Contraindications
How Hyperbaric Oxygen Therapy (HBOT) helps the body.
There are 6 primary effects of increased Oxygen solubility (HBOT) in the body:
1). Vasoconstrictor – reduces edema and inflammation.
2). Promotes neovascularization – produces collagen and new capillaries,
3). Promotes the power of leukocytes (a type of white blood cells) to kill harmful organisms in the body,
4). Kills anaerobic bacteria, bacteria that do not live or grow when oxygen is present. In humans, these bacteria are most commonly found in the gastrointestinal tract.
5). Helps heal tissue that is Vaso-deficient (tendons, ligaments, meniscus in the joints, spinal discs, bones, and even brain tissues) and poorly perfused tissue (Example: slow-healing wounds like wounds resulting from diabetes),
6). Helps regrow damaged nervous system cells – Such as neuropathy.
Contraindications
As with most medical therapies, absolute and relative contraindications exist with the use of hyperbaric oxygen therapy (HBOT).
Relative Contraindications to Hyperbaric Oxygen Therapy
Situations or medical conditions where HBOT may still be possible, but carries higher risks, so treatment should only be considered with extra caution and medical supervision.
Absolute Contraindications
**Means do not use mHBOT
| Absolute Contraindication | Reason Contraindicated | Necessary Conditions Prior to HBOT |
|---|---|---|
| Untreated pneumothorax | Gas emboli, tension pneumothorax, pneumomediastinum | Thoracostomy |
| Bleomycin | Interstitial pneumonitis | No treatment for extended time from use of medication |
| Cisplatin | Impaired wound healing | No treatment for extended time from use of medication |
| Disulfiram | Blocks superoxide dismutase, which protects against oxygen toxicity | Discontinue medication |
| Doxorubicin | Cardiotoxicity | Discontinue medication |
| Sulfamylon | Impaired wound healing | Discontinue and remove medication |
Relative Contraindications
| Relative Contraindication | Reason Contraindicated | Necessary Conditions Prior to HBOT |
|---|---|---|
| Asthma | Air trapping upon ascent leading to pneumothorax | Must be well controlled with medications |
| Claustrophobia | Anxiety | Treatment with benzodiazepines |
| Congenital spherocytosis | Severe hemolysis | None; HBOT for emergencies only |
| Chronic obstructive pulmonary disease (COPD) | Loss of hypoxic drive to breathe | Observation in chamber |
| Eustachian tube dysfunction | Barotrauma to tympanic membrane | Training, PE tubes |
| High fever | Higher risk of seizures | Provide antipyretic |
| Pacemakers or epidural pain pump | Malfunction or deformation of device under pressure | Ensure company has pressure-tested device and confirm safe operating depth |
| Pregnancy | Unknown effect on fetus (some studies suggest HBOT is safe) | None, but HBOT may be used in emergencies |
| Seizures | May have lower seizure threshold | Should be stable on medications; may be treated with benzodiazepines |
| Upper respiratory infection (URI) | Barotrauma | Resolution of symptoms or use of decongestants |