Croatian indications for hyperbaric oxygenation: doubts of the world projected in a small country

Abstract

The recently issued "Croatian List of Indications for Hyperbaric Oxygen Treatment" (HBO2T) includes indications from the Undersea and Hyperbaric Medical Society List of Indications and the European Consensus List of Indication for Hyperbaric Oxygen, but also several considered by many as "off-label." Now approved by Croatian national health authorities, these indications are no longer "off-label" in Croatia. This represents a real controversy, confronting administrative vs. scientific/professional issues. Few systematic reviews have been published in The Cochrane Library so far on the subject of HBO2T, and most of them did not result in definitive recommendations for clinical practice. Croatian patients might benefit from the current list of indications because they will have the opportunity to be treated at the government's expense. Researchers will have easier access to potential subjects for clinical studies, subjects that are urgently needed to establish whether standard and off-label indications for HBO2T are in accordance with the principles of evidence-based medicine.