Search Results (257)

Background: Central retinal artery occlusion (CRAO) causes sudden, often profound monocular vision loss. We compared the efficacy and safety of hyperbaric oxygen therapy (HBOT) versus intravenous thrombolysis (IVT) using a systematic review and meta-analysis. Methods: Following PRISMA 2020 guidance, we searched PubMed, Cochrane Library, Web of Science, and VHL from inception to 27 May 2025, screened records in duplicate, and synthesized visual outcomes (best-corrected visual acuity [BCVA], logMAR), onset-to-treatment time, and adverse events using random-effects models. Results: Twenty-five observational studies (781 patients; 557 HBOT eyes, 225 IVT eyes) met inclusion. Both HBOT and IVT were associated with significant improvements in BCVA (HBOT: MD −0.57 logMAR; IVT: MD −0.53 logMAR). Clinically meaningful improvement occurred in 45.8% after HBOT and 42.0% after IVT. Adverse event rates were similar (HBOT 11.3%; IVT 10.2%) but differed in type (ear barotrauma with HBOT; hemorrhagic events with IVT). Conclusions: HBOT and IVT both improve visual outcomes in CRAO. Differences in adverse event profiles and substantial heterogeneity among IVT studies underscore the need for adequately powered comparative trials and standardized treatment pathways. Registration: Not prospectively registered; PRISMA 2020 checklist is provided. Full article

Stroke remains a leading cause of death and disability worldwide, imposing significant burdens on patients, families, and healthcare systems. Despite advances in acute management and rehabilitation, effective interventions to promote neural recovery remain limited. Hyperbaric oxygen therapy (HBOT) has emerged as a potential adjunctive treatment, but its effects on cortical functional activity—particularly the neurophysiological mechanisms underlying clinical improvements—remain insufficiently understood. This study aimed to investigate the effects of hyperbaric oxygen therapy (HBOT) on cerebral activation in stroke patients using functional near-infrared spectroscopy (fNIRS) and to evaluate its therapeutic efficacy. A total of 23 patients with intracerebral hemorrhage and 20 with cerebral infarction were enrolled. fNIRS data were collected before HBOT and within 10–30 min after treatment completion. During data acquisition, participants performed an alternating left- and right-hand grip task while wearing the fNIRS device throughout the procedure. Changes in near-infrared light intensity were monitored to objectively reflect cortical activity. The results showed that after HBOT, activation patterns in relevant brain regions during the grip task were significantly altered: activation channels during the bilateral grip task changed in cerebral infarction patients, with some brain regions overlapping with those observed in intracerebral hemorrhage patients. In intracerebral hemorrhage patients, the number of significantly activated channels decreased during the left-hand grip task but increased notably during the right-hand grip task, which may be related to cerebral functional compensation and right-hand dominance. Clinical assessments revealed significant post-treatment improvements in Brunnstrom stage, Fugl-Meyer scores, and activities of daily living. These findings suggest that HBOT may contribute to multifaceted recovery of brain function in stroke patients, not only by enhancing cerebral blood flow and oxygenation but also by facilitating neural repair and regeneration, as well as optimizing cerebral activation and functional connectivity. Thus, this study provides an objective basis for understanding the mechanisms and efficacy of HBOT in stroke rehabilitation. Full article

High-energy ballistic and avulsive injuries to the face represent some of the most complex challenges in modern reconstructive surgery. Since Robertson and Manson’s 1999 management protocol, extensive military experience and technological advancements have transformed the treatment principles while preserving the core tenets of staged care. This updated review synthesizes evidence from 36 studies published since 2000, encompassing over two decades of global experience in both military and civilian trauma. Advances in damage-control resuscitation, wound decontamination, and early skeletal stabilization have improved survival and functional outcomes. Modern imaging—particularly intraoperative CT and navigation—enables the precise verification of the reduction and removal of retained fragments, while virtual surgical planning and patient-specific implants allow the accurate restoration of facial buttresses. Early vascularized tissue transfer has reduced contracture and infection rates. Adjuncts such as hyperbaric oxygen therapy, permissive hypotension, and advanced hemostatic agents further optimize recovery. The updated four-phase protocol—resuscitation, reconstitution, reconstruction, and rehabilitation—emphasizes early definitive repair, multidisciplinary collaboration, and the integration of digital planning. These refinements extend Robertson and Manson’s foundational principles into the era of precision surgery, achieving superior aesthetic and functional outcomes for patients with devastating facial injuries. Full article

Background/Objectives: Physiological changes during hyperbaric oxygen therapy (HBOT) are not well characterized, particularly in non-emergent patients receiving HBOT as part of a repeated or maintenance treatment course, in whom understanding physiological responses during individual sessions is important for clinical monitoring. This study evaluated changes in vital signs and electrocardiographic (ECG) findings across the pre-compression, compression, maintenance, decompression, and post-treatment phases and evaluated clinical symptoms. Methods: This prospective observational study enrolled 50 hemodynamically stable non-emergent patients undergoing HBOT at a single tertiary center. Changes in vital signs and ECG findings were recorded across all phases. Repeated vital sign measurements were analyzed using linear mixed models; ECG abnormalities were assessed using generalized linear mixed models. Results: Heart rate decreased significantly across all HBOT phases compared with baseline. Blood pressure (BP) remained stable during compression and maintenance but increased significantly during decompression and post-treatment. Respiratory rate decreased during treatment and then returned to baseline. Oxygen saturation remained within normal ranges throughout all phases. Transient ECG rhythm abnormalities were observed in 10.0% of patients, primarily during compression and maintenance phases. One patient developed brief clinical symptoms accompanied by supraventricular tachycardia immediately after decompression, which resolved spontaneously without intervention. No significant oxygen toxicity or serious adverse events were observed. Conclusions: HBOT in hemodynamically stable non-emergent patients induces predictable, largely transient physiological changes and is well tolerated under standard protocols. Blood pressure elevation was most pronounced during decompression and the post-treatment phase, whereas transient ECG abnormalities were observed primarily during the compression and maintenance phases, with a single episode of supraventricular tachycardia occurring immediately after decompression. These findings provide foundational clinical data for understanding phase-specific physiological responses during HBOT and inform future studies in higher-risk patient populations. Full article

Background: Hyperbaric oxygen therapy (HBOT) has regenerative effects in various tissues, but its impact on hair follicles is unclear. This preliminary study evaluated HBOT-induced changes in hair and scalp characteristics in healthy adults. Methods: Nine healthy volunteers completed 50 HBOT sessions over three months (2.0 ATA, 100% oxygen, 90 min per session). Objective assessments included follicle density, hairs per follicle, hair volume, and shaft thickness using the Becon phototrichogram system. Subjective evaluations were conducted via a 7-point Likert questionnaire on scalp appearance, hair density, thickness, growth, and shedding. Pre- and post-treatment data were compared using paired statistical tests. Results: Positive trends were observed in follicle density (61.3→66.8 counts/cm²), hairs per follicle (1.24→1.33), and hair volume (24.9→27.7%), though not statistically significant. Hair shaft thickness decreased significantly (0.18→0.10 mm, p = 0.011), consistent with early anagen-phase regrowth. Subjective assessments showed significant improvements across all domains (p < 0.05). Scalp imaging visually supported these findings. Conclusions: HBOT may enhance hair follicle activation and scalp health in healthy adults. These preliminary findings justify further controlled studies to explore HBOT as a non-pharmacological approach to hair regeneration. Full article

Myocarditis is still a major global health issue that frequently manifests due to oxidative stress, immune-mediated myocardial damage, and unpredictable clinical progression. Experiments with autoimmune myocarditis (EAM) models have shown different ways that T-cell subsets, proinflammatory cytokines, macrophage polarization, and mitochondrial dysfunction are all connected and play a part in both acute inflammation and chronic remodeling of the heart. As a possible multimodal intervention that could affect several of these disease-causing pathways, hyperbaric oxygen therapy (HBOT) has become popular. This therapy delivers 100% oxygen to different tissues at higher atmospheric pressures. Early research shows that HBOT improves the delivery of oxygen to the inflamed myocardium, suppress the activation of NF-κB and NLRP3 inflammasomes, lowers oxidative stress, protects mitochondrial function, and boosts immune-regulatory T-cell responses. Despite these potentially promising findings, there are still a number of important translational obstacles to overcome, such as inconsistent protocols, a lack of long-term outcome data, insufficient mechanistic profiling, and doubts about the best protocol length and patient selection. To assess safety and effectiveness in human myocarditis, future studies should aim to integrate multi-omics analyses, HBOT regimens that are already standardized, sophisticated imaging, and carefully planned early-phase clinical trials. Overall, the currently available evidence supports HBOT as a biologically plausible and potentially valuable adjunct therapy for autoimmune myocarditis, expressing the need for further mechanistic and clinical investigation. Full article

Background/Objectives: The study aimed to evaluate the efficacy of hearing gain using hyperbaric oxygen (HBO) therapy on patients with idiopathic sudden sensorineural hearing loss (ISSHL), and to provide recommendations with reference to treatment session, intervention time and the impairment severity. Methods: In this retrospective chart-review study, we analyzed data of ISSHL patients referred to us from the department of Ear, Nose and Throat (ENT) between January 2016 and December 2024. Hearing sensitivity improvements were assessed using pure-tone audiometry (PTA). Results: We found that 50.7% of patients (n = 148) had improved after 5 HBO sessions and 47.7% (n = 107) had improved after 10 HBO sessions. While no difference was found between different treatment cycles, we found treatment effects varied significantly depending on disease severity. Specifically, 64.3% of patients with profound ISSHL had improved (p = 0.010) after 5 sessions, and 69.2% (p = 0.002) after 10 sessions. Such improvements in patients with profound ISSHL were 3.681-fold larger than in those with mild to moderate ISSHL. In addition, patients who had received HBO therapy within 12 days of diagnosis showed the best response, with an odds ratio (OR) of 7.768 (95% CI: 2.785–21.664) (p = 0.000 *); those receiving HBO between 13 and 27 days had an OR of 3.974 (95% CI: 1.243–12.702), (p = 0.020 *); both groups were compared with those receiving HBO after 27 days. Conclusions: Patients with more severe ISSHL showed greater improvement with HBO therapy. Also, patients who started HBO therapy earlier showed better response; those who started later, like after 27 days, showed poorer or even no response at all. Full article

Intestinal ischemia–reperfusion injury (IRI) represents a major cause of morbidity and mortality in abdominal surgery, trauma, and intestinal transplantation. The pathophysiological process involves a biphasic cascade that begins with ischemic hypoxia and progresses to amplified cellular and molecular injury upon reperfusion. This review synthesizes recent mechanistic insights regarding endothelial and microvascular dysfunction, epithelial barrier breakdown, microbiota-driven systemic propagation, and the involvement of oxidative/nitrosative stress and inflammatory signaling. The novelty of our review’s approach is the focus on experimental and translational studies and correlation of the data with future directions for mechanistic research and clinical implementation. Despite promising preclinical results, heterogeneity in study protocols or/and model limitations make clinical translation challenging. Recent studies have demonstrated that mitochondria, tight junction proteins, adhesion molecules and innate immune receptors are critical determinants of lesion evolution. Based on these, the current therapeutic strategies include antioxidants, adenosine pathway modulators, dexmedetomidine, ischemic conditioning, hyperbaric oxygen therapy, and microbiota-targeted interventions. Since each mechanism is acting on distinct molecular pathways, a multimodal therapy that integrates redox modulation, endothelial protection, microbiome regulation, and the identification and employment of precision biomarkers is likely to improve outcomes. Beyond summarizing established molecular mechanisms, this review critically reassesses why decades of promising experimental strategies for intestinal ischemia–reperfusion injury has largely failed to translate into effective clinical therapies. By distinguishing context-dependent mechanisms from pathways with consistent translational relevance, we highlight key methodological and biological barriers limiting clinical applicability. Furthermore, we propose a temporally structured, multimodal therapeutic framework that integrates phase-specific pathophysiology with targeted interventions, aiming to inform future experimental design and improve translational success. Full article

Long COVID is defined as “the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanations”, as reported by the World Health Organization. A growing number of people are dealing with a variety of lingering symptoms even after recovering from an acute infection. These can include fatigue, muscle pain, shortness of breath, headaches, cognitive issues, neurodegenerative symptoms, anxiety, depression, and a feeling of hopelessness, and therapeutic options for long COVID are investigated. The potential of hyperbaric oxygen therapy (HBOT) to improve chronic fatigue, cognitive impairments, and neurological disorders has been established; therefore, the use of HBOT to treat long COVID has also been studied. The aim of this literature search is to analyze the state of the art of a potential role of HBOT to improve chronic fatigue, cognitive impairments and neurological disorders. A literature analysis was performed, focusing on the clinical efficacy of HBOT for treating long COVID symptoms. The results from January 2021 to October 2025, using a standard registry database, showed 21 studies, including one case report, ten randomized controlled trial, eight systematic reviews and three studies regarding the molecular mechanism and markers changing after HBOT. They suggested that HBOT can improve quality of life, fatigue, cognition, neuropsychiatric symptoms and cardiopulmonary functions. HBOT is a safe treatment and has shown some benefits for long COVID symptoms. To precisely define indications, protocols, and post-treatment evaluations, we need to conduct more in-depth, large-scale studies. Full article

Background/Objectives: Hyperbaric Oxygen Therapy (HBOT) involves breathing oxygen at pressures greater than atmospheric levels and is used to treat diverse clinical conditions. However, little is known about the lived experiences and perceived needs of patients undergoing scheduled treatment in multiplace hyperbaric chambers, where nurses play a key role in support, safety, and communication. This study aimed to explore the perceptions, expectations, and needs of patients receiving scheduled HBOT sessions in a multiplace chamber in a hospital setting. Methods: A qualitative phenomenological design was used. Participants were recruited consecutively among adults who had completed at least 10 HBOT sessions and demonstrated adequate cognitive function. Individual semi-structured interviews were conducted between January and March 2023 in locations chosen by participants. Interviews were audio-recorded, transcribed, and validated by participants. Results: Twelve participants (eight men, four women; aged 25–84 years) were included. Four thematic areas emerged: (1) Biopsychosocial lived experiences, including initial uncertainty, physical discomfort such as ear pressure or mask-related issues, and progressive recognition of therapeutic benefits. (2) Interpersonal relationships, highlighting trust, security, and emotional support provided mainly by nurses. (3) Communication experiences, with participants expressing satisfaction but requesting clearer, earlier information on procedures, risks, and expected sensations. (4) Structural and organizational factors, where transportation logistics and treatment scheduling were significant sources of fatigue and discomfort. Conclusions: Patients valued HBOT and perceived notable health improvements, while identifying specific unmet informational and organizational needs. These findings suggest the importance of nurse-led educational interventions to enhance preparation, reduce anxiety, and optimize patient experience during HBOT. Full article

Background: Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for spinal cord injuries (SCIs) to mitigate a secondary injury and enhance neurological recovery. While the preclinical evidence is consistently supportive, clinical data remain heterogeneous across traumatic (TSCI) and non-traumatic (NTSCI) etiologies. Methods: A hybrid systematic review was conducted in accordance with the PRISMA 2020 guidelines and included an illustrative single-center clinical case. PubMed, OVID Medline, and Google Scholar were searched for studies published between 1978 and 2024. Due to methodological heterogeneity, qualitative synthesis was performed. Results: Fifty studies comprising 1102 patients were included. Neurological improvement was more frequently observed in incomplete injuries and when HBOT was initiated early. Conclusions: HBOT may represent a useful adjunct in selected SCI patients, although standardized protocols and controlled trials are required to better define its role. Full article

Hard-to-heal wounds remain a significant challenge for healthcare professionals, particularly in aging populations. Although most chronic wounds are associated with diabetes or chronic venous insufficiency, rare etiologies should also be considered. One such cause is envenomation by Phoneutria spp. (native to South America, rare in Europe). Their venom contains potent neurotoxins. While systemic manifestations are more commonly reported, localized necrotic skin lesions may also occur. This case report presents a rare chronic wound following a suspected Phoneutria spider bite and highlights the importance of an individualized, multimodal treatment approach. A 61-year-old male patient with a progressive thigh wound following a spider bite sustained during work. Despite initial self-treatment and pharmacotherapy the wound deteriorated. The patient was admitted to the authors’ facility, where surgical treatment included necrosectomy and a sandwich graft using an acellular dermal matrix combined with a split-thickness skin graft. Adjunctive therapies included negative pressure wound therapy and hyperbaric oxygen therapy. After discharge, outpatient wound care was continued. Treatment was monitored with photographic documentation and serial microperfusion measurements. Complete wound closure was achieved after 4 months of specialized therapy. Management of chronic wounds requires a multidisciplinary and individualized approach with surgical intervention, advanced wound care and specialized outpatient follow-up. Full article

Acute lung injury (ALI) is in part precipitated by hyperbaric oxygen or other mechanical insults. It constitutes the fundamental pathological process underlying acute respiratory distress syndrome (ARDS). The manifestation of the condition is characterized by an uncontrolled inflammatory response and alveolar edema, consequent to the disruption of the alveolar–capillary barrier. This phenomenon is associated with elevated morbidity and mortality rates. The current therapeutic interventions for ALI are not well researched or articulated. However, recent studies have indicated that stem cells may possess therapeutic potential in the context of ALI. The present study demonstrates that these exosome preparations have the capacity to significantly ameliorate radiographic findings, histological parameters, and vascular permeability in murine models of ALI. Concurrently, they attenuate the inflammatory response to a certain extent. The present review commences with an examination of the pathogenic mechanisms and manifestations of pulmonary injury induced by hyperbaric oxygen or other external factors. The subsequent sections of the text provide detailed accounts of the latest advances in exosome-based therapies for mitigating such injury, including their mechanisms of action and future translational prospects. While exosome-based treatments have demonstrated considerable advancement in preclinical research, numerous challenges must be surmounted before their widespread implementation in clinical settings can be realized, underscoring the necessity for sustained research in this domain. Full article

Background: Hyperbaric oxygen therapy (HBOT) is considered a potential adjunctive modality to enhance tissue regeneration in oral and maxillofacial surgery. By increasing tissue oxygen availability, HBOT may support bone and soft-tissue repair under hypoxic and chronically inflamed conditions. Aim: This narrative review evaluates current experimental and clinical evidence regarding HBOT in high-risk dental indications, including osteoradionecrosis (ORN), medication-related osteonecrosis of the jaw (MRONJ), chronic osteomyelitis, poorly healing postoperative wounds, and procedures in patients with systemic comorbidities. Methods: A structured search of PubMed, Web of Science, and the Cochrane Library identified 123 relevant English-language publications (from 1 January 2000–September 2025) addressing HBOT mechanisms and clinical applications in oral and maxillofacial surgery, including clinical trials, observational studies, preclinical models, and systematic reviews. Results: Available evidence suggests that HBOT may improve healing outcomes and reduce complication rates in early-stage ORN and MRONJ when used as an adjunct to surgery and systemic therapy. However, findings in implantology—particularly in irradiated or diabetic patients—and in periodontal therapy remain limited, heterogeneous, and methodologically inconsistent. Conclusions: HBOT may be considered in selected clinical scenarios, particularly where healing is impaired by hypoxia or systemic disease. Nevertheless, current evidence remains insufficient to support routine use. Standardized, high-quality studies with clearly defined endpoints and uniform therapeutic protocols are needed to determine its clinical effectiveness and optimal indications. Full article

Background and Objectives: To evaluate and synthesize evidence on the independent clinical effectiveness, safety, and applicability of Negative Pressure Wound Therapy (NPWT) and Hyperbaric Oxygen Therapy (HBOT) in diabetic foot ulcers (DFUs), and to determine whether current evidence allows for a direct comparison between both interventions: NPWT and HBOT are widely advanced therapies for DFUs. Although both show benefits, the relative superiority of one over the other remains unclear. Systematic review of the literature conducted in accordance with PRISMA guidelines. Materials and Methods: A comprehensive literature search was performed using two electronic databases. The review included randomized controlled trials, systematic reviews, meta-analyses, and non-randomized studies. Methodological quality and risk of bias were assessed using validated tools: RoB 2.0 for randomized trials, AMSTAR-2 for systematic reviews, and ROBINS-I for non-randomized studies. Results: A total of 22 studies were included. NPT was shown to be effective in accelerating wound healing, though results varied depending on the type of intervention and clinical context. HBOT demonstrated beneficial effects on angiogenesis and significantly reduced the rate of major amputations. Both therapies presented significant advantages in the management of diabetic foot ulcers. Conclusions: Negative pressure therapy and hyperbaric oxygen therapy are both effective treatments for diabetic foot ulcer healing. However, treatment selection should be individualized based on patient-specific clinical factors, ulcer severity, and available healthcare resources. Integrating these advanced therapies within a multidisciplinary care approach may optimize outcomes and reduce the risk of complications. Future research should include standardized, head-to-head RCTs. Full article