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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
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 treating 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. We hope to have the information posted in the near future.
- History of hyperbaric medicine and oxygen
- 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
- Necrotizing soft tissue infections
- Radiation necrosis injury
- Brain abscess
- Crushing injuries
- Problem wounds
- Refractory bone infections
- Skin grafts and flaps
- Experimental Uses (to be posted)
- Bites from the brown recluse
- 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
Policy Coverage Bulletin
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.
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This page was revised on July 5, 2001.