Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized environment. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a potential risk of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, bubbles of air in your blood vessels, and wounds that may not heal as a result of diabetes or radiation injury.

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized environment. Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, a potential risk of scuba diving. Other conditions treated with hyperbaric oxygen therapy include serious infections, bubbles of air in your blood vessels, and wounds that may not heal as a result of diabetes or radiation injury.


In Which Diseases Is Hyperbaric Oxygen Therapy Used?

Sudden hearing loss is a disease that develops in less than 3 days and can be diagnosed with audiometry, i.e. a hearing test. Although the cause of the disease is not known precisely, it is suggested that it may be caused by different reasons such as vascular and circulatory problems, infections and immune system diseases. The sooner the treatment is started, the higher the chance of success.

Hyperbaric oxygen therapy (HBOT) is thought to improve the hearing impaired due to ischemia, that is, decreased blood supply, by increasing the oxygen in the inner ear. Hyperbaric Oxygen Therapy is effective by improving inner ear metabolism, increasing oxygenation and resolving edema.

It has been shown that successful results have been obtained in patients who were treated within the first month following the development of sudden hearing loss. The aim is to prevent permanent damage to the inner ear.

Avascular necrosis

Avascular or otherwise known as aseptic necrosis is defined as the death of bone tissue due to malnutrition. It is frequently seen in the head area of the thigh bone in the leg. Although less common, it can also develop in different parts of the body such as arms, knees, wrists and feet.

Patients usually present with complaints of pain and limitation of movement. Although the cause of the disease is not known precisely, it develops due to the decrease in blood supply in the bone and thus oxygenation.

Hyperbaric oxygen therapy (HBOT) is effective by increasing oxygenation, especially in patients with early stage avascular necrosis. It has been reported that 93% of the patients who received HBOT in the early stage stopped the progression of the disease or recovered completely.

Radiation necrosis

Radiation necrosis, is an undesirable effect that occurs after a short or long time in some of the patients receiving radiotherapy. It can occur with different complaints depending on the area where radiotherapy is applied, the dose of radiotherapy and the patient’s own characteristics.

The nutrition and oxygenation of the area where radiotherapy is applied decreases and becomes more sensitive. The self-healing abilities of these regions are also decreasing. Even minor traumas can cause death in these tissues.


Hyperbaric oxygen therapy helps to eliminate the negative effects of radiotherapy on different tissues such as intestines, bladder, skin, brain tissue, genital organs and bone tissue. This increases the oxygen levels of tissues and supports the formation of new capillaries.

Suspected skin flaps and grafts

Skin grafts and flap applications are one of the most frequently used surgical operations in the treatment of non-healing, problematic wounds. It is also known as “skin patch surgeries” colloquially. In people with circulatory disorders, especially diabetics and patients with vascular occlusion, these operations may have a low chance of success.

Low oxygen levels prevent healing in grafts and flaps with suspected involvement. Hyperbaric oxygen therapy significantly increases the success rate of graft and flap operations with its effect of supporting circulation and increasing tissue oxygen. It is applied to prepare the wound area before the operation and to accelerate the healing after the operation.

Chronic Osteomyelitis

Osteomyelitis, is an infection of bone tissue that results in progressive bone death. Chronic osteomyelitis is defined as the chronicity of this infection due to inadequate treatment for a long time. The disease can persist for months or even years.

In the treatment of chronic osteomyelitis, besides drug applications, wound care and surgical interventions when necessary, hyperbaric oxygen therapy (HBOT) significantly increases the chance of success. Success rates reaching 90% with HBOT have been reported in the studies.

HBOT (Hyperbaric oxygen therapy) provides many different and beneficial effects in patients with chronic osteomyelitis. It accelerates wound healing, increases the oxygen level in the bone tissue, increases the effect of some antibiotics and helps the lesion area to be better blood.

HBOT is applied to patients with chronic osteomyelitis as well as some patients with acute osteomyelitis. It provides successful results in the healing of the bone and wound area in spine, skull bones and breastbone infections.

Conditions in which wound healing is delayed

Causes such as diabetes, vascular occlusion, circulatory failure and radiation therapy that prevent the healing of the tissues delay the closure of the wounds and ultimately lead to “problematic” wounds that do not heal. Chronic wounds that do not heal for a long time require many different specialties to work together. In addition to wound care, medication, surgical interventions, providing sufficient oxygen to the wound area is one of the important factors for healing.

Chronic wounds are hypoxic, meaning they have low oxygen levels. Especially in patients with diabetes and circulation problems, it is not possible to deliver sufficient oxygen to the wound area. In oxygen-free tissues, “anaerobic” (anaerobic) bacteria grow and these bacteria lead to the development of infection in the scar tissue. With hyperbaric oxygen therapy, it is possible to increase the oxygen levels in the wound tissue to sufficient levels for healing. While the partial pressure of oxygen is 5-20 mmHg in a wound that does not heal under normal conditions, this value can reach 1000-1700 mmHg with hyperbaric oxygen treatment.

Hyperbaric oxygen therapy also contributes to the healing of chronic wounds by increasing collagen synthesis, supporting healthy bone tissue and blood circulation, and increasing the effect of some antibiotics.

Crush injuries, compartment syndrome and other acute traumatic ischemia

Blood flow in the tissues decreases due to crushing, compression and prolonged immobility after accidents and disasters such as traffic accidents, trauma, earthquakes. When tissues and organs cannot be supplied with sufficient blood and oxygen, the process results in “necrosis”, ie death. Edema in these tissues is an important problem that prevents healing. Hyperbaric oxygen therapy (HBOT) provides a highly successful antiedematous effect. By reducing edema, increasing oxygen levels and supporting circulation, HBOT prevents tissue damage and tissue death, especially in ischemic wounds that develop as a result of motor vehicle accidents, gunshot injuries, dents, tight plaster and bandage applications.

Thermal burns

Burn; It is tissue damage that develops due to various physical and chemical factors such as electric current, heat, and radiation. Burns are classified in 4 degrees according to their width and depth:

  1. First degree burns: They are superficial burns. Often seen as sunburn and hot water burns. It heals without a trace.
  2. Second degree burns: These are deeper burns. It is very painful. Liquid-filled bubbles (bulla) form on the skin. It takes a longer time and heals by leaving a scar.
  3. Third degree burns: It includes all layers of the skin and affects the subcutaneous tissue as well. Sweat glands and hair follicles are also damaged. The skin loses its elasticity. It takes a very long time to heal and heals with intense scars.
  4. Fourth degree burns: The burn has reached deep organs such as bone tissue.

While mild burns can be treated on an outpatient basis, patients with severe burns may need to be hospitalized. The aim of treatment is to control edema, prevent tissue loss by providing sufficient oxygen, prevent the spread of damage, reduce the risk of infection, accelerate wound healing and protect patients against organ failure.

During hyperbaric oxygen therapy, oxygen levels increase, and it is possible to provide enough oxygen to the tissues with its vasoconstrictor and edema-reducing effect. With its anti-inflammatory effect, the inflammatory response that develops as a result of the burn blocks the cascade.

Hyperbaric oxygen treatment should be applied in burns that involve more than 20% of the body surface, burns accompanied by carbon monoxide poisoning and major trauma, electrical burns, burns of the hands, face, perineum, burns affecting the respiratory tract, and burns that develop in risky patients.

Freezing is also included in thermal injuries. It is a frozen hypothermia trauma. Blood circulation is impaired due to the severe narrowing of the veins. Tissues are damaged both as a result of impaired circulation and insufficient oxygenation, and during rewarming. Hyperbaric oxygen therapy offers an effective treatment method in cold bite or frostbite injuries as well as in hot burns.

Decompression sickness (Vurgun’s disease)

Decompression sickness is also known as ‘profite’. It is a diving disease that develops depending on dive time, depth, ascent speed and some personal factors. During diving, nitrogen gas, which is dissolved in the blood, cannot be discharged sufficiently as it rises to the surface, causing air bubbles to form in the veins and body tissues. It may progress with mild symptoms, or it may present with life-threatening severe pictures.

The disease is examined in 2 types:

  • Type 1 Decompression Disease: It is a mild decompression disease with joint pain and skin findings.
  • Type 2 Decompression Disease: It progresses with more severe symptoms. It can result in death by affecting the circulation, respiratory and nervous system.

The main treatment method for decompression sickness is hyperbaric oxygen therapy. In case of any doubt, the Underwater Medicine and Hyperbaric Medicine Specialist should be contacted without delay and the patient should be transferred to the nearest center with a pressure chamber under suitable conditions.

Air or gas embolism

Gas embolism is a disease that occurs as a result of the entry of air or other gas into the circulatory system, with mild or severe symptoms depending on the volume of the gas and the area of the blockage. It may develop during surgical procedures or due to diving. Asthma, COPD and some diseases that cause adhesions in the lungs can increase the risk of gas embolism. Hyperbaric oxygen therapy is the main treatment method in gas emboli. The patient should be transferred to the pressure room under suitable conditions and treatment should be started without wasting time. The success of treatment increases in patients who are treated early.

Carbon monoxide poisoning

Carbon monoxide gas is a colorless, odorless, tasteless and poisonous gas. It occurs as a result of incomplete combustion of carbon-containing substances. Generally, stove and water heater poisoning develop due to smoke exposure and exhaust gas inhalation during a fire. Carbon monoxide poisoning may progress with mild symptoms such as nausea, vomiting, fatigue, headache, dizziness, depending on the severity, as well as loss of consciousness, cardiac arrest and death.

Carbon monoxide gas binds to hemoglobin, which is in the blood and carries oxygen to the tissues, 200-240 times more than oxygen. As a result of not being able to carry enough oxygen to tissues with hemoglobin, many different signs and symptoms occur.

The course of the disease varies depending on the exposure time, the carbon monoxide concentration exposed, the time of initiation of the treatment and the method of oxygen therapy. Children, the elderly, pregnant women, those with some chronic diseases and those who have consumed alcohol are in the higher risk group of patients.

Treatment is based on breathing oxygen into the patient. Hyperbaric oxygen therapy is the main treatment method in severe poisoning and risky patients.

Hyperbaric oxygen therapy quickly removes carbon monoxide from hemoglobin. It ensures that high amounts of oxygen are dissolved in the blood and sufficient oxygen is transported to the tissues.

Gas gangrene and other necrotizing infections

Necrotizing infections are infectious diseases that are uncommon but impair the quality of life and can be life threatening. Foreign bodies may develop after surgical interventions or trauma, or they may occur without any known cause. Patients often have a risk factor such as cancer, diabetes, and immune system disease. In the early period following the injury, pain, edema, a crackling sound to the touch and a very foul-smelling discharge can be seen.

The common feature of these infections is hypoxia, in other words oxygen deficiency. It has been shown that the course of the disease is positively affected and the chance of success increases with the hyperbaric oxygen treatment applied in addition to medical and surgical treatments. Hyperbaric oxygen therapy increases the oxygen level, creating an unsuitable environment for bacteria breeding conditions. It enhances the effect of some antibiotics and supports the body’s immune system functions.

Retinal artery occlusion (sudden vision loss)

The retina, which is the main layer related to the visual function of the eye, is the tissue with the highest oxygen consumption in our body. Therefore, insufficient oxygen levels can cause rapid damage to the retina, leading to impaired vision. Any obstruction in the retinal vessel feeding the eye and in the branches of this vessel can cause sudden vision loss. This type of vision loss occurs suddenly and painlessly. Depending on the severity of the obstruction, it can be seen as partial vision loss or total vision loss.

Certain diseases such as vascular occlusion, hypertension, diabetes, and heart valve diseases may also increase the risk of retinal artery occlusions. After the examination by ophthalmologists, patients are diagnosed with a definitive diagnosis, drug treatments are arranged and they are referred for hyperbaric oxygen therapy as soon as possible.

Hyperbaric oxygen therapy increases the oxygen level in the retinal tissue where blood supply is impaired, and ensures the preservation of retinal vitality and functions. Patients diagnosed with sudden vision loss due to retinal artery occlusion should apply to a center with a pressure chamber as soon as possible.

Anoxic encephalopathy

Anoxic encephalopathy is a neurological condition that develops as a result of impaired oxygenation of the brain. It can occur for different reasons such as trauma, cardiac arrest, stroke, suffocation or poisoning. Brain tissue is one of the tissues most sensitive to oxygen deficiency in our body. When the oxygenation of the brain stops, consciousness disappears after 10 seconds and brain damage develops in a short time.

In anoxic encephalopathy, hyperbaric oxygen therapy allows oxygen to reach the oxygen-free areas of the brain by increasing the level of oxygen dissolved in the brain tissue and reducing brain edema. Patients should be treated as soon as possible, and care should be taken not to interrupt the patient’s other treatments and intensive care needs during hyperbaric oxygen therapy.