Oxygen is a substance we need, the lack of which we feel instantly and even a slight reduction can have a drastic effect on our health. Therefore, it is not surprising that the possibility of oxygen treatment, in particular hyperbaric oxygen therapy (HBOT), is of such interest and is so effective in a variety of pathologies.

What is hyperbaric oxygen therapy?

Hyperbaric oxygenation is a method of artificially increasing the oxygen capacity of the blood as a result of increasing the concentration of oxygen in the inhaled gas mixture with an increasing total barometric pressure of the external environment. This type of treatment takes place in a hyperbaric atmosphere (excess pressure), and patients inhale purified oxygen. To achieve the effect, it is necessary that the pressure during treatment significantly exceeds the ambient pressure. Therefore, a person is placed in a pressure chamber, where the pressure (depending on the disease) increases from 1.5 to 3 times (1).

To date, almost three and a half centuries have passed since the creation of the first hyperbaric chamber (2). The sharp increase in interest in the method of hyperbaric oxygenation in the second half of the XIX century contributed to the rapid spread of barotherapy in major cities in Europe and America. And today this method of treatment is widely used around the world. The pressure chamber is a special structure, similar in appearance to an underwater bathyscaphe. This design is a sealed capsule with transparent windows. The patient is kept lying in the pressure chamber, he only needs to lie down and inhale oxygen-enriched air (3). The capsule contains sensors that can detect pressure and oxygen levels. Their indicators are controlled and regulated by a doctor or nurse.

The mechanism of action of HBOT

Scientists have proven that during hyperbaric oxygenation, the blood is saturated with oxygen much more than during normal respiration.

In scientific language, during hyperbaric oxygenation, the increase in the intensity of bioenergetic processes is manifested in the form of activation of oxidative phosphorylation and increased energy production in tissues (4). Hyperbaric oxygen mobilizes the detoxification system of the body, namely the inhibition of the formation of toxic metabolites, activation of their destruction, and stimulation of the genesis of low-toxic substances, etc. (3). Hyperbaric oxygenation is able to: stimulate the metabolic systems of the nervous system from the toxic effects of ammonia when changing the blood supply, to compensate for the conversion of pyruvate to lactate or alanine, etc. (5).

In other words, with HBOT, along with blood flow, oxygen enters various parts of the body, especially those that are in dire need of it. In this procedure, the body starts the recovery process in all tissues – nerve, muscle, bone, cartilage, and others.

In which diseases HBOT is recommended

HBOT is recommended for inclusion in the treatment of severe, chronic forms of infectious diseases (and their complications), such as acute and chronic viral hepatitis, meningitis, meningoencephalitis, botulism, neurological consequences of borreliosis, erysipelas, and many others (5).

The therapeutic effect of HBOT in infectious diseases is due to the elimination of oxygen starvation in the patient’s body, accelerating metabolism, improving blood supply to all organs and tissues, increasing immunity, suppressing the activity of microorganisms, and enhancing the action of drugs (6).

Vascular pathology: obliterating diseases of the vessels of the extremities, trophic ulcers due to circulatory disorders, gas emboli of blood vessels, etc. (6).

Pathology of the gastrointestinal tract and liver: peptic ulcer of the stomach and duodenum, posthemorrhagic syndrome after gastric bleeding, intestinal diseases. Acute hepatitis, chronic hepatitis, liver cirrhosis, liver failure (6).

Pathology of the nervous system: ischemic stroke, traumatic brain injury, encephalopathy, spinal cord injury, paresis of peripheral nerves (7).

Poisoning: carbon monoxide poisoning, botulism, methemoglobin-forming substances, cyanides (7).

Eye pathology: retinal circulatory disorders, diabetic retinopathy, optic nerve dystrophy with methyl alcohol poisoning (8).

Pathology of the endocrine system: decompensated insulin-dependent diabetes, complications of diabetes, diffuse toxic goiter (9). The HBOT course was also effective during weight correction programs.

Maxillofacial pathology: periodontitis, necrotic gingivitis, and stomatitis, healing after plastic surgery (10).

Gynaecology, Urology, andrology: chronic inflammatory diseases of the pelvic organs in women, prostatitis in men. There was a marked improvement in sexual function in elderly men after the end of the HBOT course (9).

Obstetric pathology: intrauterine hypoxia of the fetus, the risk of miscarriage, fetal malnutrition, immune conflict pregnancy, pregnancy with concomitant pathology, pathology of the endocrine system in women, infertility of various etiologies (11). HBOT is also effective in different pathology of newborns: asphyxia during childbirth, cerebrovascular disorders, hemolytic disease of newborns, ulcerative necrotic enterocolitis.

Wound pathology: prevention of wound infection, sluggish granulating wounds, burn wound surfaces, frostbite, postoperative wounds in plastic surgery, and others (10).

Radiation lesions and cancer: radiation osteonecrosis, myelitis, enteritis; a special group consists of patients receiving chemotherapy and radiation therapy for cancer (12).It is recommended to use HBOT in preparation for and after surgery: the patient recovers quickly and painlessly from anaesthesia, significantly reducing the healing time and the risk of complications. This is the basis for the widespread use of HBOT in cosmetology and plastic surgery (13).


Today HBOT is of particular interest since this type of therapy is necessary for patients with severe COVID-19. But the possibility of using HBOT for the treatment of milder cases and the recovery of patients after illness is also being actively explored and has already shown its benefits. Recently it was shown that HBOT in COVID-19 patients may make it possible to contribute to reverse hypoxemia and ameliorate the pulmonary capillary circulation diffusion despite the thickness in the alveolar membrane in disease (5). To guarantee its beneficial effects, there is still a need for more controlled trials to measure different inflammatory and hematological parameters that demonstrate that exudate and inflammation are reduced beside the improvements in alveolar circulation diffusion (14).

Who can be treated with HBOT

So, HBOT was effective to treat a long list of diseases and also for prophylactics, as far as obtained results indicate the high efficiency of HBOT, which is included in the set of health-improving measures. In healthy people, the use of the HBOT method is based on the unique complex action of oxygen under high pressure, which significantly increases the body’s adaptive capacity. HBOT normalizes different body systems and reduces the risk of disease. Sessions in the pressure chamber relieve fatigue, restore strength after hard work, increase muscle tone, have an anti-stress tonic and tonic effect, and reduce the adverse effects of a polluted atmosphere. Patients who have undergone HBOT, note an increase in efficiency and stabilization of psycho-emotional state. In sports medicine, impressive results have been obtained to increase the level of fitness of athletes and accelerate recovery after training (5).

But, of course, there are a few contradictions for HBOT treatment. For example, a history of epilepsy (or any other seizure disorder); residual cavities (cavities, abscesses, and air cysts) in the lungs; severe forms of hypertension; violation of the patency of the Eustachian tubes and canals connecting the paranasal sinuses with the external environment (polyps and inflammatory processes in the nasopharynx, middle ear, paranasal sinuses, developmental anomalies, and the like); claustrophobia and the presence of increased sensitivity to oxygen require a particularly careful approach when prescribing HBOT treatment (15).

Therefore, for safe and effective HBOT treatment, it must be supervised by experienced professionals.

Dr. Oksana Klymenko M.D., PhD, 
SNHS Dip. (Holistic Nutrition), Medical Doctor, Researcher in the fields 
of molecular physiology and pathophysiology, 
molecular biology, genetics, cell biology


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