Hyperbaric medicine explained

Hyperbaric medicine

Hyperbaric medicine is a medical treatment in which an increase in barometric pressure over ambient pressure is employed increasing the partial pressures of all gases present in the compressed air. The immediate effects include reducing the size of gas embolisms and raising the partial pressures of all gases present according to Henry's law.Currently, there are two types of hyperbaric medicine depending on the gases compressed, hyperbaric air and hyperbaric oxygen.

Hyperbaric air (HBA), consists of compressed room air (79% nitrogen, 21% oxygen, and minor gases) and is FDA-approved for acute mountain sickness. The hyperbaric air environment is created by placing the patient in a portable hyperbaric air chamber and inflating that chamber up to 7.35 psi gauge (1.5 atmospheres absolute) using a foot-operated or electric air pump. Although the mechanisms of hyperbaric air are poorly understood it is thought that it relieves hypoxemia caused by the decreased partial pressure of oxygen resulting from high altitude by increasing the partial pressure of air (including oxygen and nitrogen) simulating a descent in altitude.[1] [2] [3]

Hyperbaric oxygen therapy (HBOT), the medical use of greater than 99% oxygen at an ambient pressure higher than atmospheric pressure, and therapeutic recompression for decompression illness, intended to reduce the injurious effects of systemic gas bubbles by physically reducing their size and providing improved conditions for elimination of bubbles and excess dissolved gas.

The equipment required for hyperbaric oxygen treatment consists of a Pressure vessel for human occupancy, which may be of rigid or flexible construction, and a means of a controlled atmosphere. Operation is performed to a predetermined schedule by trained personnel who monitor the patient and may adjust the schedule as required. HBOT found early use in the treatment of decompression sickness, and has also shown great effectiveness in treating conditions such as gas gangrene and carbon monoxide poisoning. More recent research has examined the possibility that it may also have value for other conditions such as cerebral palsy and multiple sclerosis, but no significant evidence has been found.

A Pressure vessel for human occupancy (PVHO) is an enclosure that is intended to be occupied by one or more persons at a pressure which differs from ambient by at least 2psi. All chambers made for hyperbaric medicine fall under the jurisdiction of the Federal Food and Drug Agency (FDA). The FDA requires hyperbaric chambers to comply with the American Society of Mechanical Engineers PVHO Codes[4] and the National Fire Protection Association Standard 99, Health Care Facilities Code. [5]

Hyperbaric medicine poses some inherent hazards that are mitigated by FDA-compliant equipment and trained personnel. Serious injury can occur at pressures as low as 2 psig (13.8 kPa) if a person in the PVHO is rapidly decompressed.[6] [7] If oxygen is used in the hyperbaric therapy, this can increase the fire hazard. This is why the FDA requires hyperbaric chambers to meet ASME PVHO and NFPA 99 standards. All chambers that meet FDA standards must have an ASME data plate, and people seeking hyperbaric treatment should check to ensure the equipment and facilities are to proper standards.

Therapeutic recompression is usually also provided in a hyperbaric chamber. It is the definitive treatment for decompression sickness and may also be used to treat arterial gas embolism caused by pulmonary barotrauma of ascent. In emergencies divers may sometimes be treated by in-water recompression (when a chamber is not available) if suitable diving equipment (to reasonably secure the airway) is available.

A number of hyperbaric treatment schedules have been published over the years for both therapeutic recompression and hyperbaric oxygen therapy for other conditions.

Scope

Hyperbaric medicine includes hyperbaric oxygen treatment, which is the medical use of oxygen at greater than atmospheric pressure to increase the availability of oxygen in the body;[8] and therapeutic recompression, which involves increasing the ambient pressure on a person, usually a diver, to treat decompression sickness or an air embolism by eliminating bubbles that have formed within the body.

Medical uses

In the United States the Undersea and Hyperbaric Medical Society, known as UHMS, lists approvals for reimbursement for certain diagnoses in hospitals and clinics. The following indications have approved (for reimbursement) uses of hyperbaric oxygen therapy as defined by the UHMS Hyperbaric Oxygen Therapy Committee:[9]

There is no reliable evidence to support its use in autism, cancer, diabetes, HIV/AIDS, Alzheimer's disease, asthma, Bell's palsy, cerebral palsy, depression, heart disease, migraines, multiple sclerosis, Parkinson's disease, spinal cord injury, sports injuries, or stroke.[50] Furthermore, there is evidence that potential side effects of hyperbaric medicine pose an unjustified risk in such cases. A Cochrane review published in 2016 reviewed a small set of clinical trials attempting to treat autism spectrum disorders with hyperbaric oxygen therapy. They noted a small sample size and large "confidence intervals" did not provide much evidence. No links between improvements in social abilities or cognitive function were noted. There are also ethical issues with further trials, as the eardrum can be damaged during hyperbaric therapy.[51] Despite the lack of evidence, in 2015, the number of people utilizing this therapy has continued to rise.[52]

There is also insufficient evidence to support its use in acute traumatic or surgical wounds.[53]

Hearing issues

There is limited evidence that hyperbaric oxygen therapy improves hearing in patients with sudden sensorineural hearing loss who present within two weeks of hearing loss. There is some indication that HBOT might improve tinnitus presenting in the same time frame.[54]

Chronic ulcers

HBOT in diabetic foot ulcers increased the rate of early ulcer healing but does not appear to provide any benefit in wound healing at long-term follow-up. In particular, there was no difference in major amputation rate.[55] For venous, arterial and pressure ulcers, no evidence was apparent that HBOT provides a long-term improvement over standard treatment.

Radiation injury

There is some evidence that HBOT is effective for late radiation tissue injury of bone and soft tissues of the head and neck. Some people with radiation injuries of the head, neck or bowel show an improvement in quality of life. Importantly, no such effect has been found in neurological tissues. The use of HBOT may be justified to selected patients and tissues, but further research is required to establish the best people to treat and timing of any HBO therapy.[56]

Neuro-rehabilitation

As of 2012, there was no sufficient evidence to support using hyperbaric oxygen therapy to treat people who have traumatic brain injuries.[57] In acute stroke, HBOT does not show benefit.[58] [59] Small clinical trials, however, have shown benefits from HBOT for stroke survivors between 6 months to 3 years after the acute phase.[60] [61]

HBOT in multiple sclerosis has not shown benefit and routine use is not recommended.[62] [63]

A 2007 review of HBOT in cerebral palsy found no difference compared to the control group.[64] Neuropsychological tests also showed no difference between HBOT and room air and based on caregiver report, those who received room air had significantly better mobility and social functioning.[64] Children receiving HBOT were reported to experience seizures and the need for tympanostomy tubes to equalize ear pressure, though the incidence was not clear.[65]

Cancer

In alternative medicine, hyperbaric medicine has been promoted as a treatment for cancer. However, a 2011 study by the American Cancer Society reported no evidence it is effective for this purpose.[66] A 2012 review article in the journal, Targeted Oncology, reports that "there is no evidence indicating that HBO neither acts as a stimulator of tumor growth nor as an enhancer of recurrence. On the other hand, there is evidence that implies that HBO might have tumor-inhibitory effects in certain cancer subtypes, and we thus strongly believe that we need to expand our knowledge on the effect and the mechanisms behind tumor oxygenation."[67]

Migraines

Low-quality evidence suggests that hyperbaric oxygen therapy may reduce the pain associated with an acute migraine headache in some cases.[68] It is not known which people would benefit from this treatment, and there is no evidence that hyperbaric medicine can prevent future migraines. More research is necessary to confirm the effectiveness of hyperbaric oxygen therapy for treating migraines.

Respiratory distress

Patients who are having extreme difficulty breathing – acute respiratory distress syndrome – are commonly given oxygen and there have been limited trials of hyperbaric equipment in such cases. Examples include treatment of the Spanish flu[69] and COVID-19.

Contraindications

The toxicology of the treatment has been reviewed by Ustundag et al.[70] and its risk management is discussed by Christian R. Mortensen, in light of the fact that most hyperbaric facilities are managed by departments of anaesthesiology and some of their patients are critically ill.[71]

An absolute contraindication to hyperbaric oxygen therapy is untreated pneumothorax. The reason is concern that it can progress to tension pneumothorax, especially during the decompression phase of therapy, although treatment on oxygen-based tables may avoid that progression. The COPD patient with a large bleb represents a relative contraindication for similar reasons. Also, the treatment may raise the issue of occupational health and safety (OHS), for chamber inside attendants, who should not be compressed if they are unable to equalise ears and sinuses.[72]

The following are relative contraindicationsmeaning that special consideration must be made by specialist physicians before HBO treatments begin:

Pregnancy is not a relative contraindication to hyperbaric oxygen treatments,[76] although it may be for underwater diving. In cases where a pregnant woman has carbon monoxide poisoning there is evidence that lower pressure (2.0 ATA) HBOT treatments are not harmful to the fetus, and that the risk involved is outweighed by the greater risk of the untreated effects of CO on the fetus (neurologic abnormalities or death.)[77] [78] In pregnant patients, HBO therapy has been shown to be safe for the fetus when given at appropriate levels and "doses" (durations). In fact, pregnancy lowers the threshold for HBO treatment of carbon monoxide-exposed patients. This is due to the high affinity of fetal hemoglobin for CO.

Therapeutic principles

The therapeutic consequences of HBOT and recompression result from multiple effects.[79]

Clinical pressure (2.0–3.0 Bar)

The increased overall pressure is of therapeutic value in the treatment of decompression sickness and air embolism as it provides a physical means of reducing the volume of inert gas bubbles within the body;[80] Exposure to this increased pressure is maintained for a period long enough to ensure that most of the bubble gas is dissolved back into the tissues, removed by perfusion and eliminated in the lungs.

The improved concentration gradient for inert gas elimination (oxygen window) by using a high partial pressure of oxygen increases the rate of inert gas elimination in the treatment of decompression sickness.[81] [82]

For many other conditions, the therapeutic principle of HBOT lies in its ability to drastically increase partial pressure of oxygen in the tissues of the body. The oxygen partial pressures achievable using HBOT are much higher than those achievable while breathing pure oxygen under normobaric conditions (i.e. at normal atmospheric pressure). This effect is achieved by an increase in the oxygen transport capacity of the blood. At normal atmospheric pressure, oxygen transport is limited by the oxygen binding capacity of hemoglobin in red blood cells and very little oxygen is transported by blood plasma. Because the hemoglobin of the red blood cells is almost saturated with oxygen at atmospheric pressure, this route of transport cannot be exploited any further. Oxygen transport by plasma, however, is significantly increased using HBOT because of the higher solubility of oxygen as pressure increases.

Proangiogenic stem progenitor cell mobilization

A study suggests that exposure to hyperbaric oxygen (HBOT) might also mobilize stem/progenitor cells from the bone marrow by a nitric oxide-dependent mechanism.[83]

Low pressure hyperoxia, stem progenitor cell mobilization and inflammatory cytokine expression

A more recent study suggests that stem cell mobilization, similar to that seen in the Thom study, is also invoked at relative normo-baric pressure with a significantly smaller increase in oxygen concentration. This study also found a significant decrease in the expression of the systemic inflammatory cytokine TNF-α in venous blood. These results suggest that hyperbaria may not be required to invoke the transcriptional responses seen at higher partial pressures of oxygen and that the effect is due solely to oxygen.

Hyperbaric chambers

Construction

The traditional type of hyperbaric chamber used for therapeutic recompression and HBOT is a rigid shelled pressure vessel. Such chambers can be run at absolute pressures typically about 6bar, 6disp=output onlyNaNdisp=output only or more in special cases. Navies, professional diving organizations, hospitals, and dedicated recompression facilities typically operate these. They range in size from semi-portable, one-patient units to room-sized units that can treat eight or more patients. The larger units may be rated for lower pressures if they are not primarily intended for treatment of diving injuries.

A rigid chamber may consist of:

Flexible monoplace chambers are available ranging from collapsible flexible aramid fiber-reinforced chambers which can be disassembled for transport via truck or SUV, with a maximum working pressure of 2 bar above ambient complete with BIBS allowing full oxygen treatment schedules.[86] [87] [88] to portable, air inflated "soft" chambers that can operate at between 0.3bar0.5bar above atmospheric pressure with no supplemental oxygen, and longitudinal zipper closure.[89]

Oxygen supply

In the larger multiplace chambers, patients inside the chamber breathe from either "oxygen hoods" – flexible, transparent soft plastic hoods with a seal around the neck similar to a space suit helmet – or tightly fitting oxygen masks, which supply pure oxygen and may be designed to directly exhaust the exhaled gas from the chamber. During treatment patients breathe 100% oxygen most of the time to maximise the effectiveness of their treatment, but have periodic "air breaks" during which they breathe chamber air (21% oxygen) to reduce the risk of oxygen toxicity. The exhaled treatment gas must be removed from the chamber to prevent the buildup of oxygen, which could present a fire risk. Attendants may also breathe oxygen some of the time to reduce their risk of decompression sickness when they leave the chamber. The pressure inside the chamber is increased by opening valves allowing high-pressure air to enter from storage cylinders, which are filled by an air compressor. Chamber air oxygen content is kept between 19% and 23% to control fire risk (US Navy maximum 25%). If the chamber does not have a scrubber system to remove carbon dioxide from the chamber gas, the chamber must be isobarically ventilated to keep the CO2 within acceptable limits.

A soft chamber may be pressurized directly from a compressor.[89] or from storage cylinders.

Smaller "monoplace" chambers can only accommodate the patient, and no medical staff can enter. The chamber may be pressurised with pure oxygen or compressed air. If pure oxygen is used, no oxygen breathing mask or helmet is needed, but the cost of using pure oxygen is much higher than that of using compressed air. If compressed air is used, then an oxygen mask or hood is needed as in a multiplace chamber. Most monoplace chambers can be fitted with a demand breathing system for air breaks. In low pressure soft chambers, treatment schedules may not require air breaks, because the risk of oxygen toxicity is low due to the lower oxygen partial pressures used (usually 1.3 ATA), and short duration of treatment.

For alert, cooperative patients, air breaks provided by mask are more effective than changing the chamber gas because they provide a quicker gas change and a more reliable gas composition both during the break and treatment periods.

Treatments

Initially, HBOT was developed as a treatment for diving disorders involving bubbles of gas in the tissues, such as decompression sickness and gas embolism, It is still considered the definitive treatment for these conditions. The chamber treats decompression sickness and gas embolism by increasing pressure, reducing the size of the gas bubbles and improving the transport of blood to downstream tissues. After elimination of bubbles, the pressure is gradually reduced back to atmospheric levels. Hyperbaric chambers are also used for animals.

As of September 2023, a number of hyperbaric chambers in the US are turning divers with decompression sickness away, and only treating more profitable scheduled cases. The number of hyperbaric medical facilities in the US is estimated at about 1500, of which 67 are treating diving accidents, according to Divers Alert Network. Many facilities only provide hyperbaric treatment for wound care for economic reasons. Emergency hyperbaric services are more expensive to train and staff, and liability is increased.

Protocol

See main article: Hyperbaric treatment schedules.

Emergency HBOT for decompression illness follows treatment schedules laid out in treatment tables. Most cases employ a recompression to 2.8bar absolute, the equivalent of 18m (59feet) of water, for 4.5 to 5.5 hours with the casualty breathing pure oxygen, but taking air breaks every 20 minutes to reduce oxygen toxicity. For extremely serious cases resulting from very deep dives, the treatment may require a chamber capable of a maximum pressure of 8bar, the equivalent of 70m (230feet) of water, and the ability to supply heliox as a breathing gas.[90]

U.S. Navy treatment charts are used in Canada and the United States to determine the duration, pressure, and breathing gas of the therapy. The most frequently used tables are Table 5 and Table 6. In the UK the Royal Navy 62 and 67 tables are used.

The Undersea and Hyperbaric Medical Society (UHMS) publishes a report that compiles the latest research findings and contains information regarding the recommended duration and pressure of the longer-term conditions.[91]

Home and out-patient clinic treatment

There are several sizes of portable chambers, which are used for home treatment. These are usually referred to as "mild personal hyperbaric chambers", which is a reference to the lower pressure (compared to hard chambers) of soft-sided chambers. The American Medical Association is opposed to home use or any other use of hyperbaric chambers if it is not "in facilities with appropriately trained staff including physician supervision and prescription and only when the intervention has scientific support or rationale" due demonstrated hazard [92]

In the US, these "mild personal hyperbaric chambers" are categorized by the FDA as CLASS II medical devices and requires a prescription in order to purchase one or take treatments.[93] As with any hyperbaric chamber, the FDA require compliance with ASME and NFPA standards. The most common option (but not approved by FDA) some patients choose is to acquire an oxygen concentrator which typically delivers 85–96% oxygen as the breathing gas.

Oxygen is never fed directly into soft chambers but is rather introduced via a line and mask directly to the patient. FDA approved oxygen concentrators for human consumption in confined areas used for HBOT are regularly monitored for purity (±1%) and flow (10 to 15 liters per minute outflow pressure). An audible alarm will sound if the purity ever drops below 80%. Personal hyperbaric chambers use 120 volt or 220 volt outlets. The FDA warns against the use of oxygen concentrators or oxygen tanks with chambers that does not meet ASME and FDA standards, regardless if the concentrators are FDA approved.[94]

Possible complications and concerns

There are risks associated with HBOT, similar to some diving disorders. Pressure changes can cause a "squeeze" or barotrauma in the tissues surrounding trapped air inside the body, such as the lungs,[95] behind the eardrum,[96] [97] inside paranasal sinuses,[96] or trapped underneath dental fillings.[98] Breathing high-pressure oxygen may cause oxygen toxicity.[99] Temporarily blurred vision can be caused by swelling of the lens, which usually resolves in two to four weeks.[100] [101]

There are reports that cataracts may progress following HBOT'[102] and rarely, may develop de novo, but this may be unrecognized and under reported. The cause is not fully explained, but evidence suggests that lifetime exposure of the lens to high partial pressure oxygen may be a major factor. Oxidative damage to lens proteins is thought to be responsible. This may be an end-stage of the relatively well documented myopic shift detected in most hyperbaric patients after a course of multiple treatments.

Effects of pressure

Patients inside the chamber may notice discomfort inside their ears as a pressure difference develops between their middle ear and the chamber atmosphere.[103] This can be relieved by ear clearing using the Valsalva maneuver or other techniques. Continued increase of pressure without equalizing may cause ear drums to rupture, resulting in severe pain. As the pressure in the chamber increases further, the air may become warm.

To reduce the pressure, a valve is opened to allow air out of the chamber. As the pressure falls, the patient's ears may "squeak" as the pressure inside the ear equalizes with the chamber. The temperature in the chamber will fall. The speed of pressurization and de-pressurization can be adjusted to each patient's needs.

Side effects

Oxygen toxicity is a limitation on both maximum partial pressure of oxygen, and on length of each treatment.

HBOT can accelerate the development of cataracts over multiple repetitive treatments, and can cause temporary relative myopia over the shorter term.

Regulation and legality

The use of hyperbaric chambers for medical and therapeutic procedures is generally regulated. Authorities have warned of potential risks to patients receiving treatment in unlicensed facilities, notably in Israel,[104] Canada,[105] and the United States.[106] In Italy, the use of hyperbaric chambers for therapy was severely restricted to limited medical settings after a serious fire which killed ten patients in 1997.[107] [108]

In some jurisdictions, the use and availability of HBOT is further restricted at the subnational level. In the U.S. state of North Carolina, several cities including Durham, Raleigh and Charlotte have ordered operators of mild hyperbaric oxygen therapy to close to protect public safety due to a risk of fire.[109]

Unlicensed and fraudulent operators have been subject to prosecution. In Australia, Oxymed Australia Pty Ltd and director Malcolm Hooper were ordered to pay AUS $3 million in fines after advertising hyperbaric therapy against the country's Therapeutic Goods Act.[110] In Canada, certain soft-shelled hyperbaric chambers were removed from the market for a potential risk to patients.[111]

Costs

HBOT is recognized by Medicare in the United States as a reimbursable treatment for 14 UHMS "approved" conditions. A 1-hour HBOT session may cost between $300 and higher in private clinics, and over $2,000 in hospitals. U.S. physicians (M.D. or D.O.) may lawfully prescribe HBOT for "off-label" conditions such as stroke,[112] [113] and migraine.[114] [115] Such patients are treated in outpatient clinics. In the United Kingdom most chambers are financed by the National Health Service, although some, such as those run by Multiple Sclerosis Therapy Centres, are non-profit. In Australia, HBOT is not covered by Medicare as a treatment for multiple sclerosis.[116] China and Russia treat more than 80 maladies, conditions and trauma with HBOT.[117]

Personnel

Research

Aspects under research include radiation-induced hemorrhagic cystitis;[118] and inflammatory bowel disease,[119] rejuvenation.[120]

Some research found evidence that HBOT improves local tumor control, mortality, and local tumor recurrence for cancers of the head and neck.[121]

Some research also found evidence of an increase in stem progenitor cells[122] and a decrease in inflammation.[123]

Neurological

Tentative evidence shows a possible benefit in cerebrovascular diseases.[124] Rats subjected to HBOT after some time following the acute phase of experimentally-induced stroke showed reduced inflammation, increased brain-derived neurotrophic factor, and evidence of neurogenesis.[125] Another rat study showed improved neurofunctional recovery as well as neurogenesis following the late-chronic phase of experimentally-induced stroke.[126]

The clinical experience and results so far published has promoted the use of HBOT therapy in patients with cerebrovascular injury and focal cerebrovascular injuries.[127] However, the power of clinical research is limited because of the shortage of randomized controlled trials.[124]

Radiation wounds

A 2010 review of studies of HBOT applied to wounds from radiation therapy reported that, while most studies suggest a beneficial effect, more experimental and clinical research is needed to validate its clinical use.[128]

History

Hyperbaric air

Junod built a chamber in France in 1834 to treat pulmonary conditions at pressures between 2 and 4 atmospheres absolute.[129]

During the following century "pneumatic centres" were established in Europe and the USA which used hyperbaric air to treat a variety of conditions.[130]

Orval J Cunningham, a professor of anesthesia at the University of Kansas in the early 1900s observed that people with circulatory disorders did better at sea level than at altitude and this formed the basis for his use of hyperbaric air. In 1918, he successfully treated patients with the Spanish flu with hyperbaric air. In 1930 the American Medical Association forced him to stop hyperbaric treatment, since he did not provide acceptable evidence that the treatments were effective.

Hyperbaric oxygen

The English scientist Joseph Priestley discovered oxygen in 1775. Shortly after its discovery, there were reports of toxic effects of hyperbaric oxygen on the central nervous system and lungs, which delayed therapeutic applications until 1937, when Behnke and Shaw first used it in the treatment of decompression sickness.

In 1955 and 1956 Churchill-Davidson, in the UK, used hyperbaric oxygen to enhance the radiosensitivity of tumours, while, at the University of Amsterdam, successfully used it in cardiac surgery.

In 1961 et al. published on the use of hyperbaric oxygen in the treatment of clostridial gas gangrene.[131]

In 1962 Smith and Sharp reported successful treatment of carbon monoxide poisoning with hyperbaric oxygen.

The Undersea Medical Society (now Undersea and Hyperbaric Medical Society) formed a Committee on Hyperbaric Oxygenation which has become recognized as the authority on indications for hyperbaric oxygen treatment.

Incidents

Fires inside a hyperbaric chamber are incredibly dangerous. A review article published in 1997 found 77 human fatalities in 35 different hyperbaric chamber fires that occurred from 1923 to 1996.[132] Further studies indicate while the treatment is often considered safe, the use of hyperbaric medicine comes with risks to the operating personnel for improper use, urging proper machine maintenance and safety procedures for the device's use.[133]

Further reading

External links

Notes and References

  1. Treatment of moderate acute mountain sickness with pressurization in a portable hyperbaric (Gamow™) Bag . 10.1580/0953-9859-2.4.268 . 1991 . Robertson . J.A. . Shlim . D.R. . Journal of Wilderness Medicine . 2 . 4 . 268–273 .
  2. Altitude mountain sickness among tourist populations: A review and pathophysiology supporting management with hyperbaric oxygen . 10.3109/03091902.2010.497890 . 2011 . Butler . G. J. . Al-Waili . N. . Passano . D. V. . Ramos . J. . Chavarri . J. . Beale . J. . Allen . M. W. . Lee . B. Y. . Urteaga . G. . Salom . K. . Journal of Medical Engineering & Technology . 35 . 3–4 . 197–207 . 20836748 .
  3. High-Altitude Illness . 10.1056/nejm200107123450206 . 2001 . Hackett . Peter H. . Roach . Robert C. . New England Journal of Medicine . 345 . 2 . 107–114 . 11450659 .
  4. Web site: Safety Standard for Pressure Vessels for Human Occupancy . Codes and Standards . American Society of Mechanical Engineers . 25 April 2020.
  5. Web site: Federal Food and Drug Agency . Hyperbaric chamber . Product Classification . US FDA . 25 March 2024.
  6. Benton . Peter . Woodfine . James . Westwood . Paul . Arterial gas embolism following a 1-meter ascent during helicopter escape training: a case report . Aviation and Space Environemental Medicine . January 1996 . 67 . 1 . 63–64 . 8929206 . 25 March 2024.
  7. Hampson . Neil . Moon . Richard . Arterial gas embolism breathing compressed air in 1.2 metres of water . Diving and Hyperbaric Medicine . September 2020 . 50 . 3 . 292–294 . 10.28920/dhm50.3.292-294 . 32957133 . 25 March 2024. 7819734 .
  8. Book: Betts. J Gordon. Desaix. Peter. Johnson. Eddie. Johnson. Jody E. Korol. Oksana. Kruse. Dean. Poe. Brandon. Wise. James. Womble. Mark D. Young. Kelly A. Anatomy & Physiology. Houston. OpenStax CNX. 978-1-947172-04-3. September 13, 2023. 22.4 Gas exchange.
  9. Web site: Indications for hyperbaric oxygen therapy . 2011 . Undersea & Hyperbaric Medical Society . 21 August 2011.
  10. Web site: Air or Gas Embolism . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  11. Web site: Carbon Monoxide . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  12. Piantadosi CA . Carbon monoxide poisoning . Undersea & Hyperbaric Medicine . 31 . 1 . 167–77 . 2004 . 15233173 . 2008-05-20 . usurped . https://web.archive.org/web/20110203090807/http://archive.rubicon-foundation.org/4002 . 2011-02-03 .
  13. Web site: Cyanide Poisoning . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  14. Hall AH, Rumack BH . Clinical toxicology of cyanide . Annals of Emergency Medicine . 15 . 9 . 1067–74 . September 1986 . 3526995 . 10.1016/S0196-0644(86)80131-7 .
  15. Takano T, Miyazaki Y, Nashimoto I, Kobayashi K . Effect of hyperbaric oxygen on cyanide intoxication: in situ changes in intracellular oxidation reduction . Undersea Biomedical Research . 7 . 3 . 191–97 . September 1980 . 7423657 . 2008-05-20 . https://web.archive.org/web/20110203090802/http://archive.rubicon-foundation.org/2888 . 2011-02-03 . usurped .
  16. Web site: Central Retinal Artery Occlusion . Undersea and Hyperbaric Medical Society . 2014-05-30 .
  17. Web site: Clostridal Myositis and Myonecrosis (Gas gangrene) . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  18. Hart GB, Strauss MB . Gas Gangrene – Clostridial Myonecrosis: A Review . J. Hyperbaric Med . 5 . 2 . 125–44 . 1990 . 2008-05-20 . https://web.archive.org/web/20110203090838/http://archive.rubicon-foundation.org/4428 . 2011-02-03 . usurped .
  19. Zamboni WA, Riseman JA, Kucan JO . Management of Fournier's Gangrene and the role of Hyperbaric Oxygen . J. Hyperbaric Med . 5 . 3 . 177–86 . 1990 . 2008-05-20 . https://web.archive.org/web/20110203090958/http://archive.rubicon-foundation.org/4431 . 2011-02-03 . usurped .
  20. Web site: Crush Injury, Compartment syndrome, and other Acute Traumatic Ischemias . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  21. Bouachour G, Cronier P, Gouello JP, Toulemonde JL, Talha A, Alquier P . Hyperbaric oxygen therapy in the management of crush injuries: a randomized double-blind placebo-controlled clinical trial . The Journal of Trauma . 41 . 2 . 333–39 . August 1996 . 8760546 . 10.1097/00005373-199608000-00023 .
  22. Web site: Decompression Sickness or Illness and Arterial Gas Embolism . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  23. Book: Bennett and Elliott's physiology and medicine of diving . 5th Rev . Brubakk AO, Neuman TS . 2003 . Saunders Ltd. . United States . 978-0-7020-2571-6 . 800 .
  24. Acott C . A brief history of diving and decompression illness . South Pacific Underwater Medicine Society Journal . 29 . 2 . 1999 . 0813-1988 . 16986801 . 2008-03-18 . https://web.archive.org/web/20110905152645/http://archive.rubicon-foundation.org/6004 . 2011-09-05 . usurped .
  25. Web site: Enhancement of Healing in Selected Problem Wounds . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  26. Zamboni WA, Wong HP, Stephenson LL, Pfeifer MA . Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study . Undersea & Hyperbaric Medicine . 24 . 3 . 175–79 . September 1997 . 9308140 . https://web.archive.org/web/20090208222429/http://archive.rubicon-foundation.org/2279 . usurped . February 8, 2009 .
  27. Kranke P, Bennett MH, Martyn-St James M, Schnabel A, Debus SE, Weibel S . Hyperbaric oxygen therapy for chronic wounds . The Cochrane Database of Systematic Reviews . 6 . CD004123 . June 2015 . 2015 . 26106870 . 10.1002/14651858.CD004123.pub4 . 7055586 .
  28. Abidia A, Laden G, Kuhan G, Johnson BF, Wilkinson AR, Renwick PM, Masson EA, McCollum PT . 6 . The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial . European Journal of Vascular and Endovascular Surgery . 25 . 6 . 513–18 . June 2003 . 12787692 . 10.1053/ejvs.2002.1911 . free .
  29. Kalani M, Jörneskog G, Naderi N, Lind F, Brismar K . Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers. Long-term follow-up . Journal of Diabetes and Its Complications . 16 . 2 . 153–58 . 2002 . 12039398 . 10.1016/S1056-8727(01)00182-9 .
  30. Chen J . The Effects of Hyperbaric Oxygen Therapy on Diabetic Retinopathy . Investigative Ophthalmology & Visual Science . 44 . 4017–B720 . 2003 . 5 . 2008-12-16 . https://web.archive.org/web/20090113053223/http://abstracts.iovs.org/cgi/content/abstract/44/5/4017 . 2009-01-13 . dead .
  31. Chang YH, Chen PL, Tai MC, Chen CH, Lu DW, Chen JT . Hyperbaric oxygen therapy ameliorates the blood-retinal barrier breakdown in diabetic retinopathy . Clinical & Experimental Ophthalmology . 34 . 6 . 584–89 . August 2006 . 16925707 . 10.1111/j.1442-9071.2006.01280.x . 35547243 .
  32. Basile C, Montanaro A, Masi M, Pati G, De Maio P, Gismondi A . Hyperbaric oxygen therapy for calcific uremic arteriolopathy: a case series . Journal of Nephrology . 15 . 6 . 676–80 . 2002 . 12495283 .
  33. Web site: Severe Anemia . Undersea and Hyperbaric Medical Society .
  34. Hart GB, Lennon PA, Strauss MB . Hyperbaric oxygen in exceptional acute blood-loss anemia . J. Hyperbaric Med . 2 . 4 . 205–10 . 1987 . 2008-05-19 . https://web.archive.org/web/20090116015734/http://archive.rubicon-foundation.org/4352 . 2009-01-16 . usurped .
  35. Web site: Idiopathic Sudden Sensorineural Hearing Loss . Undersea and Hyperbaric Medical Society . 2014-05-30 .
  36. Web site: Intracranial Abscess . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  37. Lampl LA, Frey G, Dietze T, Trauschel M . Hyperbaric Oxygen in Intracranial Abscesses . J. Hyperbaric Med . 4 . 3 . 111–26 . 1989 . 2008-05-19 . https://web.archive.org/web/20090116015734/http://archive.rubicon-foundation.org/4352 . 2009-01-16 . usurped .
  38. Book: Dimitrios Kontoyiannis . Chamilos G, Kontoyiannis DP . Fishman's Pulmonary Diseases and Disorders . McGraw-Hill . Grippi MA, Elias JA, Fishman JA, Kotloff RM, Pack AI, Senior RM . 2015 . Chapter 133: Aspergillus, Candida, and other opportunistic mold infections of the lung . 2065 . 5th . 978-0-07-179672-9 .
  39. Web site: Necrotizing Soft Tissue Infections . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  40. Escobar SJ, Slade JB, Hunt TK, Cianci P . Adjuvant hyperbaric oxygen therapy (HBO2)for treatment of necrotizing fasciitis reduces mortality and amputation rate . Undersea & Hyperbaric Medicine . 32 . 6 . 437–43 . 2005 . 16509286 . https://web.archive.org/web/20090216104038/http://archive.rubicon-foundation.org/4061 . usurped . February 16, 2009 .
  41. Web site: Refractory Osteomyelitis . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  42. Mader JT, Adams KR, Sutton TE . Infectious diseases: pathophysiology and mechanisms of hyperbaric oxygen . J. Hyperbaric Med . 2 . 3 . 133–40 . 1987 . 2008-05-16 . https://web.archive.org/web/20090213215933/http://archive.rubicon-foundation.org/4339 . 2009-02-13 . usurped .
  43. Kawashima M, Tamura H, Nagayoshi I, Takao K, Yoshida K, Yamaguchi T . Hyperbaric oxygen therapy in orthopedic conditions . Undersea & Hyperbaric Medicine . 31 . 1 . 155–62 . 2004 . 15233171 . 2008-05-20 . https://web.archive.org/web/20090216104322/http://archive.rubicon-foundation.org/4000 . 2009-02-16 . usurped .
  44. Web site: Hyperbaric Oxygen Treatments for Complications of radiation Therapy . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  45. Zhang LD, Kang JF, Xue HL . Distribution of lesions in the head and neck of the humerus and the femur in dysbaric osteonecrosis . Undersea Biomedical Research . 17 . 4 . 353–58 . July 1990 . 2396333 . 2068005 . 2008-05-20 . https://web.archive.org/web/20110203090757/http://archive.rubicon-foundation.org/2570 . 2011-02-03 . usurped .
  46. Lafforgue P . Pathophysiology and natural history of avascular necrosis of bone . Joint Bone Spine . 73 . 5 . 500–07 . October 2006 . 16931094 . 10.1016/j.jbspin.2006.01.025 .
  47. Web site: Skin Grafts and Flaps Compromised . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  48. Web site: Thermal Burns . Undersea and Hyperbaric Medical Society . 2011-08-21 .
  49. Cianci P, Lueders H, Lee H, Shapiro R, Sexton J, Williams C, Green B . Adjunctive Hyperbaric Oxygen Reduces the Need for Surgery in 40–80% Burns . J. Hyperbaric Med . 3 . 2 . 97–101 . 1988 . 2008-05-16 . https://web.archive.org/web/20110312111210/http://archive.rubicon-foundation.org/4369 . 2011-03-12 . usurped .
  50. Web site: Hyperbaric Oxygen Therapy: Don't Be Misled . Food and Drug Administration . 22 August 2013. https://www.talkingaboutthescience.com/studies/FDA2013.pdf. 22 August 2013.
  51. Xiong T, Chen H, Luo R, Mu D . Hyperbaric oxygen therapy for people with autism spectrum disorder (ASD) . The Cochrane Database of Systematic Reviews . 10 . CD010922 . October 2016 . 11 . 27737490 . 6464144 . 10.1002/14651858.CD010922.pub2 .
  52. News: Walker . Joseph Lauvrak . Hyperbaric Oxygen Therapy Gets More Popular as Unapproved Treatment . Wall Street Journal . 2015-03-14.
  53. Eskes. Anne. Vermeulen. Hester. Lucas. Cees. Ubbink. Dirk T. 2013-12-16. Cochrane Wounds Group. Hyperbaric oxygen therapy for treating acute surgical and traumatic wounds. Cochrane Database of Systematic Reviews. 12. CD008059. en. 10.1002/14651858.CD008059.pub3. 24343585.
  54. Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP . Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus . The Cochrane Database of Systematic Reviews . 10 . CD004739 . October 2012 . 23076907 . 10.1002/14651858.CD004739.pub4 .
  55. Book: Effectiveness of Hyperbaric Oxygen Therapy in patients with Late Radiation Tissue Injury or Diabetic Foot Ulcer . Lauvrak . Vigdis . Frønsdal . Katrine Bjørnebek . Ormstad . Sari Susanna . Vaagbø . G . Fure . Brynjar . vanc . 2015 . 978-82-8121-945-8.
  56. Lin . ZC . Bennett . MH . Hawkins . GC . Azzopardi . CP . Feldmeier . J . Smee . R . Milross . C . Hyperbaric oxygen therapy for late radiation tissue injury. . The Cochrane Database of Systematic Reviews . 15 August 2023 . 2023 . 8 . CD005005 . 10.1002/14651858.CD005005.pub5 . 37585677 . 10426260 . August 15, 2024 . 19 October 2023.
  57. Bennett MH, Trytko B, Jonker B . Hyperbaric oxygen therapy for the adjunctive treatment of traumatic brain injury . The Cochrane Database of Systematic Reviews . 12 . CD004609 . December 2012 . 23235612 . 10.1002/14651858.CD004609.pub3 .
  58. Carson S, McDonagh M, Russman B, Helfand M . 9900873 . Hyperbaric oxygen therapy for stroke: a systematic review of the evidence . Clinical Rehabilitation . 19 . 8 . 819–33 . December 2005 . 16323381 . 10.1191/0269215505cr907oa .
  59. Bennett MH, Weibel S, Wasiak J, Schnabel A, French C, Kranke P . Hyperbaric oxygen therapy for acute ischaemic stroke . The Cochrane Database of Systematic Reviews . 2014 . 11 . CD004954 . November 2014 . 25387992 . 10.1002/14651858.CD004954.pub3 . 10754477 .
  60. Efrati S, Fishlev G, Golan M . Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial . . 8 . 1 . e53716 . 2013 . 10.1371/journal.pone.0053716 . 3546039 . 23335971 . 2013PLoSO...853716E . free .
  61. Rosario ER, Kaplan SE, Rosenberg SS . The Effect of Hyperbaric Oxygen Therapy on Functional Impairments Caused by Ischemic Stroke . . 2018 . 172679 . 2018 . 10.1155/2018/3172679 . 6198568 . 30402285. free .
  62. Bennett M . Heard R . Hyperbaric oxygen therapy for multiple sclerosis . The Cochrane Database of Systematic Reviews . 1 . CD003057 . 2004 . 2011 . 14974004 . 10.1002/14651858.CD003057.pub2 . Bennett MH . 8407327 .
  63. Bennett M, Heard R . Hyperbaric oxygen therapy for multiple sclerosis . CNS Neuroscience & Therapeutics . 16 . 2 . 115–24 . April 2010 . 20415839 . 10.1111/j.1755-5949.2009.00129.x . 6493844 .
  64. Collet JP, Vanasse M, Marois P, Amar M, Goldberg J, Lambert J, Lassonde M, Hardy P, Fortin J, Tremblay SD, Montgomery D, Lacroix J, Robinson A, Majnemer A . 18668055 . 6 . Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial. HBO-CP Research Group . Lancet . 357 . 9256 . 582–86 . February 2001 . 11558483 . 10.1016/S0140-6736(00)04054-X .
  65. McDonagh MS, Morgan D, Carson S, Russman BS . Systematic review of hyperbaric oxygen therapy for cerebral palsy: the state of the evidence . Developmental Medicine and Child Neurology . 49 . 12 . 942–47 . December 2007 . 18039243 . 10.1111/j.1469-8749.2007.00942.x . free .
  66. Web site: Hyperbaric Oxygen Therapy . . 14 February 2015 . 14 April 2011.
  67. Moen I, Stuhr LE . Hyperbaric oxygen therapy and cancer – a review . Targeted Oncology . 7 . 4 . 233–42 . December 2012 . 23054400 . 3510426 . 10.1007/s11523-012-0233-x .
  68. Bennett MH, French C, Schnabel A, Wasiak J, Kranke P, Weibel S . Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache . The Cochrane Database of Systematic Reviews . 12 . CD005219 . December 2015 . 2016 . 26709672 . 10.1002/14651858.CD005219.pub3 . 8720466 .
  69. Sellers, L. M. (1964). "The Fallibility of the Forrestian Principle. "Semper Primus Pervenio Maxima Cum Vi". (Orval James Cunningham)." Trans Am Laryngol Rhinol Otol Soc 23: 385–405
  70. Ustundag A, Duydu Y, Aydin A, Eken A, Dundar K, Uzun G . Evaluation of the potential genotoxic effects of hyperbaric oxygen therapy . Toxicology Letters . Oct 2008 . 180 . S142 . 10.1016/j.toxlet.2008.06.792 .
  71. Hyperbaric oxygen therapy . The Western Journal of Medicine . 136 . 3 . 333–37 . March 1982 . 18749067 . 1273677 . 10.1016/j.cacc.2008.07.007 . Mortensen . Christian Risby .
  72. Liu YH, Hsia TC, Liu JC, Chen W . Fracture of the maxillary bone during hyperbaric oxygen therapy . CMAJ . 179 . 12 . 1351 . December 2008 . 19047622 . 2585132 . 10.1503/cmaj.080713 .
  73. Book: Jain KK . Textbook of Hyperbaric Medicine . http://www.oxygenrescuecarecentersofamerica.com/pdf/information/Chp%208%20Indications%20Contraindications%20and%20Complcations%20of%20HBO%20Therapy.pdf . 22 September 2016 . 75–80 . Indications, Contraindications, and Complications of HBO Therapy.
  74. Takenaka S, Arimura T, Higashi M, Nagayama T, Ito E . Experimental study of bleomycin therapy in combination with hyperbaric oxygenation . Nihon Gan Chiryo Gakkai Shi . 15 . 5 . 864–75 . August 1980 . 6159432 .
  75. Stubbs JM, Johnson EG, Thom SR . Trends Of Treating Patients, That Have Received Bleomycin Therapy In The Past, With Hyperbaric Oxygen Treatment (Hbot) And A Survey Of Considered Absolute Contraindications To Hbot . Undersea Hyperb Med Abstract . 32 . supplement . 2005 . https://web.archive.org/web/20090216104243/http://archive.rubicon-foundation.org/1638 . usurped . February 16, 2009 . 2008-05-23.
  76. Book: Marx JA . Rosen's Emergency Medicine: Concepts and Clinical Practice . https://archive.org/details/rosensemergencym00002unse . registration . 5th . chapter 194 . 2002 . Mosby . 978-0323011853.
  77. Van Hoesen KB, Camporesi EM, Moon RE, Hage ML, Piantadosi CA . Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review . JAMA . 261 . 7 . 1039–43 . February 1989 . 2644457 . 10.1001/jama.1989.03420070089037 .
  78. Elkharrat D, Raphael JC, Korach JM, Jars-Guincestre MC, Chastang C, Harboun C, Gajdos P . 25109979 . Acute carbon monoxide intoxication and hyperbaric oxygen in pregnancy . Intensive Care Medicine . 17 . 5 . 289–92 . 1991 . 1939875 . 10.1007/BF01713940 .
  79. Book: Gesell, Laurie B. . vanc . . Hyperbaric Oxygen Therapy Indications . The Hyperbaric Oxygen Therapy Committee Report . Durham, NC . 2008 . 12th . 978-0-930406-23-3.
  80. Jørgensen TB, Sørensen AM, Jansen EC . Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy . Acta Anaesthesiologica Scandinavica . 52 . 4 . 566–68 . April 2008 . 18339163 . 10.1111/j.1399-6576.2008.01598.x . 11470093 .
  81. Behnke . Albert R . vanc . Albert R. Behnke . The isobaric (oxygen window) principle of decompression . The New Thrust Seaward . Trans. Third Marine Technology Society Conference, San Diego . Marine Technology Society . Washington DC . 1967 . https://web.archive.org/web/20080820004155/http://archive.rubicon-foundation.org/4029 . usurped . August 20, 2008 . 20 July 2016.
  82. Van Liew HD, Conkin J, Burkard ME . The oxygen window and decompression bubbles: estimates and significance . Aviation, Space, and Environmental Medicine . 64 . 9 Pt 1 . 859–65 . September 1993 . 8216150 .
  83. Thom SR, Bhopale VM, Velazquez OC, Goldstein LJ, Thom LH, Buerk DG . Stem cell mobilization by hyperbaric oxygen . American Journal of Physiology. Heart and Circulatory Physiology . 290 . 4 . H1378–86 . April 2006 . 16299259 . 10.1152/ajpheart.00888.2005 . 29013782 .
  84. Kemper . Bart . Cross . Linda . Developing "Design by Analysis" Methodology for Windows for Pressure Vessels for Human Occupancy . ASCE-ASME Journal of Risk and Uncertainty in Engineering Systems, Part B: Mechanical Engineering . September 2020 . 6 . 3 . 10.1115/1.4046742 . free .
  85. Book: U.S. Navy Supervisor of Diving . U.S. Navy Diving Manual. Volume 5: Diving Medicine and Recompression Chamber Operations . SS521-AG-PRO-010, Revision 6 . Chapter 21: Recompression Chamber Operation . April 2008 . U.S. Naval Sea Systems Command . http://www.usu.edu/scuba/navy_manual6.pdf . 2009-06-29 . https://web.archive.org/web/20140331063312/http://www.usu.edu/scuba/navy_manual6.pdf . March 31, 2014 . live.
  86. Web site: Uncompromising composite hyperbaric oxygen chamber closes the gap. Malnati. Peggy . vanc . 30 April 2015. compositesworld.com newsletter. Composites World. 29 March 2016.
  87. Web site: Hematocare : The revolution at 3 ata. Staff. 2014. Gaumond Medical Group Inc.. 29 March 2016.
  88. Web site: Hyperlite folding portable hyperbaric chambers. Staff. Technical specifications. SOS Ltd.. 29 March 2016. London.
  89. Web site: www.oxyhealth.com . Portable Hyperbaric Chambers | Hyperbaric Oxygen Chamber | Hyperbaric Oxygen . Oxyhealth.com. 2010-09-25.
  90. Book: U.S. Navy Supervisor of Diving . U.S. Navy Diving Manual . SS521-AG-PRO-010, revision 6 . Apr 2008 . U.S. Naval Sea Systems Command . http://www.usu.edu/scuba/navy_manual6.pdf . 5 . 20 . 2009-06-29 . https://web.archive.org/web/20140331063312/http://www.usu.edu/scuba/navy_manual6.pdf . March 31, 2014 . live.
  91. Web site: Undersea and Hyperbaric Medical Society . Uhms.org . 2011-08-21.
  92. Web site: Oppose Unsafe Use of "Mild Hyperbaric Therapy" D-270.986 . AMA Policy Finder . American Medical Association . 25 March 2024.
  93. Web site: Product Classification, Chamber, Hyperbaric . United States Food and Drug Administration. 2011-08-22.
  94. Web site: Hyperbaric Oxygen Therapy: Get the Facts . FDA Consumer Updates . 26 July 2021 . US FDA.
  95. Broome JR, Smith DJ . Pneumothorax as a complication of recompression therapy for cerebral arterial gas embolism . Undersea Biomedical Research . 19 . 6 . 447–55 . November 1992 . 1304671 . 2008-05-23 . https://web.archive.org/web/20110203054105/http://archive.rubicon-foundation.org/2600 . 2011-02-03 . usurped .
  96. Fitzpatrick DT, Franck BA, Mason KT, Shannon SG . Risk factors for symptomatic otic and sinus barotrauma in a multiplace hyperbaric chamber . Undersea & Hyperbaric Medicine . 26 . 4 . 243–47 . 1999 . 10642071 . 2008-05-23 . https://web.archive.org/web/20110811180739/http://archive.rubicon-foundation.org/2316 . 2011-08-11 . usurped .
  97. Fiesseler FW, Silverman ME, Riggs RL, Szucs PA . Indication for hyperbaric oxygen treatment as a predictor of tympanostomy tube placement . Undersea & Hyperbaric Medicine . 33 . 4 . 231–25 . 2006 . 17004409 . 2008-05-23 . https://web.archive.org/web/20110203091018/http://archive.rubicon-foundation.org/5033 . 2011-02-03 . usurped .
  98. Stein L . Dental Distress. The 'Diving Dentist' Addresses the Problem of a Diving-Related Toothache . Alert Diver . January/ February . 45–48 . 2000 . 2008-05-23.
  99. Smerz RW . Incidence of oxygen toxicity during the treatment of dysbarism . Undersea & Hyperbaric Medicine . 31 . 2 . 199–202 . 2004 . 15485081 . 2010-01-02 . https://web.archive.org/web/20110513021600/http://archive.rubicon-foundation.org/4010 . 2011-05-13 . usurped .
  100. Butler FK . Diving and hyperbaric ophthalmology . Survey of Ophthalmology . 39 . 5 . 347–66 . 1995 . 7604359 . 10.1016/S0039-6257(05)80091-8 .
  101. Butler FK, White E, Twa M . Hyperoxic myopia in a closed-circuit mixed-gas scuba diver . Undersea & Hyperbaric Medicine . 26 . 1 . 41–45 . 1999 . 10353183 . 2008-05-23 . https://web.archive.org/web/20090609091709/http://archive.rubicon-foundation.org/2312 . 2009-06-09 . usurped .
  102. Gesell LB, Adams BS, Kob DG . De Novo Cataract Development Following A Standard Course Of Hyperbaric Oxygen Therapy . Undersea Hyperb Med Abstract . 27 . supplement . 389–92 . 2000 . https://web.archive.org/web/20090216104337/http://archive.rubicon-foundation.org/6862 . usurped . February 16, 2009 . 2008-06-01. 18251434 .
  103. Lehm Jan P, Bennett Michael H . Predictors of middle ear barotrauma associated with hyperbaric oxygen therapy . South Pacific Underwater Medicine Society Journal . 2003 . 33 . 127–33 . https://web.archive.org/web/20090722225821/http://archive.rubicon-foundation.org/8076 . usurped . July 22, 2009 . 2009-07-15 .
  104. Web site: 2023-12-17 . Health Ministry warns public not to go to unlicensed hyperbaric oxygen chambers . 2024-05-22 . The Jerusalem Post JPost.com . en.
  105. Web site: Government of Canada . Health Canada . 2021-10-28 . Unlicensed soft-shelled hyperbaric chambers may pose serious health risks - Recalls, advisories and safety alerts – Canada.ca . 2024-05-22 . recalls-rappels.canada.ca.
  106. Office of the Commissioner . July 26, 2021 . Hyperbaric Oxygen Therapy: Get the Facts . FDA . en . U.S. Food and Drug Administration.
  107. News: 2024-01-31 . Italian Authorities Still Plan to Prosecute Substance Abuse Cases . 2024-05-22 . Washington Post . en-US . 0190-8286.
  108. Colvin . AP . January 3, 1998 . Fire-safety standards for hyperbaric oxygen facilities . The Lancet . 351 . 9095 . 69 . 10.1016/s0140-6736(05)78048-x . 9433452 . 0140-6736.
  109. News: Brosseau . Carli . July 5, 2022 . Durham joins NC cities barring 'mild hyperbaric oxygen therapy.' Find out why. . The News & Observer.
  110. Web site: Australian Government Department of Health and Aged Care . December 3, 2021 . Oxymed Australia Pty Ltd and director Malcolm Hooper ordered to pay $3 million for unlawful advertising of hyperbaric oxygen therapy devices . May 22, 2024 . Australian Therapeutic Goods Administration.
  111. Web site: KelownaNow . Health Canada seizes several unlicensed hyperbaric chambers due to serious health risks . 2024-05-22 . KelownaNow . en.
  112. Jain KK . Effect of Hyperbaric Oxygenation on Spasticity in Stroke Patients . J. Hyperbaric Med . 4 . 2 . 55–61 . 1989 . 2008-08-06 . https://web.archive.org/web/20081101083531/http://archive.rubicon-foundation.org/4394 . 2008-11-01 . usurped .
  113. Singhal AB, Lo EH . Advances in emerging nondrug therapies for acute stroke 2007 . Stroke . 39 . 2 . 289–91 . February 2008 . 18187678 . 3705573 . 10.1161/STROKEAHA.107.511485 .
  114. Eftedal OS, Lydersen S, Helde G, White L, Brubakk AO, Stovner LJ . 22145164 . A randomized, double blind study of the prophylactic effect of hyperbaric oxygen therapy on migraine . Cephalalgia . 24 . 8 . 639–44 . August 2004 . 15265052 . 10.1111/j.1468-2982.2004.00724.x .
  115. Fife WP, Fife CE . William Paul Fife . Treatment of Migraine with Hyperbaric Oxygen . J. Hyperbaric Med . 4 . 1 . 7–15 . 1989 . 2008-08-06 . https://web.archive.org/web/20090609091744/http://archive.rubicon-foundation.org/4386 . 2009-06-09 . usurped .
  116. Web site: IN-DEEP. Hyperbaric Oxygen Therapy for MS. Making Sense of MS Research. 8 November 2012.
  117. Textbook of Hyperbaric Medicine KK Jane, 5th Edition, 2010
  118. Yoshida T, Kawashima A, Ujike T, Uemura M, Nishimura K, Miyoshi S . Hyperbaric oxygen therapy for radiation-induced hemorrhagic cystitis . International Journal of Urology . 15 . 7 . 639–41 . July 2008 . 18643783 . 10.1111/j.1442-2042.2008.02053.x .
  119. Noyer CM, Brandt LJ . Hyperbaric oxygen therapy for perineal Crohn's disease . The American Journal of Gastroenterology . 94 . 2 . 318–21 . February 1999 . 10.1111/j.1572-0241.1999.00848.x . 10022622 . 9674423 .
  120. Yafit Hachmo et al., (2020). Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells : a prospective trial. Aging (Albany NY).
  121. Bennett MH, Feldmeier J, Smee R, Milross C . Hyperbaric oxygenation for tumour sensitisation to radiotherapy . The Cochrane Database of Systematic Reviews . 4 . CD005007 . April 2018 . 7 . 29637538 . 6494427 . 10.1002/14651858.cd005007.pub4 .
  122. Feldmeier J, Carl U, Hartmann K, Sminia P . Hyperbaric oxygen: does it promote growth or recurrence of malignancy? . Undersea & Hyperbaric Medicine . 30 . 1 . 1–18 . Spring 2003 . 12841604 .
  123. MacLaughlin KJ, Barton GP, Braun RK, Eldridge MW . Effect of intermittent hyperoxia on stem cell mobilization and cytokine expression . Medical Gas Research . 2019 Jul-Sep . 9(3) . 139–144 . July 2019 . 31552878. 10.4103/2045-9912.266989 . 6779002 . free .
  124. Fischer BR, Palkovic S, Holling M, Wölfer J, Wassmann H . Rationale of hyperbaric oxygenation in cerebral vascular insult . Current Vascular Pharmacology . 8 . 1 . 35–43 . January 2010 . 19485935 . 10.2174/157016110790226598 .
  125. Lee Y, Chio C, Tsai K . Long course hyperbaric oxygen stimulates neurogenesis and attenuates inflammation after ischemic stroke . . 2013 . 512978 . 2013 . 10.1155/2013/512978 . 3595722 . 23533308. free .
  126. Hu Q, Liang X, Zhang JH . Delayed hyperbaric oxygen therapy promotes neurogenesis through reactive oxygen species/hypoxia-inducible factor-1α/β-catenin pathway in middle cerebral artery occlusion rats . . 45 . 6 . 1807–1814 . 2014 . 10.1161/STROKEAHA.114.005116 . 4102647. 24757104.
  127. Michalski D, Härtig W, Schneider D, Hobohm C . Use of normobaric and hyperbaric oxygen in acute focal cerebral ischemia – a preclinical and clinical review . Acta Neurologica Scandinavica . 123 . 2 . 85–97 . February 2011 . 20456243 . 10.1111/j.1600-0404.2010.01363.x . 32844269 . free .
  128. Spiegelberg L, Djasim UM, van Neck HW, Wolvius EB, van der Wal KG . Hyperbaric oxygen therapy in the management of radiation-induced injury in the head and neck region: a review of the literature . Journal of Oral and Maxillofacial Surgery . 68 . 8 . 1732–39 . August 2010 . 20493616 . 10.1016/j.joms.2010.02.040 .
  129. Aerotherapeutics. 1. 271. y. y.
  130. Sharkey. Sarah . vanc . April 2000. Current indications for hyperbaric oxygen therapy. ADF Health. 1. 2. 18 December 2013.
  131. Brummelkamp WH, Hogendijk L, Boerema I . 1961 . Treatment of anaerobic infections (clostridial myositis) by drenching the tissues with oxygen under high atmospheric pressure . Surgery . 49 . 299–302 .
  132. Sheffield . P. J. . Desautels . D. A. . September 1997 . Hyperbaric and hypobaric chamber fires: a 73-year analysis . Undersea & Hyperbaric Medicine . 24 . 3 . 153–164 . 1066-2936 . 9308138 .
  133. Mago . Vishal . January–March 2024 . Safety of Hyperbaric Medicine in Clinical Scenarios . Annals of African Medicine . en-US . 23 . 1 . 1–4 . 10.4103/aam.aam_16_22 . free . 38358163 . 10922184 . 1596-3519.
  134. Simini . Bruno . November 8, 1997 . Milan fire fuels concerns over hyperbaric oxygen facilities . The Lancet . 350 . 9088 . 1375 . 10.1016/s0140-6736(05)65155-0 . 0140-6736.
  135. Web site: 2012-04-25 . Men Charged In Fatal Hyperbaric Chamber Explosion - CBS Miami . 2024-05-13 . www.cbsnews.com . en-US.
  136. Web site: 2012-02-22 . Equine hyperbaric oxygen chamber explosion in Florida kills woman and horse . 2024-05-13 . DVM 360 . en.
  137. Web site: 2016-04-12 . Vet blames dog for hyperbaric chamber explosion . 2024-05-13 . FOX 5 Atlanta . en-US.
  138. Web site: Post . The Jakarta . Fire kills 4 inside hyperbaric chamber - National . 2024-05-22 . The Jakarta Post . en.
  139. Web site: Hyperbaric company and director fined $726,750 . 2024-05-22 . WorkSafe Victoria . en.

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Hyperbaric medicine".

Except where otherwise indicated, Everything.Explained.Today is © Copyright 2009-2024, A B Cryer, All Rights Reserved. Cookie policy.