Abstract
Hyperbaric oxygen therapy (HBOT) consists of using of pure oxygen at increased pressure (in general, 2–3 atmospheres) leading to augmented oxygen levels in the blood (Hyperoxemia) and tissue (Hyperoxia). The increased pressure and oxygen bioavailability might be related to a plethora of applications, particularly in hypoxic regions, also exerting antimicrobial, immunomodulatory and angiogenic properties, among others. In this review, we will discuss in detail the physiological relevance of oxygen and the therapeutical basis of HBOT, collecting current indications and underlying mechanisms. Furthermore, potential areas of research will also be examined, including inflammatory and systemic maladies, COVID-19 and cancer. Finally, the adverse effects and contraindications associated with this therapy and future directions of research will be considered. Overall, we encourage further research in this field to extend the possible uses of this procedure. The inclusion of HBOT in future clinical research could be an additional support in the clinical management of multiple pathologies.
Highlights
Hyperbaric oxygen therapy (HBOT) is a therapeutical approach based on exposure to pure concentrations of oxygen (O2) in an augmented atmospheric pressure
According to ECHM recommendation the use of HBOT is recommended in the treatment of radiation proctitis (Type 1 recommendation, Level A evidence), mandibular osteoradionecrosis and haemorrhagic radiation cystitis (Type 1 recommendation, Level B evidence) and suggested in the treatment of osteoradionecrosis of other bone than the mandible, for preventing loss of osseointegrated implants in irradiated bone and in the treatment of soft-tissue radionecrosis, in particular in the head and neck area (Type 2 recommendation, Level C evidence)
Its therapeutical basis could be understood from three different perspectives: Physical (Hyperbaric 100% oxygen), physiological (Hyperoxia and hyperoxemia) and cellular/molecular effects
Summary
Ortega 1,2,3,* , Oscar Fraile-Martinez 1,2,* , Cielo García-Montero 1,2 , Enrique Callejón-Peláez 4, Miguel A. Álvarez-Mon 1,2 , Natalio García-Honduvilla 1,2 , Jorge Monserrat 1,2 , Melchor Álvarez-Mon 1,2,6, Julia Bujan 1,2 and María Luisa Canals 7
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