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Hyperbaric oxygen therapy (HBOT) has been used in clinical practice for many years to treat decompression sickness (DCS), carbon monoxide poisoning, and clostridial infections, as well as to enhance wound healing. However, newer applications have demonstrated efficacy in managing a wider range of conditions, including compartment syndrome, burns, frostbite, and sensorineural hearing loss. More recently, HBOT has been used to treat cardiovascular disease and COVID-19.[1][2] HBOT exerts therapeutic effects through inhalation of high concentrations of oxygen (O2) within a pressurized chamber. Under typical therapeutic conditions, the amount of oxygen dissolved in plasma may exceed 10 to 20 times that observed during breathing room air at normal atmospheric pressure, depending on the pressure applied. Oxygen-rich plasma is subsequently delivered to hypoxic or ischemic tissue, promoting angiogenesis, reducing edema, and modulating the immune response.[3][4][5]

Like any medical treatment, HBOT carries potential side effects, complications, and contraindications. Side effects can be divided into 2 categories: those related to oxygen and those related to hyperbaric conditions or the chamber environment. Breathing 100% oxygen at pressures exceeding 2 ATA for prolonged periods can produce oxygen toxicity. This phenomenon remains incompletely understood but is thought to arise from the release of ROS, natural byproducts of cellular respiration. ROS can damage cellular structures, including membranes, and induce oxidative stress.