How are patients selected for hyperbaric oxygen therapy (HBOT)?

Updated: Nov 16, 2020
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

In an effort to select patients appropriately for HBOT, various objective vascular evaluation methods have been used, including transcutaneous oximetry, capillary perfusion pressure, laser Doppler, and other types of vascular studies. Debate is ongoing regarding which method provides the most reliable data and whether these methods are more useful than other clinical markers of wound failure.

Note that HBOT should be used in conjunction with a complete wound healing care plan. As with all chronic wounds, other underlying host factors (eg, large vessel disease, glycemic control, nutrition, infection, presence of necrotic tissue, offloading) must be simultaneously addressed in order to have the highest chance of successful healing and functional capacity.

Because the goals of HBOT for wound healing include cellular proliferation and angiogenesis, HBOT is generally performed daily for a minimum of 30 treatments. Treatment is generally at 2 to 2.4 ATA for a total of 90 minutes of 100% oxygen breathing time. Based on the response to therapy, extended courses of therapy may be indicated.


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