent inhalation of 
pure oxygen under a pressure greater than one atmosphere. 
During the 1960s, HBO was proposed as a treatment for cancer, heart 
attack, senility, and other conditions, but research studies did not 
obtain reproducible results. The skepticism engendered among medical 
personnel by these failures extended to HBO's use for treating 
clinical conditions that it had been shown to help. A review of these 
conditions is provided. HBO acts both mechanically, due to its 
pressure component, and physiologically, due to its oxygen component. 
HBO therapy has been effective in treating decompression sickness (the 
illness resulting from too-rapid changes in pressure by divers or 
aviators), and air embolism (introduction of air into the circulatory 
system, often unintentionally by medical personnel) by mechanically 
reducing the size of gas bubbles, and increasing oxygen levels in the 
Oxygen is essential for proper function of certain cells of the immune 
system and, in certain injuries, such as burns and crush injuries, HBO 
treatment can increase the supply of oxygen to tissues otherwise 
deprived of it. Complications of HBO treatment include trauma to or 
rupture of cavities, neurotoxicity resulting from exposure to 100 
percent oxygen for long periods, and other sequelae. 
HBO therapy is indicated for decompression sickness, air embolism, 
carbon monoxide poisoning, acute traumatic ischemia (crush injuries 
that deprive tissues of oxygen), and bacterial invasion of a necrotic 
wound (in which tissue has died). HBO may also stimulate regrowth of 
blood vessels in damaged tissue adjacent to areas treated by radiation 
therapy and may promote bone formation in cases of osteomyelitis (bone 
infection) that have not responded to other treatments. This therapy 
also shows promise for treating a variety of 'problem wounds', but 
randomized, prospective studies are lacking.  
Overall, HBO therapy is safe and effective for certain conditions, and 
well-formulated clinica l trials could help extend its use to others. 
(Consumer Summary produced by Reliance Medical Information, Inc.)