Hyperbaric Oxygen Therapy: Panacea or Properly Indicated? w Prof Simon Mitchell.

Hyperbaric oxygen therapy (HBOT) which is used across a wide range of acute and chronic conditions, but for most clinicians, it remains something of a mystery outside of diving-related emergencies.

In this episode, we explore what HBOT is, how it works, and when it’s indicated. Using a clinical case as a starting point, we discuss the approved uses, contraindications, practicalities, and emerging areas of interest — including concussion and long COVID-19 infection.

Practical clinical pearls:

1. HBOT has well-defined, evidence-based indications, and referrals should be made only to accredited facilities.
2. For decompression illness and arterial gas embolism, air or gas embolism, carbon monoxide poisoning, sudden acute hearing loss consider referring urgently for hyperbaric assessment.
3. Confirm the facility’s accreditation and safety protocols before referring.
4. Discuss suitability with a hyperbaric service early if in doubt.
5. Be cautious about non-accredited “wellness” HBOT clinics promoting unproven benefits. Do no harm.

Guest bio:

Simon Mitchell is an anaesthesiologist at Auckland City Hospital, a diving physician at North Shore Hospital, and Professor of Anaesthesiology at the University of Auckland.

He is widely published, with two books and over 170 scientific papers or chapters, including co-authorship of the 5th edition of Diving and Subaquatic Medicine and the Hyperbaric and Diving Medicine chapters in the last four editions of Harrison’s Principles of Internal Medicine.

Simon has twice served as Vice President of the Undersea and Hyperbaric Medicine Society (USA) and received the Behnke Award for scientific contributions to diving medicine in 2010. Since 2019, he has been Editor-in-Chief of the Diving and Hyperbaric Medicine Journal.

Outside of medicine, Simon has had a long career in sport, scientific, commercial, and military diving. He has participated in exploratory wreck and cave diving expeditions worldwide and in 2002 performed what was then the deepest dive to a shipwreck. In 2023, he was part of the Wet Mules expedition to the Pearse Resurgence in New Zealand, where a 230 m hydrogen dive was conducted — the first of its kind in over 30 years. He is a Fellow of the Explorers’ Club of New York and was named Rolex Diver of the Year in 2015.

Resources:

·Undersea and Hyperbaric Medical Society. HBO Indications [Internet]. Available from: https://www.uhms.org/resources/featured-resources/hbo-indications.html

·National Center for Biotechnology Information (NCBI). Hyperbaric Oxygen Therapy: Patient Selection [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499820/

·UpToDate. Hyperbaric Oxygen Therapy [Internet]. Available from: https://www.uptodate.com/contents/hyperbaric-oxygen-therapy#H19

·U.S. Food and Drug Administration (FDA). Hyperbaric Oxygen Therapy: Get the Facts [Internet]. Available from: https://www.fda.gov/consumers/consumer-updates/hyperbaric-oxygen-therapy-get-facts

·National Center for Biotechnology Information (NCBI). Hyperbaric Medicine Overview for Wound Healing [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459172/

·Mitchell SJ. Decompression illness: a comprehensive overview. Diving Hyperb Med. 2024 Mar 31;54(1 Suppl):1–53. doi: 10.28920/dhm54.1.suppl.1-53. PMID: 38537300; PMCID: PMC11168797.

Please see local healthpathway for regional advice.

Email me:

thespecialistgp@outlook.co.nz

Listen here:

Apple : https://podcasts.apple.com/us/podcast/the-specialist-gp/id1845748299

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