Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified

Abstract

Hyperbaric oxygen therapy (HBOT) is an important advanced therapy in the treatment of problem wounds, including diabetic foot ulcers and late effect radiation injury. HBOT remains among the safest therapies used today. Nonetheless, there are side effects associated with HBOT. It is important for providers to be able to identify, understand, and quantify these side effects for prevention, management, and informed consent. The past two decades have seen significant advancements in our understanding of the underlying mechanisms of HBOT. This has led to a better understanding of the underlying reason for clinical benefit. It has also led to a better understanding of its side effects. Moreover, more recent literature allows for better quantification of these side effects. This review will highlight these side effects. Wound healing in the case of problem nonhealing wounds requires the use of various advanced treatment modalities, including HBOT. HBOT has been shown to significantly improve healing rates in certain problem wounds, including advanced diabetic foot ulcers and late effect radiation injury. It is provided in a variety of clinical settings by providers with varying levels of expertise. It is important for those providing this therapy to understand the potential side effects. Research in HBOT has led to significant advancements in the area of wound healing. At the same time, there remains a variety of treatment protocols used at different institutions. It is important to quantify risk and benefit at different treatment pressures and times to better standardize treatment and improve patient care.

Improved Healing of Diabetic Foot Ulcer upon Oxygenation Therapeutics through Oxygen-Loading Nanoperfluorocarbon Triggered by Radial Extracorporeal Shock Wave

“…Oxidative Medicine and Cellular Longevity strategy can effectively reduce the cost of treatment and avoid serious side effects, such as barotrauma, central nervous system and pulmonary oxygen toxicity, and increased risk of claustrophobia [39]. In addition, the cell viability of 4T1 and HUVE cells was not significantly affected by the different doses of Nano-PFC, which exhibited that Nano-PFC has great biocompatibility for different types of cells (Figure 2(d)).…”

Bioinorganics and Wound Healing

“…Oxygen delivery for wound healing has been widely described in the literature and carried out through various methods, ranging from systemic approaches like HBO, which has been shown to be effective for some cases of delayed wound healing72a–c but is not always found to bring statistically significant improvements to healing, it also presents several disadvantages like the need for pressure chamber ( Figure ), risks of cataract maturation, barotrauma, pneumothorax, and oxygen toxicity seizures, with only a temporary effect as oxygen levels are systemically elevated by HBO for the 1–2 h treatment time, but return to baseline within 3 min up leaving the chamber;72d to local delivery using perfluorocarbons or inorganic peroxides and percarbonates that either allowed these to temporarily delay necrosis appearance in ischemic skin flap models although the influence of the produced peroxides has not been discussed, or increased wound closure, re‐epithelialization, epidermal thickness, collagen content of dermis, and neovascularization . Recently, polymer/perfluorocarbon‐based oxygen‐loaded particles have been prepared as a mean of oxygen delivery, but only allowed and increased oxygen level in blood during a few minutes.…”

A Catalase‐Like Metal‐Organic Framework Nanohybrid for O2‐Evolving Synergistic Chemoradiotherapy

“…On account of this, elevation of tumor O 2 is highly expected to benefit the radiotherapy. Quite different from hyperbaric oxygen therapy suffering from safety concerns and ineffective outcomes, smart nanomedicines carrying O 2 ‐generating agents (e.g., catalase, MnO 2 ) can produce O 2 triggered by external light and/or unique pathological stimuli, providing potent strategies to reprogramm tumour hypoxia to promote O 2 ‐enhanced radiotherapy. Alternatively, to maximize the responses in a given dose of radiation, high‐ Z materials are recommended to sensitize hypoxic cells to radiation, among which gold nanoparticles (AuNPs) are outstanding candidates owing to their large X‐ray attenuation coefficient.…”