REPRINTED FROM THE 2023 HYPERBARIC INDICATIONS MANUAL 15 Edition:Intracranial Abscess.

The term "intracranial abscess" (ICA) includes cerebral abscess, subdural empyema, and epidural empyema, which share many diagnostic and therapeutic similarities and, frequently, very similar etiologies. Infection may occur and spread from a contiguous infection such as sinusitis, otitis, mastoiditis, or dental infection; hematogenous seeding; or cranial trauma. Brain abscess usually results from predisposing factors such as HIV infection, immunosuppressive drug treatment, surgery, adjacent infection (i.

Hyperbaric Oxygen for Lower Limb Trauma (HOLLT): an international multi-centre randomised clinical trial.

Introduction: Hyperbaric oxygen treatment (HBOT) is sometimes used in the management of open fractures and severe soft tissue crush injury, aiming to reduce complications and improve outcomes.

Methods: Patients with open tibial fractures were randomly assigned within 48 hours of injury to receive standard trauma care or standard care plus 12 sessions of HBOT. The primary outcome was the incidence of necrosis or infection or both occurring within 14 days of injury.

Radiation-induced cystitis treated with hyperbaric oxygen therapy (RICH-ART): a randomised, controlled, phase 2-3 trial.

Background: Late radiation cystitis is an adverse effect of cancer treatment with radiotherapy in the pelvic region. Symptoms of late radiation cystitis can be assessed with the Expanded Prostate Index Composite Score (EPIC). Previous reports indicate that hyperbaric oxygen therapy reduces symptoms from late radiation cystitis, but the evidence is predominantly based on non-randomised and retrospective studies.

Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation.

Background: In neuromodulation therapies, hardware-related infections are a major challenge often leading to hardware removal.

Objective: To investigate the role of adjuvant hyperbaric oxygen therapy (HBOT) in hardware-related infections.

Methods: Fourteen hardware-related infection events in 12 consecutive patients between 2002 and 2015 were treated with antibiotics and adjuvant HBOT at the Karolinska University Hospital (Stockholm, Sweden).

Hyperbaric oxygen therapy in spontaneous brain abscess patients: a population-based comparative cohort study.

Background: There is a need to improve outcome in patients with brain abscesses and hyperbaric oxygen therapy (HBOT) is a promising treatment modality. The objective of this study was to evaluate HBOT in the treatment of intracranial abscesses.

Method: This population-based, comparative cohort study included 40 consecutive adult patients with spontaneous brain abscess treated surgically between January 2003 and May 2014 at our institution.

Hyperbaric Oxygen in Lower Limb Trauma (HOLLT); protocol for a randomised controlled trial.

Introduction: Open fractures with significant soft tissue injury are associated with high rates of complications, such as non-union, infection, chronic pain and disability. Complications often require further inpatient care, and in many cases, multiple operations and prolonged rehabilitation. Use of hyperbaric oxygen therapy as an adjunct to standard orthopaedic trauma care has the potential to reduce the complications of musculoskeletal injury and thus improve outcomes.

A pro/con review comparing the use of mono- and multiplace hyperbaric chambers for critical care.

Hyperbaric oxygen treatment (HBOT) of critically ill patients requires special technology and appropriately trained medical team staffing for '24/7' emergency services. Regardless of the chamber system used it is essential that the attending nurse and critical care specialist understand the physics and physiology of hyperbaric oxygen for safe treatment and compression/decompression procedures. Mechanical ventilation through endotracheal tube or tracheotomy is hampered by the increased gas density and flow resistance with risks of hypoventilation, carbon dioxide retention and oxygen seizures.

Theoretical tissue compartment inert gas pressures during a deep dive with and without deep decompression stops: a case analysis.

Background: Deep decompression stops are increasingly common in recreational technical diving. Concerns exist that they shift decompression stress back into slower tissues. A diver recorded an exceptional exposure dive, with deeps stops, on a commercially available dive computer.

Hyperbaric oxygen therapy activates hypoxia-inducible factor 1 (HIF-1), which contributes to improved wound healing in diabetic mice.

Hyperbaric oxygen (HBO) therapy has been used as an adjunctive therapy for diabetic foot ulcers, although its mechanism of action is not completely understood. Recently, it has been shown that HBO mobilizes the endothelial progenitor cells (EPCs) from bone marrow that eventually will aggregate in the wound. However, the gathering of the EPCs in diabetic wounds is impaired because of the decreased levels of local stromal-derived factor-1α (SDF-1α).

Hyperbaric critical care patient data management system.

A patient data management system (PDMS) has been used for years in the intensive care unit (ICU) at the Karolinska University Hospital to provide bedside or remote clinical patient documentation and information. Data from monitors, mechanical ventilators and syringe pumps are fed into a central clinical information management system to monitor, display trends and record data of vital parameters, ventilator settings and drugs. In order to continue routine critical care monitoring and recording during hyperbaric oxygen therapy (HBOT), without endangering the safety demands of hyperbaric procedures, we have modified the PDMS system for hyperbaric use.

Hyperbaric oxygen treatment of postoperative neurosurgical infections.

Objective: To evaluate the clinical usefulness of hyperbaric oxygen (HBO) therapy for neurosurgical infections after craniotomy or laminectomy.

Methods: The study involved review of medical records, office visits, and telephone contacts for 39 consecutive patients who were referred in 1996 to 2000. Infection control and healing without removal of bone flaps or foreign material, with a minimum of 6 months of follow-up monitoring, were considered to represent success.

Necrotizing fasciitis following transobturator tape treated by extensive surgery and hyperbaric oxygen.

The transobturator sling procedure (TVT-O) was developed to minimize surgical risks involved in treating genuine stress incontinence. All data suggest that most risks associated with the retropubic route such as injuries to the bladder, intestines or vessels are practically obsolete with the obturator route. However, severe soft-tissue infections have been reported with this new technique.

Effects of carbon monoxide poisoning on neutrophil responses in patients treated with hyperbaric oxygen.

Background: Carbon monoxide (CO) poisoning can cause tissue injury. Neutrophil granulocytes have been proposed to contribute to the injury, which may be ameliorated by hyperbaric oxygen (HBO2) treatment. We sought to assess the relationship between acute CO poisoning and blood neutrophil count, plasma cytokine, and cortisol responses, as well as the mechanism behind the observed beneficiary effects of HBO2 treatment.

[13 cases of cervical necrotizing fasciitis--all patients survived. Surgery, antibiotics and hyperbaric oxygenation give the best results].

Cervical necrotizing fasciitis is a serious, rapidly progressive infection along fascia planes that sometimes involves skin, subcutaneous tissue and muscle (myositis). The condition, often of dental or pharyngeal origin, is associated with high morbidity and mortality. Thirteen consecutive cases of cervical necrotizing fasciitis treated with hyperbaric oxygen at the Karolinska Hospital during the period 1997-2003 were reviewed.

Hyperbaric oxygen (HBO) therapy in treatment of diabetic foot ulcers. Long-term follow-up.

Background: The cause of diabetic foot ulcers is multifactorial, e.g., neuropathy and angiopathy, leading to functional disturbances in the macrocirculation and skin microcirculation.

Hyperbaric oxygen treatment of postoperative neurosurgical infections.

Objective: To evaluate the clinical usefulness of hyperbaric oxygen (HBO) therapy for neurosurgical infections after craniotomy or laminectomy.

Methods: The study involved review of medical records, office visits, and telephone contacts for 39 consecutive patients who were referred in 1996 to 2000. Infection control and healing without removal of bone flaps or foreign material, with a minimum of 6 months of follow-up monitoring, were considered to represent success.