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Clinical Indications for Hyperbaric Oxygen Therapy

UHMS-Recognized Clinical Indications for Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy (HBOT) is recognized as an important adjunctive treatment for a number of complex medical conditions involving tissue hypoxia, infection, ischemia, radiation injury, and impaired wound healing.

House of Hyperbaric provides educational resources focused on the approved and evidence-supported clinical indications recognized by the Undersea & Hyperbaric Medical Society (UHMS).

In hyperbaric medicine, an approved indication refers to a condition for which Hyperbaric Oxygen Therapy has demonstrated sufficient scientific rationale, published clinical evidence, and expert consensus to support its use as part of accepted medical care.

The Undersea & Hyperbaric Medical Society (UHMS) publishes the Hyperbaric Medicine Indications Manual, which serves as one of the primary references used by clinicians, hospitals, and payers when evaluating appropriate HBOT utilization.

Many of these indications are also recognized by:

  • Centers for Medicare & Medicaid Services (CMS)
  • Commercial insurance carriers
  • Hospital-based hyperbaric programs
  • Accredited hyperbaric treatment centers

HBOT is typically used as part of a multidisciplinary treatment plan alongside surgery, wound care, infectious disease management, vascular intervention, rehabilitation, and ongoing physician oversight.

Clinical Indications for Hyperbaric Oxygen Therapy

Below is a comprehensive list of the current on-label uses for hyperbaric oxygen therapy.

Air or Gas Embolism

Hyperbaric Oxygen Therapy is considered a primary treatment for arterial gas embolism and other gas embolic events where rapid recompression and oxygen delivery are critical.

Carbon Monoxide Poisoning

HBOT is used in select cases of carbon monoxide poisoning, including severe exposure and cases complicated by neurologic symptoms or cyanide toxicity.

Clostridial Myositis and Myonecrosis (Gas Gangrene)

Gas gangrene is a rapidly progressive soft tissue infection requiring urgent medical and surgical intervention. HBOT may help inhibit anaerobic bacterial activity and support tissue preservation.

Crush Injury, Compartment Syndrome, and Acute Traumatic Ischemia

HBOT may support tissue survival and recovery in traumatic injuries associated with swelling, vascular compromise, and tissue hypoxia.

Decompression Sickness

HBOT is a primary treatment for decompression illness associated with pressure-related gas bubble formation.

Arterial Insufficiencies

This category includes selected problem wounds and compromised tissue associated with impaired arterial blood flow, including certain diabetic foot ulcers.

Severe Anemia

In rare situations where transfusion is not possible or contraindicated, HBOT may temporarily support oxygen delivery to tissues.

Intracranial Abscess

HBOT may be used as an adjunctive therapy in selected intracranial infections alongside neurosurgical and antimicrobial treatment.

Necrotizing Soft Tissue Infections

Hyperbaric Oxygen Therapy may support treatment of severe necrotizing infections when combined with surgery, antibiotics, and intensive medical management.

Refractory Osteomyelitis

HBOT may be incorporated into multidisciplinary management of chronic refractory bone infection.

Delayed Radiation Injury (Soft Tissue and Bony Necrosis)

Radiation injury may result in progressive tissue damage and impaired healing months or years after cancer treatment. HBOT is commonly used in selected radiation-related injuries involving soft tissue and bone.

Compromised Grafts and Flaps

HBOT may support tissue viability in compromised grafts and flaps with impaired oxygen delivery or vascular compromise.

Acute Thermal Burn Injury

HBOT may be used in select severe burn injuries to support oxygenation and tissue recovery.

Idiopathic Sudden Sensorineural Hearing Loss

Hyperbaric Oxygen Therapy may be considered in selected patients with sudden sensorineural hearing loss as part of an early treatment strategy.

Central Retinal Artery Occlusion

HBOT may be utilized in selected acute retinal ischemic events where rapid intervention is critical to preserve tissue viability.