Hyperbaric Oxygen Therapy Beneficial for Calciphylaxis?

Doug Brunk

August 25, 2023


Hyperbaric oxygen therapy (HBOT) may have a role in treating calciphylaxis, with benefits in both mortality and wound healing.


  • Although intravenous sodium thiosulfate (IV STS) is considered standard care in the treatment of calciphylaxis, HBOT has been reported to have beneficial effects.

  • Researchers retrospectively reviewed records of 93 patients newly diagnosed with calciphylaxis. Patients were seen at Massachusetts General Hospital, Boston, between January 2006 and December 2021.

  • The researchers compared mortality and wound healing outcomes for 57 patients treated with IV STS only (control group) with those of 36 patients treated with HBOT plus IV STS (treatment group).

  • Traditional survival analyses and Cox proportional hazard modeling were used to examine mortality data, and mixed effects modeling was used to analyze longitudinal wound outcomes.


  • Univariate survival analyses showed that HBOT plus IV STS was associated with significantly longer survival time than IV STS alone (P = .016), particularly for those with nonnephrogenic calciphylaxis (P < .0001).

  • An increased number of HBOT sessions conferred improved mortality outcomes, with 1, 5, 10, and 20 sessions yielding decreasing hazard ratios.

  • There was also a significant positive association between an increasing number of HBOT sessions and increased wound score (P = .042). Increases were seen with each session.

  • Anxiety/claustrophobia was the most common side effect reported among those in the HBOT group (22%).


  • "Given the proposed benefits and seemingly low side effect profile, it is the authors' recommendation that HBOT be offered as an additional intervention to patients with calciphylaxis, especially if they have open wounds, to improve outcomes and expedite wound healing," the researchers concluded.


  • Daniela Kroshinsky, MD, MPH, of the Department of Dermatology at Massachusetts General Hospital, Boston, and colleagues conducted the study, which was published August 14, 2023, in the Journal of the American Academy of Dermatology.


  • Limitations included small sample size, retrospective design, and the potential for not adequately capturing patients who received external care. Large prospective trials would help clarify the role of HBOT for calciphylaxis. The researchers were unable to match patients by disease or wound severity.


  • The researchers reported no relevant disclosures.

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