Hyperbaric Oxygen Therapy: Principles and Applications

Contents
Abbreviations
1: History and Development of Hyperbaric Medicine
	1.1	 Brief History of Hyperbaric Medicine
	1.2	 HBOT and Radiosensitization
	1.3	 Future Perspectives of HBOT in Therapeutics
	References
2: Physiology of Oxygen Transport and Gas Laws
	2.1	 Composition of Air
	2.2	 Gas Laws
		2.2.1	 Henry’s Law
		2.2.2	 Dalton’s Law
		2.2.3	 Boyle’s Law
		2.2.4	 Amonton’s Law/Gay-Lussac’s Law
		2.2.5	 Ideal Gas Law
		2.2.6	 Fick’s Law of Gas Diffusion
		2.2.7	 Adiabatic Compression of Gases and Joule–Thomson Effect
		2.2.8	 LaPlace’s Law
	2.3	 Oxygen Transport in Normobaric and Oxygen–Hemoglobin Dissociation Curve
	References
3: Biochemical and Physiological Aspects of HBOT
	3.1	 Bohr Effect and Haldane Effect
	3.2	 Oxygen Consumption
	3.3	 Oxygen Debt
	3.4	 Oxidative Phosphorylation and Electron Transport Chain
	3.5	 Reactive Oxygen Species and Oxidative Damage
	3.6	 Physiology of Oxygen Utilization in HBOT
	3.7	 Nutraceuticals as an Accessory to HBOT
	References
4: Physiological Effects of Elevated Barometric Pressure
	4.1	 Effect of Increased Pressure on Physiological Functions
		4.1.1	 Effects on Hematological Functions
		4.1.2	 Changes in Cardiovascular and Skeletal System
		4.1.3	 Effect on Respiratory System
		4.1.4	 Effect of Other Atmospheric Gases on Physiological Functions
		4.1.5	 Effect on Neurological and Endocrine Functions
	4.2	 Pressure Considerations in HBOT
	References
5: Hyperbaric Chambers: Design and Function
	5.1	 Monoplace Chambers
		5.1.1	 Advantages of Monoplace Chambers
		5.1.2	 Drawbacks
	5.2	 Multiplace Chambers
		5.2.1	 Advantages of Multiplace Chambers
		5.2.2	 Drawbacks
	5.3	 Safety Measures and Other Considerations for Hyperbaric Facility
		5.3.1	 Staffing Requirements for Hyperbaric Facility
		5.3.2	 Risk Management and Risk Assessment
		5.3.3	 Procedures
		5.3.4	 Patient Safety
		5.3.5	 Fire Safety
	References
6: Transcutaneous Oximetry as an Assessment Tool in HBOT
	6.1	 Importance of Transcutaneous Oximetry in HBOT
	6.2	 Algorithms and Considerations in the Measurement of Transcutaneous Oxygen Tension
	References
7: Evaluating the Recommended Indications of HBOT
	7.1	 Air or Gas Embolism
		7.1.1	 Complications of Gas or Air Embolism
		7.1.2	 Management of air or Gas Embolism by HBOT
	7.2	 Carbon Monoxide (CO) Poisoning
		7.2.1	 HBOT as a Treatment Strategy for CO Poisoning
	7.3	 Central Retinal Artery Occlusion (CRAO)
		7.3.1	 Pathophysiology of Central Retinal Artery Occlusion (CRAO)
		7.3.2	 HBOT in Treatment of CRAO—Strategies and Clinical Evidences for its Effectiveness
	7.4	 Idiopathic Sudden Sensorineural Hearing Loss (ISSHL)
		7.4.1	 Idiopathic Sudden Sensorineural Hearing Loss (ISSHL)
		7.4.2	 Evaluation of HBOT as a Treatment Strategy for ISSHL
	7.5	 Wound Healing
		7.5.1	 Physiology of Wound Healing
		7.5.2	 Hyperbaric Oxygen Therapy as an Adjunctive Treatment for Wound Healing
	7.6	 Arterial Insufficiency—Diabetic Foot Ulcers and Problem Wound
		7.6.1	 Problem Wounds or Non-healing Wounds
		7.6.2	 HBOT for the Treatment of Non-healing Wounds
	7.7	 Chronic Wounds
		7.7.1	 Management of Chronic Wounds
		7.7.2	 Assessment of Chronic Wound and Wound Environment
		7.7.3	 HBOT for the Management of Chronic Wounds
	7.8	 Gas Gangrene or Clostridial Myonecrosis
		7.8.1	 Etiology and Clinical Complications of Gas Gangrene
		7.8.2	 HBOT as an Adjunctive Treatment for Gas Gangrene
	7.9	 Necrotizing Soft Tissue Infections
		7.9.1	 Necrotizing Soft Tissue Infections—Complications and Treatment Strategies
		7.9.2	 Use of HBOT against Necrotizing Soft Tissue Infections
	7.10	 Refractory Osteomyelitis
		7.10.1	 Refractory Osteomyelitis
		7.10.2	 Clinical Management of Refractory Osteomyelitis
		7.10.3	 Cierny-Mader Classification of Osteomyelitis
		7.10.4	 Treatment of Refractory Osteomyelitis by HBOT
	7.11	 Malignant Otitis Externa
		7.11.1	 Malignant Otitis Externa
		7.11.2	 Myringotomy as an Assessment Tool in Malignant Otitis Externa
		7.11.3	 Management of Malignant Otitis Externa by HBOT
	7.12	 Compromised Skin Grafts and Flaps
		7.12.1	 Considerations for Skin Grafts and Flaps
		7.12.2	 Wound Management on Compromised Grafts and Flaps
		7.12.3	 HBOT for Treatment of Compromised Grafts and Flaps
	7.13	 Crush Injuries
		7.13.1	 Classification of Crush Injuries and Challenges
		7.13.2	 Physiological and Biochemical Aspects of Crush Injuries
		7.13.3	 Effect of HBOT on Wound Healing in Crush Injuries
	7.14	 Severe Anemia
		7.14.1	 Clinical Scenario of Severe Blood Loss and Complications
		7.14.2	 Management of Severe Anemia by HBOT
	7.15	 Sickle Cell Anemia
		7.15.1	 Pathophysiology and Clinical Aspects of Sickle Cell Anemia
		7.15.2	 HBOT in Management of SCA
	7.16	 Decompression Sickness
		7.16.1	 Pathophysiology and Effects of Decompression Sickness
		7.16.2	 Use of HBOT as a Therapeutic in Treatment of Decompression Sickness
	7.17	 Intracranial Abscess
		7.17.1	 Pathogenic Condition and Host Defense in Intracranial Abscess
		7.17.2	 HBOT as an Adjunctive Therapy for Management of Intracranial Abscess
	7.18	 Femoral Head Necrosis
		7.18.1	 Pathogenesis and Staging of Femoral Head Necrosis
		7.18.2	 HBOT as an Aid against Femoral Head Necrosis
	7.19	 Thermal Burns
		7.19.1	 Pathophysiology of Burn Wounds
		7.19.2	 Role of HBOT in Treatment of Thermal Burns
	7.20	 Delayed Radiation Injuries
		7.20.1	 Pathology and Complications of Delayed Radiation Injuries
		7.20.2	 HBOT as an Aid in Treatment of Delayed Radiation Injuries
		7.20.3	 Marx’s Protocol for Radionecrosis Treatment Using HBOT
	References
8: HBOT in Emergency Procedures
	8.1	 Standard and Emergency Indications for HBOT
	8.2	 Potential Benefits of HBOT in Emergency Conditions
	References
9: Patient Selection and Patient Care
	9.1	 Patient Evaluation Before HBOT
	9.2	 Patient Selection Criteria
	References
10: HBOT in Aging and Regeneration
	10.1	 Aging and Regeneration
	10.2	 HBOT as a Regenerative and Anti-Aging Therapy
	References
11: Oxygen Toxicity and Side Effects of HBOT
	11.1	 Oxygen Toxicity
	11.2	 Mechanism of Oxygen Toxicity
	11.3	 Physiological Manifestations of Oxygen Toxicity
	11.4	 Side Effects of HBOT
		11.4.1	 Pulmonary Barotrauma
		11.4.2	 Middle Ear Barotrauma
		11.4.3	 Sinus/Paranasal Barotrauma
		11.4.4	 Dental Barotrauma
		11.4.5	 Other Side Effects of HBOT
	11.5	 Specific Drug Interaction with HBOT
	11.6	 Effect of HBOT on Drug Mechanism
	References
12: Contraindications of HBOT
	12.1	 Risk Assessment of Barometric Changes
	12.2	 Risk Assessment of Oxygen Breathing Under Hyperbaric Conditions
	12.3	 General Contraindications to HBOT
		12.3.1	 Absolute Contraindications
		12.3.2	 Relative Contraindications
	12.4	 Specific Cases for Contraindications
	References