Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Executive summary
The procedure
Hyperbaric oxygen therapy (HBOT) involves the intermittent inhalation of 100 per cent
oxygen in chambers pressurised above one atmosphere absolute. The treatment duration
and number of sessions required depend on the reason for HBOT. Each treatment
duration can vary from 45 to 300 minutes, although most treatments are in excess of 90
minutes, for a variable number of sessions.
This report evaluates the safety and effectiveness of HBOT for the following indications:
thermal burns; diabetic wounds including diabetic gangrene and diabetic foot ulcers; nondiabetic
wounds and decubitus (or pressure) ulcers; soft tissue infections including
necrotising fasciitis, Fournier’s gangrene, and necrotising arachnidism; actinomycosis;
soft tissue radionecrosis; osteomyelitis; osteoradionecrosis; skin graft survival; multiple
sclerosis and cerebral palsy; cardiovascular conditions including acute myocardial
infarctions, cerebrovascular disease, and peripheral obstructive arterial disease (POAD);
soft tissue injuries including acute ankle sprains and crush injuries; facial paralysis (Bell’s
palsy); cluster and migraine headaches; Legg-Calve-Perthes disease (necrosis of the
femoral head, especially prevalent in children); sudden deafness and acoustic trauma;
Crohn’s disease; osteoporosis; cancer and carbon monoxide poisoning.
Medicare Services Advisory Committee – role and approach
The Medicare Services Advisory Committee (MSAC) is a key element of a measure taken
by the Commonwealth Government to strengthen the role of evidence in health
financing decisions in Australia. MSAC advises the Commonwealth Minister for Health
and Aged Care on the evidence relating to the safety, effectiveness and cost-effectiveness
of new and existing medical technologies and procedures, and under what circumstances
public funding should be supported.
A rigorous assessment of the available evidence is thus the basis of decision making
when funding is sought under Medicare. The medical literature available on the
technology is searched and the evidence assessed and classified according to the National
Health and Medical Research Council (NHMRC) four-point hierarchy of evidence. A
supporting committee with expertise in this area then evaluated the evidence and
provided advice to MSAC.
MSAC’s assessment of hyperbaric oxygen therapy
Safety
Potential risks for patients undergoing therapy with hyperbaric oxygen are myopia,
barotrauma, claustrophobia or oxygen toxicity. Estimates of incidence are uncertain,
although most adverse events are self-limiting and resolve after termination of therapy.
Serious, life-threatening events are rare.
x Hyperbaric oxygen therapy