HBO Threshold Levels

• HBO
• HBO Treatment Indication With Protocol
• 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 loss	1	20

      *   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

• For Tables and respective indications, see HBO Treatment Indication with Protocol
• For HBO Treatment Tables, see  HBO Treatment Tables

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 ():.