A scoping review and evaluation of hyperbaric oxygen therapy for skeletal muscle injury in preclinical models

Although hyperbaric oxygen therapy (HBOT) is promising for the alleviation of limb trauma or crush muscle injuries, critical examination of the state of related science is lacking. We conducted a scoping review and evaluation of HBOT on muscle injury in preclinical models. A search of PubMed and Web of Science databases yielded 157 reports published from the start of the databases until November 7, 2024, which narrowed to 19 after removing duplicates, non-muscle studies, and dissertations/reviews. The studies involved mice or rats treated with tourniquets or exposed to a myotoxic agent (bupivacaine and cardiotoxin) or crush to induce muscle injury. HBOT counteracted metabolic effects and had differential effects on oxidative stress in the tourniquet model. Overall, HBOT promoted or quickened muscle regeneration initiated by myotoxic agents and crush. These findings also indicate that HBOT benefits may persist, and early initiation of HBOT is important. However, more sessions do not always yield better outcomes. The evaluation of the state of the science revealed that the inclusion of females in these studies is limited, and milder pressure levels have been undertested, which may be important for fewer adverse effects and access. Future research in these and other areas may lead to increased use and acceptability of HBOT for the treatment of limb trauma or crush muscle injuries.