Summary: | The Centers for Medicare & Medicaid Services (CMS) has requested the Tufts-New England Medical Center Evidence-based Practice Center (Tufts-NEMC EPC) to conduct a "horizon scan" on the uses of hyperbaric oxygen therapy (HBOT). There are several technology assessments (TA) available for HBOT in wound care and other well-established therapeutic indications. This review is intended to inform CMS of existing and emerging applications of HBOT. As such, this report is a limited systematic review of the literature. It does not synthesize the results or critically appraise individual clinical studies. Patients undergoing HBOT typically breathe 100% oxygen at a pressure of about 2 to 2.5 atmospheric absolute (ATA). An ATA is defined as the atmospheric pressure at sea level that is equivalent to 101.3 kilo Pascals per square inch. There are two types of chambers - a monoplace chamber or a multiplace chamber - for administering HBOT. In a monoplace chamber only one patient undergoes HBOT, while a multiplace chamber can hold multiple patients and/or medical personnel. HBOT is typically used for treatment of wounds, carbon monoxide (CO) poisoning, and clostridial gas gangrene. The HBOT technique uses systemic blood flow to deliver high concentrations of oxygen to tissues. The treatment duration can vary from 45 to 300 minutes, although a typical HBOT session ranges from 90 to 120 minutes
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