Hyperbaric oxygenation is defined as the administration of 100% oxygen in a compression chamber at an ambient pressure greater than one atmosphere absolute. The increased pressure (up to three atmospheres) induces a 10- to 15-fold plasma oxygen concentration resulting in increased tissue oxygenation. Hyperbaric oxygen therapy improves the bactericidal capacity of leukocytes, stimulates important mechanisms in wound healing, reduces tissue oedema and maintains tissue oxygenation even in the absence of haemoglobin., Commonly accepted indications supported by scientific evidence include the decompression sickness, arterial gas embolism, severe carbon monoxide poisoning, delayed radiation injury, clostridial myonecrosis and also the improvement of healing of vulnerable skin or soft tissue grafts. Hyperbaric oxygen therapy is also used in healing difficulties of specific problem wounds, extreme blood loss, intracranial abscesses, necrotizing soft tissue infections, osteomyelitis, crush syndrome, burns and sudden deafness. Since hyperbaric oxygenation involves the administration of oxygen in a pharmacological dose, side effects are possible due to barotrauma and oxygen toxicity. During hyperbaric oxygen therapy, an increased amount of oxygen-free radicals may be generated, depending on the duration and extent of pressure elevation during treatment. Although many different organ systems may be affected, the brain is of greatest clinical significance. Neurotoxicity is manifested by visual disturbances, auditory hallucinations, nausea, facial twitching, irritability, dizziness and convulsion.
