Here is the final blog from our month long focus of celebrating Hyperbaric Awareness Month.
Thank you #HyperbaricAware #hyperbaricawareUSA and #UHMS

NOTE: While these are effectively ‘snapshots’ of each indication we strongly recommend a thorough reading of each chapter in the UHMS Indications resources to appreciate the full view for HBO2 treatment of these conditions. "Currently 14 indications for HBO2 are recognized by the UHMS, with recommendations for treatment. What follows is an abbreviated description of each. To read this article in its entirety, please connect to #HyperbaricAware: Hyperbaric Indications and Patient Selection Criteria Part 4 of 4

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The burn wound is a complex and dynamic injury.
A significant and consistently positive body of evidence from animal and human studies of thermal injury supports the use of hyperbaric oxygen as an adjuvant treatment.

"THERMAL BURNS The burn wound is a complex and dynamic injury. A significant and consistently positive body of evidence from animal and human studies of thermal injury supports the use of hyperbaric oxygen as an adjuvant treatment. HBO2 is a means of promoting healing. The majority of clinical reports have shown reduction in mortality, length of hospital stay, number of surgeries and cost of care. It has been demonstrated to be safe in the hands of those thoroughly trained in rendering this therapy in the critical care setting and with appropriate monitoring precautions. Careful patient selection is mandatory.

The National Burn Repository reviewed the combined data of acute burn admissions for the time period between 2006 through 2015. Patients age 60 or older represented 14% of burn cases. More than 75% of reported total burn cases involved less than 10% total body surface area and resulted in a mortality of 0.6%. Mortality rates were 3.3% for all cases and 5.8% for fire/flame injuries.

Infection remains the leading overall cause of death from burns. Susceptibility to infection is greatly increased due to the loss of the integumentary barrier to bacterial invasion, the ideal substrate present in the burn wound, and the compromised or obstructed microvasculature, which prevents humoral and cellular elements from reaching the injured tissue. Deaths increased with advancing age and burn size as well as presence of inhalation injury. A 20-39% burn in patients younger than 60 confers a mortality rate of 2.5%; the mortality rate increases to 14% with inhalation injury. The same injury in a 60-year-old shows a mortality of 32%, which increases to 55.8% in the presence of inhalation injury.

Pneumonia was the most frequent, clinically related complication, occurring in 5.4% of fire/flame- or flame-injured patients. The frequency of pneumonia and respiratory failure was greater in patients with four days or greater of mechanical ventilation, and the rate of complications increased with age.

Ongoing tissue damage is a major factor in thermal injury. It is due to multiple factors, including the failure of surrounding tissue to supply borderline cells with oxygen and nutrients necessary to sustain viability. Complete capillary occlusion may progress by a factor of 10 during the first 48 hours after injury. Local microcirculation is compromised to the greatest extent during the 12 to 24 hours post-burn. Burns are in this dynamic state of flux for up to 72 hours after injury. Ischemic necrosis quickly follows.

Hyperbaric oxygen treatment after burns has shown reversal of the zone of stasis, reduction of ischemia and ischemic necrosis, prevention of progression of partial- to full-thickness injury, moderation of inflammation, lessening of capillary leak, preservation of dermal elements, a reduced need for grafting, shortened hospital stay, and a reduction in cost of care. HBO2 is recommended to treat serious burns – i.e., greater than 20% total body surface area and/or with involvement of the hands, face, feet or perineum – that are deep partial- or full-thickness injury. Patients with superficial burns or those not expected to survive are not accepted for therapy. Transfer of patients for HBO2 treatment should be considered carefully and should be sent only to a facility that has both a hyperbaric chamber and a burn unit. Utilization review is recommended after 30 hyperbaric oxygen sessions.

Given our current understanding of the uniquely beneficial effects of hyperbaric oxygenation on the cellular and molecular mechanisms of wound healing, it is suggested that the formal integration of HBO2 in early burn wound management be considered, as well as further investigated in well-designed multicenter studies that provide data for burn wound healing and burn patient outcomes."
Taken from Moon RE, ed. Hyperbaric Oxygen Therapy Indications, 14 ed. North Palm Beach: Best Publishing, 2019: 1-13.

Additional Resources:
For the most up-to-date, complete guide for Hyperbaric Medicine Indications refer to
The Undersea Hyperbaric & Medical Society, Hyperbaric Medicine Indications Manual, 15th Edition released by UHMS and Best Publishing Company, 2024.

New Clinics:
Are you starting a new hyperbaric and wound care clinic, or overhauling an existing program? Are you unsure where to start with regard to staff training and credentialing? Start Here: Wound Care Education Partners: New Clinics

Enroll in Introduction to Hyperbaric Medicine:
Wound Care Education Partners offer Introduction to Hyperbaric Medicine which will provide medical professionals with basic training or continuing education in hyperbaric medicine. Check it out here: https://www.woundeducationpartners.com/live-courses/hbo-courses.html.