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Hyperbaric Medicine:
What Works and What Does Not?

Daniel S. Morrison, M.D.
R. Duncan Kirkby, Ph.D.

Hyperbaric medicine -- the delivery of pressurized oxygen to the body -- is best known for its ability to treat decompression sickness, a condition in which deep-sea divers who surface quickly develop nitrogen bubbles in their bloodstream. In recent years, it has also proven effective for treating carbon monoxide poisoning, difficult wounds, certain types of infections, and several other conditions. However, it is also widely promoted for illegitimate uses.

The information we present can guide you through the claims and counterclaims made for hyperbaric oxygen therapy (HBOT). We discuss its history, legitimate uses, experimental uses, and improper uses. Our overall advice to those seeking care is quite simple.

• Your first question should be whether the Undersea and Hyperbaric Medical Society approves the use of HBOT for ttrating the condition in question? If the answer is "yes," then consider using it in consultation with a physician who observes the guidelines and standards maintained by the Society.
• If hyperbaric oxygen is not approved for the specific medical condition, determine whether the treatment is part of an experimental protocol. If so, neither the patient nor the relevant provider of health coverage should have to pay for components of care related to or stemming from the experimental administration of the hyperbaric oxygen. Moreover, the protocol should include informed consent that meets established scientific standards.
• If the HBOT is neither approved nor part of a legitimate experimental protocol for treating a specific condition, you should assume that its use is not legitimate.

How to Navigate This Article

The total amount of information we present would occupy about 50 pages of an average book. If you only want to check whether HBOT can help a particular condition, you can go immediately to that topic. For a more through review, you can read the pages in sequence or follow the links to just the topics that interest you. (The information will be posted during the next few weeks)

• History of hyperbaric medicine and oxygen therapy
• Medical conditions for which HBOT is approved (to be posted)
  • Decompression sickness ("bends")
  • Gas embolism
  • Carbon monoxide
  • Cyanide poisoning
  • Gas gangrene
  • Anemia associated with sudden blood loss
  • Necrotizing soft tissue infections
  • Radiation necrosis injury
  • Brain abscess
  • Crushing injuries
  • Problem wounds
  • Burns
  • Refractory bone infections
  • Skin grafts and flaps
• Experimental Uses (to be posted)
  • Bites from the brown recluse spider
  • Hansen's disease (leprosy)
  • Necrosis of the head of the femur (thigh bone)
  • Intestinal obstruction
  • Severe head injury
  • Myocardial infarction (heart attack)
• Controversial and improper uses (to be posted)

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Dr. Morrison is a resident in emergency medicine at Sinai-Grace Hospital in Detroit, Michigan. Dr. Kirkby is Professor of Medical Neuroscience and Executive Director, Master's Program of Undersea and Hyperbaric Medicine at the University of Sint Eustatius School of Medicine, Netherlands-Antilles.