Clinical Significance of HBOT in Hypoxia-Induced Pathophysiological Conditions: A Comprehensive Investigative Study

Hyperbaric oxygen therapy involves breathing pure oxygen at high pressure (around 2-2.5 atmospheres), leading to increased blood oxygen levels in tissues. The therapeutic efficacy of hyperbaric oxygen therapy (HBOT) is often dose-dependent, correlating with the number of applications, particularly within hypoxic tissues. HBOT provides neuroprotection following central nervous system trauma and serves as a critical intervention for non-neurological conditions, including Fournier's gangrene, chronic osteomyelitis, and carbon monoxide poisoning. It has also been applied as an adjunctive treatment in surgical site infections, radiation-induced tissue damage, and, more recently, in COVID-19-associated hypoxemia. HBOT enhances recovery in hypoxic and ischemic tissues; relative contraindications such as uncontrolled hypertension and untreated ulcers require careful consideration. Current applications of HBOT are guided by evidence- based protocols established by international and national hyperbaric medicine associations such as the Undersea and Hyperbaric Medical Society (UHMS) and the European Underwater and Baromedical Society (EUBS). In this review, we have discussed the properties of HBOT and explored in depth the physiological relevance of oxygen in the treatment of several disorders, based on clinical evidence, including current indications and underlying mechanisms. HBOT has demonstrated promising outcomes in neurological and neuropsychological disorders, with reports of improved neuronal activation, cognitive performance, and functional recovery in both acute and chronic disease patients. In clinical reports, HBOT was found to be effective in activating nerves and treating neuropsychological disorders in both non-chronic and chronic disease patients.