is HBOT for you?
we have complied a comprehensive list below of health conditions that we would like explore further before we move forward with your HBOT journey.
These conditions prevent HBOT treatment unless corrected first.
Untreated Pneumothorax
The only true absolute contraindication.
Pressure changes in the chamber can convert a pneumothorax into a life-threatening tension pneumothorax.
Must be treated first (e.g., chest tube insertion).
Intraocular Gas
Gas trapped in the eye after eye surgery can expand or contract under pressure.
This can cause severe eye damage or permanent vision loss unless treatment is life-saving.
Absolute Contraindications
These conditions do not automatically prevent treatment, but do require careful medical evaluation before HBOT.
Medication-Related Considerations
Certain medications may interact with high oxygen levels.
Doxorubicin
May increase risk of heart toxicity.
Usually managed by stopping the drug 24 hours before treatment.
Bleomycin
Previously considered unsafe due to lung toxicity concerns.
Evidence now suggests HBOT may be safe especially if treatment occurred over 6 months ago, with proper lung assessment.
Disulfiram
Can increase risk of oxygen toxicity and seizures.
Should be discontinued prior to HBOT.
Cisplatin
May reduce wound-healing effectiveness of HBOT but does not increase adverse effects.
Mafenide
May increase carbon dioxide production and risk of acidosis.
Discontinuation prior to treatment is recommended.
Relative Contraindications
These may increase risk of air trapping or pressure injury.
Chronic Obstructive Pulmonary Disease (COPD)
Risk of carbon dioxide retention due to oxygen-induced hypoventilation.
Asthma
Air trapping may increase risk of lung barotrauma.
Pulmonary Blebs or Bullae
May rupture under pressure leading to pneumothorax.
Respiratory Conditions
Implanted Medical Devices
Some devices must be assessed for pressure tolerance.
Examples include:
Cardiac defibrillators
Pacemakers
Epidural pain pumps
Most devices tolerate pressures equivalent to 100 ft of seawater (4 ATA), but manufacturer confirmation is recommended.
Traditionally considered a relative contraindication.
However, HBOT may be beneficial in emergencies, particularly:
Carbon monoxide poisoning
Severe maternal hypoxia
Pregnancy
Neurological Considerations
Epilepsy
Increased risk of oxygen-induced seizures.
High Fever
Can lower the seizure threshold.
Proper monitoring and medication management can reduce risk.
Ear, Sinus, and Pressure Equalization Issues
HBOT requires equalizing pressure in the ears and sinuses.
Risks include:
Ear pain
Sinus barotrauma
Tympanic membrane injury
Higher-risk situations include:
Eustachian tube dysfunction
Prior ear surgery
Severe sinus infections
Upper respiratory infections
Management may include:
Decongestant sprays
Pressure equalization training
Tympanostomy tubes
Psychological Factors
Claustrophobia
May prevent treatment in some patients.
Often manageable with anxiolytics or larger chambers.
Surgical History
Certain surgical histories may increase risk:
Thoracic surgery
Spontaneous pneumothorax
Eye surgery with retained gas
All require careful medical evaluation before treatment.
Metabolic Considerations
Diabetes
Risk of therapy-induced hypoglycemia.
Managed with glucose monitoring before and during treatment.
These substances reduce treatment effectiveness due to vasoconstriction:
Avoid before HBOT:
Nicotine
Caffeine
Cocaine
Amphetamines
Lifestyle Factors Before Treatment
Congenital spherocytosis
Perilymph fistulas
Tuberculosis risk
Pulmonary lesions on imaging
Each requires individual risk-benefit assessment
Other Conditions Requiring Evaluation
Eye Conditions
HBOT may worsen oxidative stress in certain eye diseases such as:
Age-related macular degeneration
Keratoconus
Glaucoma
In some cases, mask oxygen delivery may reduce risk.
Cancer and HBOT
Active cancer is NOT considered a contraindication.
Research suggests HBOT has a neutral effect on tumor growth, and it is commonly used for:
Radiation injury
Non-healing wounds
Tissue damage from cancer treatment