Oxy-inflammation in hyperbaric oxygen therapy applications

Abstract

Hyperbaric Oxygen Therapy (HBOT) is a non-invasive method of O2 delivery that induces systemic hyperoxia. Hyperbaric chamber consists of a pressure vessel and a compressed breathing gas supply, which can regulate internal pressure. The chamber delivers 100% O2 to patients according to predetermined protocols and is monitored by trained personnel. HBOT relies on increasing the inspired O2 fraction (fiO2) and elevating the partial pressure of O2 (pO2). O2 is typically administered at pressures between 1.5 and 3.0 ATA for 60 to 120 minutes, depending on the clinical presentation. Currently, there are 15 indications for HBOT approved by the Undersea and Hyperbaric Medicine Society, categorized into three groups: emergency medicine, wound healing acceleration, and antimicrobial effects. The present narrative review aims to elucidate the mechanisms action underlying HBOT, particularly oxy-inflammation, in various pathologies within these categories.

Figure 1.

Sketch of hyperbaric chamber and the effect of hyperbaric treatment. The O₂ effect results in an increased supply of reactive oxygen species (ROS) and reactive nitrite species (RNS), with a consequent change in expression of transcription factors, proteins, inflammation status and promotion of vascularization and enhanced immunomodulatory properties.

Figure 2.

Hyperbaric Oxygen therapy (HBOT) is an adjuvant treatment in various conditions: ischemic/reperfusion, necrotizing soft tissue infection, compartment syndrome and orthopedic.