Rational Normobaric and Hyperbaric Oxygen Therapy

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Abstract
In hypoxic diseases characterized by inefficient pulmonary gas exchange, a modest increase in the inspired O2 tension suffices to restore normal transport; therefore conventional techniques of inhalation therapy suffice. In hypoxic illnesses characterized by ischemia, the limited capacity of blood to transport physically dissolved O2 prevents normobaric inhalation therapy from sufficiently augmenting the flow of O2. In these instances, and where the capacity of blood to transport O2 is abnormally reduced, hyperbaric O2 may improve O2 transport sufficiently to restore the function of viable tissues. Unfortunately, intense, prolonged exposure to hyperbaric O2 causes severe toxicity. As a result, generally accepted therapeutic indications are limited to illness likely to respond favorably to short exposures, including decompression sickness, aeroembolism, carbon monoxide poisoning, tumors treated concurrently with irradiation, and gas gangrene.