Hyperbaric oxygen (HBO) therapy has been used to treat a huge range of different medical conditions, some with more evidence than others. Much effort has been made and is ongoing to add to the evidence base looking at which medical conditions could benefit from HBO and by what mechanisms HBO actually works for these conditions.
DDRC Healthcare strives to work to best current evidence for use of HBO. We do receive enquiries about some conditions for which we do not feel sufficient evidence exists to warrant treatment with HBO.
It should be noted organisations such as DDRC Healthcare undertake stringent internal and external review to demonstrate provision of safe, quality and evidence based operation. DDRC Healthcare is registered with the Care Quality Commission and medically trained staff are always present whilst patients are undergoing HBO.
Below are discussed a few of the most common pathologies for which hyperbaric oxygen therapy has been attempted but which are NOT currently treated at DDRC Healthcare. New research in many areas is ongoing and evidence will be reviewed as it becomes available.
Conditions that we DO NOT treat with Hyperbaric Oxygen
Multiple Sclerosis (MS) is a disease which causes varied, unpredictable and often intermittent neurological problems. The damage in the nervous system causing these symptoms is thought to be inflammatory in nature and results in demyelination of the nerves.
There has been much interest in HBO as a method of slowing or reversing MS. Some trials have suggested benefit of HBO for MS however a Cochrane Review undertaken in 2011 found that the majority of trials did not find benefit in use of HBO for MS.
There are however numerous centres around the UK which provide oxygen at increased pressure for people with MS, with reports of personal benefit.
DDRC Healthcare does not advocate HBO for the treatment of MS currently, and has no links with any of the MS National Therapy Centres.
References
Bennett MH, Heard R. Hyperbaric oxygen therapy for multiple sclerosis. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD003057. DOI: 10.1002/14651858.CD003057.pub2.
Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32. doi: 10.28920/dhm47.1.24-32. Erratum in: Diving Hyperb Med. 2017 Jun;47(2):131-132. doi: 10.28920/dhm47.2.131-132. PMID: 28357821; PMCID: PMC6147240.
Cerebral palsy is a group of movement and posture disorders causing by hypoxic injury to the brain. HBO has been hypothesised as a potential therapeutic treatment for cerebral palsy as increased oxygen supply to tissues may increase activity of nerves and stem cells within the brain.
Various clinical studies of differing quality have been published, as well as a systematic review of HBO for Cerebral Palsy, with no clinical evidence of benefit.
References
Laureau J, Pons C, Letellier G, Gross R. Hyperbaric oxygen in children with cerebral palsy: A systematic review of effectiveness and safety. PLoS One. 2022 Oct 14;17(10):e0276126. doi: 10.1371/journal.pone.0276126. PMID: 36240157; PMCID: PMC9565562.
Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32. doi: 10.28920/dhm47.1.24-32. Erratum in: Diving Hyperb Med. 2017 Jun;47(2):131-132. doi: 10.28920/dhm47.2.131-132. PMID: 28357821; PMCID: PMC6147240.
McDonagh MS, Morgan D, Carson S, Russman BS. Systematic review of hyperbaric oxygen therapy for cerebral palsy: the state of the evidence. Dev Med Child Neurol. 2007 Dec;49(12):942-7. doi: 10.1111/j.1469-8749.2007.00942.x. PMID: 18039243.
These include disorders that cause a wide spectrum of symptoms disability. They can cause a person to have problems with social interaction, imaginative thought and communication.
HBO has been used in attempt to improve symptoms but currently there is no evidence to suggest that HBO can provide benefit. Given that autism is thought to have a genetic basis, the theoretical mechanism by which HBO could offer benefit is doubtful.
DDRC Healthcare does not currently advocate using HBO to treat Pervasive Developmental Disorders.
References
Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32. doi: 10.28920/dhm47.1.24-32. Erratum in: Diving Hyperb Med. 2017 Jun;47(2):131-132. doi: 10.28920/dhm47.2.131-132. PMID: 28357821; PMCID: PMC6147240.
Xiong T, Chen H, Luo R, Mu D. Hyperbaric oxygen therapy for people with autism spectrum disorder (ASD). Cochrane Database of Systematic Reviews 2016, Issue 10. Art. No.: CD010922. DOI: 10.1002/14651858.CD010922.pub2.
Strokes are caused by the disruption of blood flow to the brain depriving the brain of oxygen and causing cell death. It has been suggested that HBO may reduce the amount of brain tissue that may die by increasing the oxygen available to damaged tissue and reducing brain swelling which can cause secondary damage.
A Cochrane Review of the use of HBO in the treatment of acute stroke found that there was no significant difference in mortality rate at 6 months and no consistent evidence of improvement in disability and functional performance, however further research is required.
There has been some suggestion that HBO may have a role in neurological improvement in post stroke patients at later stages but further research is required.
References
Bennett MH, Weibel S, Wasiak J, Schnabel A, French C, Kranke P. Hyperbaric oxygen therapy for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD004954. DOI: 10.1002/14651858.CD004954.pub3.
Efrati S, Fishlev G, Bechor Y, Volkov O, Bergan J, Kliakhandler K, Kamiager I, Gal N, Friedman M, Ben-Jacob E, Golan H. Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial. PLoS One. 2013;8(1):e53716. doi: 10.1371/journal.pone.0053716. Epub 2013 Jan 15. PMID: 23335971; PMCID: PMC3546039.
Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32. doi: 10.28920/dhm47.1.24-32. Erratum in: Diving Hyperb Med. 2017 Jun;47(2):131-132. doi: 10.28920/dhm47.2.131-132. PMID: 28357821; PMCID: PMC6147240.