Definition of Hyperbaric Oxygen Therapy:
Hyperbaric oxygen (HBO2) is a treatment, in which a patient breathes near 100% oxygen intermittently while inside a treatment chamber at a pressure higher than sea level pressure (i.e., >1 atmosphere absolute; atm abs). It can be viewed as the new application of an old, established technology to help resolve certain recalcitrant, expensive, or otherwise hopeless medical problems. In certain circumstances, it represents the primary treatment modality while in others it is an adjunct to surgical or pharmacologic interventions.
Treatment can be carried out in either a mono‑ or multiplace chamber. The former accommodates a single patient; the entire chamber is pressurized with near 100% oxygen, and the patient breathes the ambient chamber oxygen directly. The latter holds two or more people (patients, observers, and/or support personnel); the chamber is pressurized with compressed air while the patients breathe near 100% oxygen via masks, head hoods, or endotracheal tubes. According to the UHMS definition and the determination of The Centers for Medicare and Medicaid Services (CMS) and other third party carriers, breathing near 100% oxygen at 1 atmosphere of pressure or exposing isolated parts of the body to near 100% oxygen does not constitute HBO2 therapy. The patient must receive the oxygen by inhalation within a pressurized chamber. Current information indicates that pressurization should be to 1.4 atm abs or higher.
The following indications are approved uses of hyperbaric oxygen therapy as defined by the Hyperbaric Oxygen Therapy Committee. The Committee Report can be purchased directly through the UHMS.
1. Air or Gas Embolism
2. Carbon Monoxide Poisoning
Carbon Monoxide Poisoning Complicated By Cyanide Poisoning
3. Clostridial Myositis and Myonecrosis (Gas Gangrene)
4. Crush Injury, Compartment Syndrome and Other Acute Traumatic Ischemias
5. Decompression Sickness
6. Arterial Insufficiencies:
Central Retinal Artery Occlusion
Enhancement of Healing In Selected Problem Wounds
7. Severe Anemia
8. Intracranial Abscess
9. Necrotizing Soft Tissue Infections
10. Osteomyelitis (Refractory)
11. Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
12. Compromised Grafts and Flaps
13. Acute Thermal Burn Injury
14. Idiopathic Sudden Sensorineural Hearing Loss (New! approved on October 8, 2011 by the UHMS Board of Directors)
14. Randomized Controlled Trials
15. Side Effects
HYPERBARIC OXYGEN THERAPY INDICATIONS: 13th EDITION
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OTHER REFERENCE LINKS:
1. FDA Position Statement on "Off Label" Conditions: "Hyperbaric Oxygen Therapy: Don't Be Misled"