F. Wattel et al., CLINICAL INDICATIONS OF HBO THERAPY - PAT IENT-MANAGEMENT - PERSONAL TRAINING, Bulletin de l'Academie nationale de medecine, 180(5), 1996, pp. 949-964
Pathophysiologic mechanisms involved in the application of HBO therapy
are poorly understood that may limit its clinical use. However, usefu
l indications are well standardized in the setting of critical care me
dicine, CO poisoning, decompression sickness, gas gangrene and soft ti
ssue anaerobic infections, crush syndrom, burns, sudden deafness... HB
O therapy is also indicated in the management of chronic limb ischemia
, diabetic foot lesion, osteomyelitis, osteoradionecrosis. These clini
cal indications have been evaluated in a Consensus Conference on Hyper
baric Medicine that has classified its application according to its ef
ficiency. Indications were classified as strongly recommended (positiv
ely affects the patient's survival), recommended (does not influence t
he patient's survival but is important for the prevention of serious d
isorders) and optional (regarded as a additional treatment modality).
Clinical application of HBO therapy requires specific equipments inclu
ding a multiplace hyperbaric chamber and specific educational program
and training for personel employed in the clinical hyperbaric center.
Lastly, HBO therapy is related to accurate rules defining its indicati
ons as well as its evaluation that are minimal prerequisites for safet
y and clinical results.