[Hyperbaric therapy and diving medicine - hyperbaric therapy part 2: adjuvant therapy]

Area of Science:

• Hyperbaric medicine
• Clinical efficacy
• Evidence-based medicine

Background:

• Hyperbaric oxygen therapy (HBOT), breathing pure oxygen at elevated pressure, is established for gas embolism and decompression illness.
• Clinical evidence for HBOT in carbon monoxide poisoning and clostridial necrosis is less defined.
• Assessing HBOT's value using evidence-based criteria presents challenges.

Purpose of the Study:

• To systematically review the clinical efficacy of hyperbaric oxygen therapy (HBOT).
• To evaluate HBOT for acute indications including gas embolism, decompression sickness, CO poisoning, and clostridial myonecrosis.
• To explore adjuvant uses of HBOT and challenges in evidence-based assessment.

Main Methods:

• Systematic literature review.
• Assessment of evidence for acute indications of HBOT.
• Evaluation of HBOT as adjuvant therapy.

Main Results:

• HBOT is the gold standard for air/gas embolism and decompression illness.
• Evidence for HBOT in acute carbon monoxide poisoning and clostridial myonecrosis requires further clarification.
• Part 1 covers acute indications; Part 2 discusses adjuvant uses and evidence-based challenges.

Conclusions:

• HBOT is definitively effective for specific acute conditions like gas embolism and decompression sickness.
• The role of HBOT in other acute conditions like CO poisoning needs more robust evidence.
• Further research is needed to establish evidence-based guidelines for all HBOT applications.