Indications
Threshold Levels
Lower Limit
Upper Limit / Utilization Review
Chronic Refractory Osteomyelitis
20*
30-40‡
Diabetic Lower Extremity Ulcer
14
40
Intracranial Abscess
5
20‡
Late Radiation Tissue Prophylaxis
30‡
Osteoradionecrosis - Mandibular
30*
60‡
Preparation of Wounds for Grafting
10
Problem Wound Support
Soft Tissue Radionecrosis
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*
Cerebral Arterial Gas Embolism
10‡
Clostridial Myonecrosis (Gas Gangrene)
Compromised Skin Grafts and Flaps
6*
Decompression Sickness
Necrotizing Soft Tissue Infections
Reattachment Limb/Digits
30
Selected Invasive Fungal Infections
7
20
Modified from National Baromedical Services [1]
* 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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