Indications for Hyperbaric Oxygen Therapy
Definition of Hyperbaric Oxygen Therapy:
The UHMS defines hyperbaric oxygen (HBO2) as an intervention in which an individual breathes near 100% oxygen intermittently while inside a hyperbaric chamber that is pressurized to greater than sea level pressure (1 atmosphere absolute, or ATA). For clinical purposes, the pressure must equal or exceed 1.4 ATA while breathing near 100% oxygen. The United States Pharmacopoeia (USP) and Compressed Gas Association (CGA) Grade A specify medical grade oxygen to be not less than 99.0% by volume, and the National Fire Protection Association specifies USP medical grade oxygen.
In certain circumstances hyperbaric oxygen therapy represents the primary treatment modality while in others it is an adjunct to surgical or pharmacologic interventions.
Treatment can be carried out in either a mono‑ or multiplace chamber. The former accommodates a single patient; the entire chamber is pressurized with near 100% oxygen, and the patient breathes the ambient chamber oxygen directly. The latter holds two or more people (patients, observers, and/or support personnel); the chamber is pressurized with compressed air while the patients breathe near 100% oxygen via masks, head hoods, or endotracheal tubes. According to the UHMS definition and the determination of The Centers for Medicare and Medicaid Services (CMS) and other third party carriers, breathing medical grade 100% oxygen at 1 atmosphere of pressure or exposing isolated parts of the body to 100% oxygen does not constitute HBO2 therapy. The patient must receive the oxygen by inhalation within a pressurized chamber. Current information indicates that pressurization should be to 1.4 ATA or higher.