Conditions assessed

Chronic wounds and diabetic foot

Certain non-healing wounds, including selected diabetic foot ulcers, may be assessed for HBOT. Treatment sits within comprehensive care: metabolic control, vascular assessment, debridement where needed, pressure offloading and infection control.

Carbon monoxide poisoning

Carbon monoxide poisoning is an emergency. HBOT may be indicated in selected cases after urgent medical assessment. If exposure is suspected, call emergency services immediately; do not wait for a clinic appointment.

Radiation tissue injury

HBOT may be considered for certain delayed tissue injuries caused by radiotherapy, including osteoradionecrosis, and in some dental care situations for irradiated patients. The plan is agreed with the treating clinical team.

Other specialist indications

Decompression illness, gas embolism, certain severe infections, crush injuries and compromised grafts or flaps require specialist assessment. Some are emergencies and cannot wait for a routine outpatient programme.

Sports recovery — a cautious approach

The role of HBOT after some sports injuries is being studied, but evidence is not conclusive across all situations. We do not promise accelerated healing or improved performance. Return to sport is decided by the sports physician and rehabilitation team.

Autism — supportive therapy

HBOT may be assessed as a complementary, supportive therapy within an individual plan for children and adults on the autism spectrum. Some families and studies report improvements in aspects of functioning (such as communication, attention or behaviour), but the evidence is limited and results vary. It is not a cure and does not replace recommended educational and behavioural therapies. An individual medical evaluation is required.

Healthy ageing (anti-ageing)

HBOT may be considered as a supportive therapy for healthy adults interested in healthy ageing. A 2020 prospective study (Hadanny et al., Aging) reported longer telomeres and fewer senescent immune cells in the blood of adults aged 64+ after 60 sessions. These are preliminary findings from a small group; we do not promise rejuvenation or longer life. Suitability is decided after medical evaluation.

Stress and combat trauma (PTSD)

Studies suggest HBOT may help, as a complementary therapy, some people with treatment-resistant post-traumatic stress. A randomised controlled trial (Doenyas-Barak et al., PLoS ONE 2022, Shamir Medical Center, Israel) in veterans with combat-related PTSD reported symptom improvement and changes in brain structure and function after 60 sessions. HBOT does not replace psychotherapy or psychiatric care; individual evaluation, including psychiatric assessment, is required.

Children and infants with cerebral palsy (CP) — supportive therapy

For some children with cerebral palsy, HBOT may be assessed as a complementary therapy alongside physiotherapy and rehabilitation programmes. Some families and studies report improvements in aspects of functioning, but the evidence is mixed and results differ from child to child. It is not a cure. Infants and children require a dedicated paediatric assessment to determine whether the therapy is suitable and under what safety conditions.

After vascular events: stroke, myocardial infarction and others

After a stroke, HBOT may be assessed as a complement to standard neurological rehabilitation. A randomised trial (Efrati et al., PLoS ONE 2013) in patients 6–36 months after stroke reported improved neurological function and quality of life after 40 sessions; a retrospective analysis (Hadanny et al., 2020) reported cognitive improvements in the chronic phase. After a myocardial infarction or other vascular events, HBOT may be considered only as support during the recovery phase, after stabilisation and with the treating physician’s (e.g. cardiologist’s) approval. It never replaces cardiology, neurology or emergency care.

References

1. Hadanny A, et al. Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells: a prospective trial. Aging (Albany NY). 2020;12(22):22445–22456. https://doi.org/10.18632/aging.202188
2. Doenyas-Barak K, et al. Hyperbaric oxygen therapy improves symptoms, brain’s microstructure and functionality in veterans with treatment resistant post-traumatic stress disorder: a prospective, randomized, controlled trial. PLoS ONE. 2022;17(2):e0264161. https://doi.org/10.1371/journal.pone.0264161
3. Efrati S, et al. Hyperbaric oxygen induces late neuroplasticity in post stroke patients — randomized, prospective trial. PLoS ONE. 2013;8(1):e53716. https://doi.org/10.1371/journal.pone.0053716
4. Hadanny A, et al. Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients — a retrospective analysis. Restorative Neurology and Neuroscience. 2020. https://pubmed.ncbi.nlm.nih.gov/31985478/