Hyperbaric oxygen therapy: its use in medical emergencies and its development in Hong Kong

Hyperbaric oxygen therapy is widely accepted as life-saving treatment for decompression illness. Yet its use in acute carbon monoxide poisoning has remained controversial because of inconsistent findings in clinical trials. Hyperbaric oxygen therapy has an adjunctive role in managing gas gangrene, necrotising soft-tissue infection, and crush injury, as supported by case series. Several cases have been reported in the literature detailing the use of hyperbaric oxygen therapy in patients with severe anaemia in whom blood transfusion is not possible. Today, use of hyperbaric oxygen therapy in Hong Kong is limited by low awareness among physicians and patients, a lack of service access, and inadequate hospital and critical care support for the existing non-hospital facility. The recent introduction of a hospital-based facility is expected to benefit more patients for whom hyperbaric oxygen therapy is appropriate. This article reviews the mechanistic basis of and emerging scientific evidence to support the use of hyperbaric oxygen therapy in a number of acute medical emergencies, as well as the past and future development of hyperbaric oxygen therapy in Hong Kong.