Hyperbaric oxygen: its mechanisms and efficacy

This review by Stephen Thom examines the biological mechanisms that help explain how hyperbaric oxygen therapy produces effects beyond simply delivering more oxygen to the bloodstream. A major focus is the temporary increase in reactive oxygen and nitrogen species produced during HBOT. Rather than acting only as damaging oxidants, these molecules also function as signals that can influence inflammation, growth factors, blood-vessel formation, stem and progenitor-cell activity, and other processes involved in tissue repair.

The review also considers the clinical evidence available at the time. Systematic reviews and randomized trials supported HBOT in areas including refractory diabetic wound healing and radiation injury, while evidence for some other applications was less developed. The paper is useful because it connects the physical effect of increased oxygen pressure with the cellular pathways that may help explain HBOT's therapeutic effects.