[Hyperbaric therapy and diving medicine - hyperbaric therapy part 1: evidence-based emergency care]

Area of Science:

• Medical Sciences
• Hyperbaric Medicine
• Emergency Medicine

Background:

• Hyperbaric oxygen therapy (HBOT), involving breathing pure oxygen at increased pressure, is established for specific conditions.
• Clinical guidelines for HBOT in acute carbon monoxide (CO) poisoning and clostridial necrosis are less defined.
• Assessing HBOT's efficacy using evidence-based medicine presents challenges.

Purpose of the Study:

• To systematically review the clinical efficacy of hyperbaric oxygen therapy (HBOT).
• To evaluate evidence for HBOT in acute indications and as adjuvant therapy.
• To identify challenges in applying evidence-based medicine criteria to HBOT.

Main Methods:

• A systematic literature review was conducted.
• The review assessed evidence for acute indications of HBOT.
• Part 2 of the review focused on adjuvant uses and evidence-based assessment challenges.

Main Results:

• HBOT is the gold standard for treating air/gas embolism and decompression illness.
• Evidence for HBOT's efficacy in acute CO poisoning and clostridial myonecrosis is less clear.
• The review examined indications including necrotizing wounds and arterial retinal occlusion.

Conclusions:

• HBOT is definitively indicated for specific conditions like gas embolism and decompression sickness.
• Further research is needed to clarify HBOT's role in other acute conditions such as CO poisoning.
• Evaluating HBOT effectiveness requires addressing limitations in current evidence-based medicine approaches.