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HBO Threshold Levels

HBO THRESHOLD LEVELS

Indications

Threshold Levels

 

Lower Limit

Upper Limit / Utilization Review

Elective - Chronic

   

Chronic Refractory Osteomyelitis

20*

30-40‡

Diabetic Lower Extremity Ulcer

14

40

Intracranial Abscess

5

20‡

Late Radiation Tissue Prophylaxis

20*

30‡

Osteoradionecrosis - Mandibular

30*

60‡

Preparation of Wounds for Grafting

10

30‡

Problem Wound Support

14

30‡

Soft Tissue Radionecrosis

20*

60‡

Emergent – Acute

   

Acute Carbon Monoxide Poisoning

 

5‡

Acute Exceptional Blood Loss Anemia

Until satisfactory hematocrit or pt. stable, asymptomatic,

or transfusion becomes possible

Acute Peripheral Ischemias

3*

14‡

Central Retinal Artery Occlusion

 

**‡

Acute Thermal Burns

5*

30‡

Cerebral Arterial Gas Embolism

 

10‡

Clostridial Myonecrosis (Gas Gangrene)

5*

10‡

Compromised Skin Grafts and Flaps

6*

20‡

Decompression Sickness

 

10‡

Necrotizing Soft Tissue Infections

5*

30‡

Reattachment Limb/Digits

5

30

Selected Invasive Fungal Infections

7

20

Idiopathic Sudden Sensorineural Hearing loss120


      *   If the patient receives less than the indicated lower treatment threshold, a case audit is to be undertaken. For these disorders, too few treatments may be unlikely to have sufficient therapeutic effect and potentially waste resources. Reasons for early termination of HBO therapy may include: death; misdiagnosis; non-compliance; deterioration, or failure to perceive improvement.

  **   For patients treated more than three days after clinical plateau.

  ‡   Recommendations of the Undersea and Hyperbaric Medical Society, Hyperbaric Oxygen therapy Indications 13th Edition, 2014



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REFERENCES

  1. . Undersea and Hyperbaric Medical Society, Durham, North Carolina. Hyperbaric Oxygen Therapy: Indications, 12th Edition. L.B. Gesell, Editor . Date of publication 2008 Jan 1;volume ():.