Research & Studies
Explore the latest scientific research and clinical studies in hyperbaric oxygen therapy and its applications in various medical conditions.
Hyperbaric oxygen therapy of spinal cord injury
Spinal cord injury (SCI) is a complex disease process that involves both primary and secondary mechanisms of injury and can leave patients with devastating functional impairment as well as psychological debilitation. While no curative treatment is available for spinal cord injury, current therapeutic approaches focus on reducing the secondary injury that follows SCI. Hyperbaric oxygen (HBO) therapy has shown promising neuroprotective effects in several experimental studies, but the limited number of clinical reports have shown mixed findings. This review will provide an overview of the potential mechanisms by which HBO therapy may exert neuroprotection, provide a summary of the clinical application of HBO therapy in patients with SCI, and discuss avenues for future studies.
The Effect of Hyperbaric Oxygen Treatment on Myoblasts and Muscles After Contusion Injury
Sports recovery and muscular regeneration via HBOT. Muscle injuries are frequently encountered in athletes and trauma patients. For example, hamstring injury is the most frequent diagnosis reported in both major and minor league baseball players, accounting for approximately 6% of all injuries.1 These injuries can be caused by a variety of mechanisms, such as laceration, strain, and contusion.2-4 Although the muscle tissue retains the potential to regenerate, the healing process is often slow and incomplete because of the fibrosis within. Therefore, many alternative methods have been discussed widely such as platelet-rich plasma (PRP), nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids injection, low-intensity pulsed ultrasound (LIPUS), cryotherapy and hyperbaric oxygen (HBO).5, 6 HBO treatment is the application of 100% oxygen at environmental pressures greater than one atmosphere.7 It has been widely applied to promote healing of bone fracture,8 articular cartilage injury,9 spinal cord injury,10 and skeletal muscle injury. Several reports have indicated the efficacy of HBO in muscle crush injuries, muscle contusions, and sports-related injuries.11, 12 For example, myogenin is a muscle-specific transcription factor coexpressed with MyoD until the myoblasts fuse with each other and differentiate into the multinucleated muscle cells. Hypoxic conditions will impair the expression of myogenin and MyoD,13 while exposure to HBO results in a higher expression of myogenin and MyoD than under normoxic conditions. Which implies HBO accelerates healing of injured muscles.14 HBO treatment increased the myoblast growth rate and myogenin and actin production. Better histologic and physiologic performances were also found after HBO treatment in an animal contusion model.
Hyperbaric Oxygen Treatment: Effects on Mitochondrial Function and Oxidative Stress
Hyperbaric oxygen treatment (HBOT)—the administration of 100% oxygen at atmospheric pressure (ATA) greater than 1 ATA—increases the proportion of dissolved oxygen in the blood five- to twenty-fold. This increase in accessible oxygen places the mitochondrion—the organelle that consumes most of the oxygen that we breathe—at the epicenter of HBOT’s effects. As the mitochondrion is also a major site for the production of reactive oxygen species (ROS), it is possible that HBOT will increase also oxidative stress. Depending on the conditions of the HBO treatment (duration, pressure, umber of treatments), short-term treatments have been shown to have deleterious effects on both mitochondrial activity and production of ROS. Long-term treatment, on the other hand, improves mitochondrial activity and leads to a decrease in ROS levels, partially due to the effects of HBOT, which increases antioxidant defense mechanisms. Many diseases and conditions are characterized by mitochondrial dysfunction and imbalance between ROS and antioxidant scavengers, suggesting potential therapeutic intervention for HBOT. In the present review, we will present current views on the effects of HBOT on mitochondrial function and oxidative stress, the interplay between them and the implications for several diseases.
Hyperbaric Oxygen for Cerebral Vasospasm and Brain Injury Following Subarachnoid Hemorrhage
HBOT protects against vasospasm and ischemic injury. Faced with the paucity of information as to what degree HBO is capable of antagonizing vasospasm after SAH, the authors postulate that the major beneficial effects of HBO in SAH include a reduction of acute brain injury and combating brain damage caused by CVS. Consequently, authors reviewed the effects of HBO on SAH-induced hypoxic signaling and other mechanisms of neurovascular injury. Moreover, authors hypothesize that HBO administered after SAH may “precondition” the brain against the detrimental sequelae of vasospasm. In conclusion, the existing evidence speaks in favor of administering HBO in both acute and delayed phase after SAH; however, further studies are needed to understand the underlying mechanisms and to establish the optimal regimen of treatment.
Hyperbaric oxygen in chronic traumatic brain injury: oxygen, pressure, and gene therapy
Gene expression changes with repetitive low-pressure oxygen therapy. HBOT is the use of increased total atmospheric pressure and partial pressure of oxygen over ambient total and oxygen partial pressures to treat various disease processes and their diseases. The combination of increased atmospheric pressure and hyperoxia express or suppress upto 8101 genes in human cells [35]. Hyperbaric oxygen therapy appears to be the oldest, most enduring, and most effective gene therapy. Physicians and researchers are playing a symphony with gene expression and suppression, the combination of which is dependent on the different total pressures and partial pressures of oxygen. With an appreciation of the scientific definition of hyperbaric oxygen therapy the field of Undersea and Hyperbaric Medicine is poised to rapidly expand with investigation of the lower dosing ranges of pressure and hyperoxia for a multitude of diagnoses.
Hyperbaric Oxygen: Its Mechanisms and Efficacy
This article outlines therapeutic mechanisms of hyperbaric oxygen therapy and reviews data on its efficacy for clinical problems seen by plastic and reconstructive surgeons.
Effects of Hyperbaric Oxygen Therapy on the Increase of iNOS and NFKB Expressions and the Acceleration of Wound Healing Process during Inflammation and Proliferation Phases
HBOT downregulates inflammation via cytokine modulation. Wound is one of the most common causes of morbidity in developing countries. Hyperbaric Oxygen Therapy (HBO), which can improve tissue oxygenation and stimulate the formation of H2O2 as a secondary messenger to Nuclear Factor Kappa Beta (NFKB) Phosporylation, has increasingly been used in wound treatment. Principal mechanism of HBO is based on intracellular generation of Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS), including Nitric Oxide (NO). In the wound area, moreover, the great amount of NO is mostly generated by the enzyme inducible Nitric Oxide Synthase (iNOS) through NFKB pathway. The beneficial effects of NO in wound repair may be attributed to its functional influences on angiogenesis, inflammation, cell proliferation, matrix deposition and remodeling.Accordingly, this research aims to determine whether Hyperbaric Oxygen Therapy (HBO) can improve iNOS and NFKB expressions and wound healing process.
Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome – Prospective Clinical Trial
Significant symptom improvement in fibromyalgia patients. Fibromyalgia Syndrome (FMS) is a persistent and debilitating disorder estimated to impair the quality of life of 2–4% of the population, with 9:1 female-to-male incidence ratio. FMS is an important representative example of central nervous system sensitization and is associated with abnormal brain activity. Key symptoms include chronic widespread pain, allodynia and diffuse tenderness, along with fatigue and sleep disturbance. The syndrome is still elusive and refractory. The goal of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on symptoms and brain activity in FMS.
Hyperbaric oxygen therapy increases telomere length and decreases immunosenescence in isolated blood cells: a prospective trial
Strong support for anti-aging benefits through telomere elongation. Aging is characterized by the progressive loss of physiological capacity. At the cellular level, two key hallmarks of the aging process include telomere length (TL) shortening and cellular senescence. Repeated intermittent hyperoxic exposures, using certain hyperbaric oxygen therapy (HBOT) protocols, can induce regenerative effects which normally occur during hypoxia. The aim of the current study was to evaluate whether HBOT affects TL and senescent cell concentrations in a normal, non-pathological, aging adult population.
Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients – a retrospective analysis
Evidence for improved cognition and reduced inflammation after stroke. Previous studies have shown that hyperbaric oxygen therapy (HBOT) can improve the motor functions and memory of post-stroke patients in the chronic stage. The aim of this study is to evaluate the effects of HBOT on overall cognitive functions of post-stroke patients in the chronic stage. The nature, type and location of the stroke were investigated as possible modifiers.
Hyperbaric oxygen therapy for the management of chronic wounds: patient selection and perspectives
Details clinical improvements in chronic wounds and diabetic ulcers. The Undersea and Hyperbaric Medical Society includes “select problem wounds” as an accepted indication for the use of hyperbaric oxygen (HBO2), however, the treatment of diabetic foot ulcers (DFUs) has dominated any discussions of problem wounds because of the prevalence of DFUs in today’s patient population and the reimbursement available for their treatment. Other wound types (eg, calciphylaxis ulcers, sickle cell ulcers, and pyoderma gangrenosum) that have well-deserved reputations as problem wounds have been infrequently treated with HBO2. While there are sound fundamental reasons why additional oxygen may have benefits in the treatment of these wounds, the challenge is finding enough high quality evidence to support routine use of HBO2.
Oxidative stress is fundamental to hyperbaric oxygen therapy
Provides insight into how HBOT modulates neuroplasticity. The goal of this review is to outline advances addressing the role that reactive species of oxygen and nitrogen play in therapeutic mechanisms of hyperbaric oxygen. The review will be organized around major categories of problems or processes where controlled clinical trials have demonstrated clinical efficacy for hyperbaric oxygen therapy. Reactive species are now recognized to play a major role in cell signal transduction cascades, and the discussion will focus on how hyperbaric oxygen acts through these pathways to mediate wound healing and ameliorate postischemic and inflammatory injuries.
Reflections on the neurotherapeutic effects of hyperbaric oxygen
Provides insight into how HBOT modulates neuroplasticity. Traumatic brain injury (TBI) and stroke are the major causes of brain damage and chronic neurological impairments. There is no agreed-upon effective metabolic intervention for TBI and stroke patients with chronic neurological dysfunction. Clinical studies published this year present convincing evidence that hyperbaric oxygen therapy (HBOT) might be the coveted neurotherapeutic method for brain repair. Here we discuss the multi-faceted role of HBOT in neurotherapeutics, in light of recent persuasive evidence for HBOT efficacy in brain repair and the new understanding of brain energy management and response to damage. We discuss optimal timing of treatment, dosage, suitable candidates and promising future directions.
Significant recovery from long COVID symptoms using HBOT.
Post-COVID-19 condition refers to a range of persisting physical, neurocognitive, and neuropsychological symptoms after SARS-CoV-2 infection. The mechanism can be related to brain tissue pathology caused by virus invasion or indirectly by neuroinflammation and hypercoagulability. This randomized, sham-control, double blind trial evaluated the effect of hyperbaric oxygen therapy (HBOT or HBO2 therapy) on post-COVID-19 patients with ongoing symptoms for at least 3 months after confirmed infection. There was significant recovery from long COVID symptoms using HBOT.
Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial
Traumatic brain injury (TBI) is the leading cause of death and disability in the US. Approximately 70-90% of the TBI cases are classified as mild, and up to 25% of them will not recover and suffer chronic neurocognitive impairments. The main pathology in these cases involves diffuse brain injuries, which are hard to detect by anatomical imaging yet noticeable in metabolic imaging. The current study tested the effectiveness of Hyperbaric Oxygen Therapy (HBOT) in improving brain function and quality of life in mTBI patients suffering chronic neurocognitive impairments.
Hyperbaric oxygen therapy for Alzheimer's dementia with positron emission tomography imaging a case report
The prevalence12 and costs2 of dementia, of which Alzheimer’s dementia (AD)3 is the dominant subtype, are substantial.3 AD is characterized by deficits in memory and executive function.4 Treatments have focused on pharmacotherapy,5 but from 2002–2012 the US Food and Drug Administration has cleared only 1 of 244 drugs tested6 and no therapy halts disease progression.7 The dual-drug hyperbaric oxygen therapy (HBOT)89 has many neurological applications.10 The first successful HBOT-treated case of AD was published in 2001.1112 The present case report is the first patient in a series of 11 HBOT-treated AD patients whose symptomatic improvement is documented with 18fluorodeoxyglucose positron emission tomography (18FDG PET).