Undersea Hyperb Med [JOURNAL]
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200 papers
Myocardial Ischemia-Associated Arterial Embolism Management from Pulmonary Cryotherapy.
Preheim B, Moayedi S, Chew KW … +1 more , Sethuraman K
Undersea Hyperb Med · 2025 · PMID 41429039
Watchman devices are increasingly implanted in patients with atrial fibrillation who cannot be anticoagulated. We report a case of a patient undergoing Watchman device insertion complicated by cerebral arterial gas embol...
Watchman devices are increasingly implanted in patients with atrial fibrillation who cannot be anticoagulated. We report a case of a patient undergoing Watchman device insertion complicated by cerebral arterial gas embolism. The treatment was delayed because the diagnosis was not initially considered. The patient was eventually treated with hyperbaric oxygen but sustained permanent disabilities. Watchman device implantation has a near 1% risk of arterial gas embolism. The possibility of cerebral gas embolism should be considered in patients emerging from anesthesia with neurologic deficits.
Recompression and Adjunctive Therapies in DCI Management in Divers: A Review of RCTs.
Fairhead T
Undersea Hyperb Med · 2025 · PMID 41429038
BACKGROUND: Decompression illness (DCI) poses significant risks for divers, particularly in remote locations with limited resources. Few randomized controlled trials (RCTs) exist, necessitating a review to consolidate cu...
BACKGROUND: Decompression illness (DCI) poses significant risks for divers, particularly in remote locations with limited resources. Few randomized controlled trials (RCTs) exist, necessitating a review to consolidate current evidence and support evidence-based treatment protocols. This review evaluates RCT evidence on the effectiveness of recompression treatment and adjunctive therapies for diving-related DCI. METHODS: This review included RCTs assessing recompression treatment or adjunctive therapies in managing DCI. Exclusions were non-human studies, trials on DCI prevention, non-English publications, incomplete trials, and those involving non-diving DCI. Databases searched from inception to May 15, 2023, included Ovid MEDLINE, CENTRAL, CINAHL, and EMBASE. Citation chasing was performed on June 1, 2023, using Web of Science. Risk-of-bias assessments were guided by considering the Cochrane risk-of- bias tool for randomized trials. RESULTS: Two RCTs were identified. One trial (n=180) indicated that tenoxicam might reduce the number of required recompressions from three (range 1-8) to two (range 1-6). The other trial (n=41) showed that a shorter initial recompression treatment table could decrease the number of recompressions (median one vs. two) in cases of mild DCI. DISCUSSION: Limitations included unblinded participants, small participant numbers, non-protocol interventions, participant blinding, and incomplete outcome data. Recommendations for future research include reaching a consensus on a universal scoring system to support the clear definition and selection of participants, subgroup analyses, and inter-trial comparisons.
Synergistic Neuroprotection by Caffeine and Astaxanthin Against CNS-OT.
Rosenberg M, Ezra R, Arieli R … +1 more , Barash U
Undersea Hyperb Med · 2025 · PMID 41429037
BACKGROUND: Central nervous system oxygen toxicity (CNS-OT) is a critical concern for Navy divers using closed-circuit rebreathers who are subjected to prolonged exposure to hyperbaric oxygen levels. We explored the pote...
BACKGROUND: Central nervous system oxygen toxicity (CNS-OT) is a critical concern for Navy divers using closed-circuit rebreathers who are subjected to prolonged exposure to hyperbaric oxygen levels. We explored the potential of specific dietary supplements, caffeine, and astaxanthin, to delay the onset of CNS-OT. METHODS: Experiments were conducted using male C57BL/6 mice exposed to pure oxygen at 507 kPa, with latency to tonic-clonic seizures recorded. Mice were orally administered caffeine (1.25, 2.5, or 5 mg/ kg), astaxanthin (8 mg/kg), or a vehicle (water). RESULTS: Caffeine and astaxanthin significantly extended the latency period to seizure onset (p<0.03). Notably, combining caffeine and astaxanthin (p<0.001 vs. control) provided better protection against CNS-OT than either substance alone. CONCLUSION: Our results suggest that administering caffeine and astaxanthin before hyperbaric oxygen exposure delays hyperoxia-induced seizures.
Increased ventilatory response to carbon dioxide after dive training.
Ekman L, Sjöblom C, Ekström M … +1 more , Frånberg O
Undersea Hyperb Med · 2025 · PMID 41429036
INTRODUCTION: Divers are reported to have a lower ventilatory response to elevated levels of carbon dioxide (CO₂) than non-divers. Hypoventilation with CO₂ retention during diving is potentially dangerous. It is unknown...
INTRODUCTION: Divers are reported to have a lower ventilatory response to elevated levels of carbon dioxide (CO₂) than non-divers. Hypoventilation with CO₂ retention during diving is potentially dangerous. It is unknown if CO₂ retention is largely inherited or develops during diving training. We aimed to investigate if a military dive training course would influence the ventilatory response to CO₂. METHODS: Novice rebreather Divers with Amphibious Rangers as controls were tested at baseline, after 12 weeks of water exercise training, and after 15 weeks of diving: participants rebreathed in a Douglas bag filled with an initial 100% oxygen, resulting in increasing levels of inspiratory CO₂ (iCO₂). The test was performed until symptom-limitation or an expiratory CO₂ of 8.0 kPa. To decrease conscious control of breathing, participants were distracted with a memory game during the test. Differences between groups and over time were analyzed using independent and paired t-tests. RESULTS: Ten Divers and six Amphibious Rangers completed baseline testing and eight Divers completed all tests. Divers had a statistically significant higher Minute Ventilation (V'E) after dive training, compared to after water exercise training and baseline, at all levels of iCO₂. However, the change in Hypercapnic ventilatory response (HCVR) before and after dive training across pCO₂ values 5.0-7.9, did not reach statistical significance. At baseline, Amphibious Rangers had a non-significant higher V'E compared to Divers at higher levels of iCO₂. CONCLUSION: A military rebreather diving program might be associated with increased ventilatory response to CO₂.
Decompression at 1.3 versus 1.6 bar and Nitrogen Elimination and Venous Gas Emboli: A Randomized Controlled Trial.
Plogmark O, Hjelte C, Olsson M … +2 more , Ekström M, Frånberg O
Undersea Hyperb Med · 2025 · PMID 41429035
INTRODUCTION: The optimal depth for decompression stops is unclear. We hypothesize that a decompression stop at 1.3 bar, compared with 1.6 bar, decreases post-dive whole-body nitrogen washout volumes and venous gas embol...
INTRODUCTION: The optimal depth for decompression stops is unclear. We hypothesize that a decompression stop at 1.3 bar, compared with 1.6 bar, decreases post-dive whole-body nitrogen washout volumes and venous gas emboli (VGE). METHODS: In this randomized crossover trial, divers performed wet air dives of 40 minutes at 3.4 bar (340 kPa) with a seven-minute-long decompression stop at either 1.3 bar (Deco 1.3) or 1.6 bar (Deco 1.6) in randomized order. The primary outcome was the difference in post-dive whole body nitrogen washout volume, analyzed using multilevel linear regression. The secondary outcome was the difference in peak VGE detected by cardiac two-dimensional ultrasound, graded using the Eftedal-Brubakk scale, and analyzed with Wilcoxon matched-pairs signed-rank tests. RESULTS: Sixteen divers completed both Deco 1.3 and Deco 1.6. Post-dive whole body nitrogen washout volumes were measured in eight of the 16 participants and were lower with Deco 1.3 than Deco 1.6 (696 ml [95% confidence interval [CI], 601 to 790] versus 1068 ml [95% CI, 962 to 1174]), mean difference of 373 ml (95% CI, 243 to 502). Deco 1.3 had lower peak bubble grades than Deco 1.6 (interquartile range 2-3 versus 3-4; P=0.005), but the median grade was the same at 3. CONCLUSIONS: Decompression stop at 1.3 bar instead of 1.6 bar decreased post-dive whole body nitrogen washout volume and VGE. These findings may inform the development of future decompression models.
Case Report: Complete Coverage Of Chronic Sickle Cell Leg Ulcer Using Hyperbaric Oxygen Therapy Combined With Skin Grafting.
Luhulla K, Martin Q, Bhoke A … +5 more , Mahfudh S, Nkya A, Magohe A, Yonazi M, Buckey JC
Undersea Hyperb Med · 2025 · PMID 41429034
INTRODUCTION: A chronic leg ulcer is a serious complication of sickle cell anemia. The ulcers are treatment- resistant, recur frequently, and are associated with more severe disease. Treatment options for chronic leg ulc...
INTRODUCTION: A chronic leg ulcer is a serious complication of sickle cell anemia. The ulcers are treatment- resistant, recur frequently, and are associated with more severe disease. Treatment options for chronic leg ulcers in patients with sickle cell disease are limited. Hyperbaric oxygen (HBO₂) therapy is a promising therapy for the management of sickle cell chronic leg ulcers as it relieves hypoxia, promotes angiogenesis, and reduces wound inflammation. CASE: A 35-year-old male with sickle cell anemia with a chronic leg ulcer for one year, despite regular wound dressing and antibiotics, was then successfully managed through HBO₂ therapy followed by skin grafting. CONCLUSION: HBO₂ therapy was effective in this case and has also shown effectiveness as an adjunct therapy in the management of sickle cell-related chronic leg ulcers in other case reports. This supports the need for further research in this area.
Reversal of a Globus Pallidus Injury in a Severe Carbon Monoxide Poisoned Patient.
Graffeo CS, Petitt MJ, Neubauer LE … +2 more , Steckler GD, Knapp BJ
Undersea Hyperb Med · 2025 · PMID 41429033
Carbon monoxide (CO) is an important source of poisoning in the United States and accounts for over 50,000 emergency department (ED) visits annually. Of these, almost 15,000 cases are reported as intentional, with over 1...
Carbon monoxide (CO) is an important source of poisoning in the United States and accounts for over 50,000 emergency department (ED) visits annually. Of these, almost 15,000 cases are reported as intentional, with over 1,000 deaths annually reported in the USA.1 Unintentional deaths from carbon monoxide poisoning are commonly associated with the improper use of generators, heaters, or other sources of combustion, such as malfunctioning home appliances or vehicular exhaust [2,3]. We describe a case of severe intentional CO poisoning that had reversal of CT and MRI findings that were consistent with a globus pallidus injury and a favorable clinical outcome in an adult male treated with Hyperbaric Oxygen Therapy (HBO₂). There are currently conflicting data and guideline recommendations regarding the utility of HBO₂ in the management of CO.4 This case provides additional evidence for HBO₂ treatment in a patient population whose clinical presentation and imaging findings are consistent with severe poisoning.
Hyperbaric Oxygen Therapy Enhances Autologous Bone Graft Integration: A Meta-Analysis.
Zulfiqar A, Spindari K
Undersea Hyperb Med · 2025 · PMID 41429032
BACKGROUND: Autologous bone grafting is crucial in reconstructive surgeries, yet high-risk patients often face challenges in achieving robust graft integration. Hyperbaric Oxygen Therapy (HBO₂) has been proposed to impro...
BACKGROUND: Autologous bone grafting is crucial in reconstructive surgeries, yet high-risk patients often face challenges in achieving robust graft integration. Hyperbaric Oxygen Therapy (HBO₂) has been proposed to improve graft outcomes by enhancing osteogenesis and vascularization. This systematic review and meta-analysis evaluated HBO₂'s efficacy in promoting autologous bone graft integration and identified contexts in which HBO₂ may be most beneficial. METHODS: A systematic search identified 11 studies that met the inclusion criteria, of which seven provided quantitative data for meta-analysis. Random-effects models generated pooled Standardized Mean Differences (SMD) and assessed heterogeneity (I²). Subgroup analysis focused on orthopedic applications. RESULTS: Compared to control groups, HBO₂ demonstrated a moderate to strong effect on bone graft integration in the primary analysis (SMD: 1.476, 95% CI: 0.814-2.138). However, heterogeneity was substantial (I² ≈ 77%), reflecting diverse protocols and patient populations. A subgroup of orthopedic studies showed a stronger, consistent effect (SMD: 1.995, 95% CI: 1.117-2.873) with low heterogeneity (I² = 3.361%). Although observational data suggest potential benefits in maxillofacial grafts, many studies in this domain are small or lack controls. One cranial study reported a negative result, indicating possible variability in craniofacial contexts. CONCLUSIONS: HBO₂ appears to substantially enhance autologous bone graft integration, particularly in orthopedic and high-risk patients, by stimulating osteogenesis and vascularization. Nonetheless, reliance on animal models, limited human data in maxillofacial settings, and considerable heterogeneity underscore the need for further research, standardized protocols, and well-powered clinical trials to confirm HBO₂'s effectiveness across diverse grafting scenarios.
Systematic Review of Otologic Adverse Events in Hyperbaric Oxygen Therapy.
Voigt A, Laspro M, Thys E … +2 more , Jethanamest D, Chiu ES
Undersea Hyperb Med · 2025 · PMID 41429031
OBJECTIVES: Hyperbaric Oxygen (HBO₂) Therapy has been associated with some risks and adverse events. Previous studies examining otologic complications from HBO₂ therapy vary in their reported incidence of adverse events....
OBJECTIVES: Hyperbaric Oxygen (HBO₂) Therapy has been associated with some risks and adverse events. Previous studies examining otologic complications from HBO₂ therapy vary in their reported incidence of adverse events. This study aims to systematically review the otologic complications associated with HBO₂ therapy and investigate contributing risk and protective factors. REVIEW METHOD: A systematic review was conducted to identify studies reporting otologic adverse effects due to HBO₂ therapy. Utilizing PRISMA 2020 guidelines, titles and abstracts were screened before conducting a full-text analysis. Studies reporting the incidence of otologic complications and studies reporting risk or protective factors for otologic complications were included. RESULTS: A search for articles on HBO₂ therapy otologic complications yielded 2,027 articles, of which 183 were relevant to the research question. Ultimately, 54 studies met the inclusion criteria. Fifteen percent of the 18,284 patients treated with HBO₂ therapy experienced adverse events. Of the middle ear barotrauma (MEB) that occurred, 42.8% was mild, and 6.4% was severe. The major risk factors were increasing age, female sex, head and neck pathology, sensory neuropathy, and pre-treatment difficulty equalizing ear pressure. The main protective factor was experience with effective equalization techniques. CONCLUSIONS: 15% of patients experienced otologic complications due to HBO₂ therapy. Older age, female sex, and a history of head and neck or neurological conditions may increase the risk for MEB. Increased monitoring of higher-risk patients during initial treatment sessions and proper equalization techniques may help prevent MEB during HBO₂ therapy. This is the most comprehensive systematic review on the topic to date.
Transcutaneous Oximetry Optimizes Clinical Management and Cost-Effectiveness of Diabetic Foot Ulcers Treated with Hyperbaric Oxygen: A Review of Point-of-Care Vascular Screening Options.
Clarke RE
Undersea Hyperb Med · 2025 · PMID 41429030
Hyperbaric oxygen therapy has been employed to treat diabetic foot ulcers for more than four decades. While supported by some high-quality evidence, there is sufficient conflicting data to render its use open to criticis...
Hyperbaric oxygen therapy has been employed to treat diabetic foot ulcers for more than four decades. While supported by some high-quality evidence, there is sufficient conflicting data to render its use open to criticism. Even systematic and other reviews favorably disposed to this treatment adjunct invariably plead for better patient selection. Common among several causes of non-healing ulcers is persistent hypoxia. Transcutaneous oximetry uniquely measures tissue oxygen tension. Combination air and oxygen testing provides an evidence-based approach to hyperbaric patient selection through demonstration of locally reversible hypoxia. Transcutaneous oximetry differentiates hyperbaric responders from non- responders early in their treatment course by detecting neoangiogenesis, thereby providing a basis for continuing hyperbaric dosing only in those who benefit. Finally, such testing guides therapeutic endpoint determination, namely, normalized peri-ulcer oxygen tensions. This contrasts with continuing medically unnecessary and costly hyperbaric treatments until wound closure. Measurements of blood pressure and blood flow are imperfect surrogates for oxygen delivery. Recently introduced near-infrared spectroscopy and long-wave infrared thermography provide insights into tissue oxygen saturation and changes in micro-vascular density, respectively. Neither, however, guides clinically efficacious and cost-effective hyperbaric oxygenation in the manner afforded by transcutaneous oximetry. This paper describes evidence-based guidance on hyperbaric oxygen dosing for diabetic foot ulcers, reviews point-of-care screening options, and argues for the continued superiority of transcutaneous oximetry in the current era.
Dermatologic medical ozone therapy complications treated with hyperbaric oxygen.
McCray P, Johnson-Arbor K
Undersea Hyperb Med · 2025 · PMID 41429029
INTRODUCTION: Medical ozone therapy, which involves topical or systemic administration of ozone gas, is promoted as a treatment for various infections and inflammatory conditions, although evidence supporting its clinica...
INTRODUCTION: Medical ozone therapy, which involves topical or systemic administration of ozone gas, is promoted as a treatment for various infections and inflammatory conditions, although evidence supporting its clinical effectiveness in humans is limited. Medical ozone administration is also associated with serious adverse effects, including gas embolus and fatality. We present the case of a patient who experienced dermatologic complications after receiving medical ozone therapy. The complications were managed with surgical intervention and hyperbaric oxygen therapy. CASE REPORT: A 43-year-old female was administered medical ozone therapy injections to the temples and central forehead by a dermatologist to enhance hair growth and collagen formation. After the procedure, the patient experienced worsening alopecia and scarring in the treated areas. She eventually underwent surgical excision and closure that was performed by a plastic and reconstructive surgeon. Intraoperatively, she was noted to have significantly fibrotic, scarred, and poorly vascularized tissue, which raised concern for poor wound healing. Her plastic surgeon referred her for adjunctive hyperbaric medicine evaluation to treat presumed skin flap vascular compromise. She completed a course of forty hyperbaric oxygen treatments before returning to the plastic surgeon for scar tissue excision and local tissue rearrangement that ultimately resulted in acceptable cosmesis. CONCLUSION: While medical ozone therapy may result in favorable effects on a cellular level, the treatment is associated with significant clinical risks that may outweigh its potential therapeutic benefits. Systemic hyperbaric oxygenation may enhance vascularity and improve the quality of devitalized tissue in areas previously treated with medical ozone therapy.
Evaluation of the efficacy of modified low-dose HBO₂ therapy.
Kumar S, Kansal V, Chaudhry HBS … +2 more , Bhutani S, Mohanty CS
Undersea Hyperb Med · 2025 · PMID 41429028
BACKGROUND: The COVID-19 pandemic, being an airborne disease, posed a challenge in providing Hyperbaric Oxygen (HBO2) Therapy in multiplace chambers by increasing the risk of cross-infectivity while on air break inside t...
BACKGROUND: The COVID-19 pandemic, being an airborne disease, posed a challenge in providing Hyperbaric Oxygen (HBO2) Therapy in multiplace chambers by increasing the risk of cross-infectivity while on air break inside the chamber. The standard regimen consisting of two air breaks was modified, and a new low-dose HBO₂ therapy regimen with no air breaks was introduced to mitigate the risk of cross- infection. This study aimed to evaluate the efficacy of the modified HBO₂ therapy regimen compared to the standard HBO2 therapy regimen for patients with soft tissue radiation injury. METHODS: A retrospective observational study compared the modified low-dose HBO₂ therapy regimen of 2.4 Atmosphere Absolute (ATA) for 60 minutes without air-break vis-a-vis the standard regimen of 2.4 ATA for 100 minutes with two air breaks of five minutes each. Patients with soft tissue radiation injury in the form of radiation cystitis and radiation proctitis were selected for comparison in the study. Data was retrieved from patients who underwent the standard and modified regimen during the COVID-19 pandemic. Late Effects Normal Tissue (LENT)/ Subjective Objective Management Analytic (SOMA) questionnaire-based scoring was compared for 30 sessions of HBO₂ therapy. Standard biostatistical methodology was used to compare the outcomes of both regimens. RESULTS: The mean LENT SOMA score decreased from the baseline to the end of 30 sessions in the HBO₂ therapy protocols. Overall, mean values decreased more for the patients who were offered the standard regimen of HBO₂ therapy. CONCLUSION: A modified low-dose HBO₂ therapy treatment regimen achieved statistically significant therapeutic benefits. However, the results were statistically more promising for the patients who underwent the standard HBO₂ therapy regimen.
Safety Of Hyperbaric Oxygen Therapy In Patients Aged 75 And Older: A Multicenter Retrospective Study.
Cracchiolo AN, Palma DM, Saporito EFG … +7 more , Palazzolo C, Mannino SM, Genco F, Vitale F, Profera L, Raineri SM, Accurso G
Undersea Hyperb Med · 2025 · PMID 41429027
BACKGROUND: The increasing life expectancy presents new challenges in managing elderly patients requiring hyperbaric oxygen (HBO₂) therapy. This retrospective study evaluates the safety and adherence to HBO₂ guidelines i...
BACKGROUND: The increasing life expectancy presents new challenges in managing elderly patients requiring hyperbaric oxygen (HBO₂) therapy. This retrospective study evaluates the safety and adherence to HBO₂ guidelines in patients aged 75 years and older, focusing on side effects and adverse events. METHODS: Data from 69 elderly patients treated between 2019 and 2023 at two Sicilian hyperbaric centres were analyzed. Demographics, indications for HBO₂, comorbidities, treatment protocols, and side effects were collected. Pre-treatment evaluations included ENT checkups, ECG, chest X-rays, and laboratory tests. Patients underwent HBO₂ sessions at 2.4-2.8 ATA, with clinical monitoring pre-and post-treatment. RESULTS: 1,799 HBO₂ sessions were performed in 69 patients (mean age 78 years; 59.4% male). The most common indications were progressive necrotizing infections (33.3%), sudden sensorineural hearing loss (17.3%), and chronic radiation-induced tissue injuries (14.5%). Side effects occurred in 14 patients (20.3%), primarily middle ear barotrauma (8.7%), sinus barotrauma (4.3%), confinement anxiety (4.3%), hypoglycemia (1.4%), and chest pain (1.4%). Most side effects were resolved with prompt care, and no life-threatening events were recorded. Adherence to guidelines and meticulous pre-treatment evaluations minimized risks. CONCLUSIONS: HBO₂ is a safe therapeutic option for elderly patients when strict pre-treatment evaluations and monitoring protocols are implemented. Despite this population's increased vulnerability, the incidence of side effects was comparable to that in younger cohorts. Future research is warranted to optimize treatment protocols and explore outcomes in larger elderly populations.
Acute Traumatic Ischemias: Roles of Hyperbaric Oxygen.
Strauss MB
Undersea Hyperb Med · 2025 · PMID 41223400
Acute traumatic ischemias are a constellation of disorders that range from crush injuries to compartment syndromes, from burns to frostbite, and from threatened flaps to compromised re-implantations. They represent a sig...
Acute traumatic ischemias are a constellation of disorders that range from crush injuries to compartment syndromes, from burns to frostbite, and from threatened flaps to compromised re-implantations. They represent a significant economic burden to the health care system. In 2016, the National Trauma Organization reported that $672 billion was spent on trauma care without consideration for loss of employment income and psychological trauma associated with the problems. In the most severe orthopedically related traumatic ischemias, for example, Gustilo Grade III-B & C open fractures [1]. Fifty percent complication rates occur even with state of the art orthopaedic and other optimal ancillary care. Hyperbaric oxygen (HBO₂) has mechanisms that mitigate the pathophysiology of the traumatic ischemias with the potential for improving those that have predicably less than optimal outcomes. This selection discusses the surgical types of traumatic ischemias, focusing primarily on crush injuries. It is noteworthy that all the traumatic ischemias have similar pathophysiology. Other sections of this Hyperbaric Medicine Indications Manual are specifically devoted to burn injuries and threatened flaps and grafts.
The Effect of Hyperbaric Oxygen on Compromised Grafts and Flaps.
Childers EJ, Baynosa RC
Undersea Hyperb Med · 2025 · PMID 41223399
The use of grafts and flaps serves as an integral tool in the armamentarium of the reconstructive surgeon. Proper planning and surgical judgment are critical in the ultimate success of these procedures. However, there ar...
The use of grafts and flaps serves as an integral tool in the armamentarium of the reconstructive surgeon. Proper planning and surgical judgment are critical in the ultimate success of these procedures. However, there are situations when grafts and/or flaps can become compromised and require urgent intervention for salvage. These instances can include irradiated or otherwise hypoxic wound beds, excessively large harvested grafts, random flap ischemia, venous or arterial insufficiency, and ischemia- reperfusion injury. Alternatively, compromised grafts and flaps can be inadvertently created secondary to trauma. It is in these types of cases that HBO₂ therapy can serve as a useful adjunct in the salvage of compromised flaps and grafts. This review outlines the extensive basic science and clinical evidence available in support of the use of HBO₂ therapy for compromised grafts and flaps. The literature demonstrates the benefit of adjunctive HBO₂ therapy for multiple types of grafts and flaps with various etiologies of compromise. HBO₂ therapy can enhance graft and flap survival by several methods including decreasing the hypoxic insult, enhancing fibroblast function and collagen synthesis, stimulating angiogenesis, and inhibiting ischemia-reperfusion injury. The expedient initiation of hyperbaric oxygen therapy as soon as flap or graft compromise is identified maximizes tissue viability and ultimately graft/flap salvage.
Does Covid-19 Cause Avascular Necrosis?
Canarslan-Demir K, Ozgok-Kangal K, Artan E … +1 more , Turgut B
Undersea Hyperb Med · 2025 · PMID 41223398
COVID-19 has been associated with an increased risk of avascular necrosis (AVN), which affects various joints, including the hip, vertebrae, knee, and jaw. Understanding AVN's pathogenesis and risk factors as a consequen...
COVID-19 has been associated with an increased risk of avascular necrosis (AVN), which affects various joints, including the hip, vertebrae, knee, and jaw. Understanding AVN's pathogenesis and risk factors as a consequence of COVID-19 is essential for improving treatment and identifying preventive measures. This retrospective cohort study aims to assess the impact of COVID-19 on the etiology of AVN and raise awareness among clinicians. The study analyzed patients diagnosed with AVN and treated with Hyperbaric Oxygen Therapy at Gülhane Training and Research Hospital from January 2018 to January 2023. Patients were categorized into two groups: those admitted before the pandemic (the control group) and those admitted after (the study group). The results showed a significant increase in AVN cases during the post-pandemic period, with a higher incidence of femoral head involvement and more advanced stages of AVN in patients with a history of COVID-19. The findings suggest that COVID-19 and high-dose steroid use may increase AVN risk, highlighting the need for careful steroid management and monitoring for joint pain in these patients. Further research is recommended to explore the link between COVID-19 and AVN, the duration of symptoms, and the prognostic implications.
Rapid Progression of Cutaneous Large B-Cell Lymphoma During Hyperbaric Oxygen Therapy: A Case Report.
Kelly M, Jones ET, Shapshak D
Undersea Hyperb Med · 2025 · PMID 41223397
We present a case of a patient with a history of chronic lymphocytic leukemia (CLL) and cutaneous B-cell lymphoma of the right leg. She had previously received radiation treatment to the affected area and subsequently de...
We present a case of a patient with a history of chronic lymphocytic leukemia (CLL) and cutaneous B-cell lymphoma of the right leg. She had previously received radiation treatment to the affected area and subsequently developed radiation fibrosis with two non-healing ulcerations at the previous tumor sites. A biopsy revealed spongiotic and sparse superficial perivascular dermatitis. Due to poor wound healing, adjunctive hyperbaric oxygen (HBO₂) therapy was initiated. However, shortly after beginning HBO₂ treatments, the wounds worsened. Repeat biopsies were performed, and the new areas were consistent with cutaneous large B-cell lymphoma. Consequently, HBO₂ therapy was discontinued, and aggressive chemotherapy/immunotherapy was initiated. We recommend that patients with a history of cutaneous B-cell lymphoma be closely monitored for signs of tumor recurrence or disease worsening if they are to undergo adjunctive hyperbaric oxygen therapy.
Myocardial Ischemia-Associated Arterial Embolism Management from Pulmonary Cryotherapy.
Elkhatib WY, Teixeira MT, Welch BT … +3 more , LeTourneau WM, Diedrich DA, Toups G
Undersea Hyperb Med · 2025 · PMID 41223396
A 52-year-old male undergoing pulmonary lesion cryoablation developed transient intraprocedural and postprocedural hypotension, transient ST elevations on telemetry with associated bradyarrhythmia, and computed tomograph...
A 52-year-old male undergoing pulmonary lesion cryoablation developed transient intraprocedural and postprocedural hypotension, transient ST elevations on telemetry with associated bradyarrhythmia, and computed tomography imaging revealing arterial gas embolism within the left ventricle and aorta. Coordinated multidisciplinary efforts involving interventional radiology, anesthesiology, cardiology, critical care, and hyperbaric medicine were employed to ensure a successful recovery, alongside important management considerations aimed at minimizing adverse outcomes.
Hyperbaric oxygen therapy for high performance athletes: a narrative review.
Johnson-Arbor K
Undersea Hyperb Med · 2025 · PMID 41223395
Elite athletes who sustain severe injuries may experience physiological, psychological, and financial repercussions. Many therapies, including hyperbaric oxygenation (HBO₂), have been investigated as potential methods of...
Elite athletes who sustain severe injuries may experience physiological, psychological, and financial repercussions. Many therapies, including hyperbaric oxygenation (HBO₂), have been investigated as potential methods of preventing and treating injuries in elite athlete populations. This narrative review explores several applications of HBO₂ therapy relevant to athletes, based on the available human and animal literature. In animal studies, the administration of HBO₂ is associated with improved muscle healing after soft tissue injury. Although human studies are inconclusive, some data suggest that short courses of HBO₂ may result in reduced pain and faster return to play after soft tissue musculoskeletal injury. For individuals with sequelae of traumatic brain injury, limited data suggest that HBO₂ may improve neurobehavioral symptoms. However, studies involving the use of hyperbaric oxygen therapy to treat concussions in athletes are limited. Mild HBO₂ has been used to facilitate post-exercise recovery and reduce fatigue and performance decrements. The treatment vessels used to deliver mild HBO₂ are typically intended for treating altitude sickness only. They are associated with safety and regulatory concerns when used for other purposes, including athletic recovery. Overall, there is limited evidence to support the use of HBO₂ to enhance recovery in athletes with musculoskeletal and mild traumatic brain injury. Further investigations should explore the optimal use of this therapy in the elite athlete population.
Hyperbaric Oxygen Treatment for Long-COVID syndrome: A Systematic Review of Current Evidence on Cognitive Decline.
Zamora FV, Santos ACFF, Zamora AV … +5 more , Galvao LKCS, Pimenta NDS, Salles JPCEA, Carneiro VB, Starling CEF
Undersea Hyperb Med · 2025 · PMID 41223394
INTRODUCTION: There is no established specific treatment for long-COVID syndrome (LCS), yet hyperbaric oxygen (HBO₂) treatment has been studied as a potential option. Therefore, we conducted a systematic review to evalua...
INTRODUCTION: There is no established specific treatment for long-COVID syndrome (LCS), yet hyperbaric oxygen (HBO₂) treatment has been studied as a potential option. Therefore, we conducted a systematic review to evaluate the benefits of HBO₂ treatment in LCS patients. METHODS: We systematically searched PubMed, Embase, and Cochrane databases until April 2024. Risk of bias and GRADE quality assessment were evaluated. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42024530421. RESULTS: Seven studies from seven countries, divided into RCTs and observational studies, included 199 participants. HBO₂ treatment protocols included breathing 100% oxygen at 2.0 ATA until 2.5 ATA; the number of sessions varied from ten to 60 depending on the patient's comorbidities and symptoms. Memory, executive function, attention, fatigue, and pain level improved with HBO2 treatment. The intervention had minimal side effects, and none were serious. CONCLUSION: HBO₂ treatment might be a potential option and safe treatment in LCS patients. However, further research should be focused on evaluating its efficacy in a larger number of patients through randomized studies.
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