1. Gas bubble-induced disorders:
(1) Decompression sickness (Class A recommendation, Level 1a evidence).
(2) Gas embolism (diving-related, iatrogenic, accidental, etc.) (Class A recommendation, Level 1b evidence).
2. Poisoning:
(1) Acute carbon monoxide poisoning (A, 1a)
(Note: High-risk individuals prone to complications from carbon monoxide poisoning should receive hyperbaric oxygen therapy). High-risk groups with potential complications include: ① loss of consciousness; ② presence of neurological, cardiovascular, or respiratory symptoms; ③ pregnant women; ④ HbCO levels >25% measured at any time; ⑤ advanced age (>60 years) or underlying conditions such as diabetes.
(2) Cyanide poisoning (B, 3b).
3. Acute ischemic states:
(1) Compromised skin flaps (A, 1b)
(Note: Not all skin flaps require hyperbaric oxygen therapy). Compromised flaps are categorized into the following 5 types: ① flaps with local hypoxia; ② flaps with low arterial perfusion; ③ flaps with arterial occlusion; ④ flaps with venous congestion; ⑤ flaps with venous occlusion. Hyperbaric oxygen salvage of compromised flaps requires adherence to the following 5 points: ① confirm the flap is compromised; ② evidence of residual perfusion in the flap; ③ pathophysiological rationale for hyperbaric oxygen therapy; ④ hyperbaric oxygen therapy should follow necessary surgical interventions; ⑤ if administered, hyperbaric oxygen therapy should be initiated as early as possible.
(2) Compartment syndrome (B, 3a).
(3) Crush injury (B, 3b).
(4) Circulatory impairment following replantation of severed limbs (or digits/toes) (C, 4).
(5) Hemorrhagic shock refractory to blood transfusion (e.g., unavailability of blood supply or religious objections to transfusion) (D, 5).
4. Infectious diseases:
(1) Necrotizing soft tissue infections (necrotizing cellulitis, necrotizing fasciitis, necrotizing myositis, etc.) (B, 2a)
(Note: Includes infections caused by anaerobic bacteria, non-anaerobic bacteria, or mixed flora). (2) Gas gangrene (B, 2b).
(3) Refractory osteomyelitis (B, 2b).
(4) Intracranial abscess (C, 4).
(5) Refractory fungal infection (D, 5).
(6) Pneumatosis cystoides intestinalis (C, 4).
(7) Necrotizing otitis externa (C, 4).
5. Radiation-induced tissue injury:
(1) Radiation osteonecrosis (confirmed or prophylactic) (B, 2b).
(2) Radiation necrosis of soft tissue (confirmed or prophylactic) (B, 2b)
(Note: Radiation necrosis of the brain, muscle, and other soft tissues).
(3) Radiation-induced hemorrhagic cystitis (B, 2b).
(4) Radiation proctitis (B, 2b).
(5) Pre- and post-operative prophylactic treatment for radiation-induced mandibular injury (C, 4).
6. Wounds:
(1) Diabetic infectious ulcers (A, 1b)
(Note: Hard-to-heal infectious ulcers in diabetic patients extending to bone or tendon, showing no improvement after 1 month of wound care). Standard diabetic wound care: ① Assess vascular status and repair blood vessels; ② Adjust diet; ③ Control blood glucose; ④ Perform debridement for life-threatening infections; ⑤ Appropriately apply dressings to maintain a clean, moist environment for granulation tissue; ⑥ Apply compression to the wound; ⑦ Manage potential infections as necessary. If no signs of wound healing are observed after 30 days of the aforementioned standardized treatment, hyperbaric oxygen therapy may be administered. Wound status should be assessed at least every 30 days during hyperbaric oxygen therapy. If the wound shows no measurable signs of healing after 30 days of hyperbaric oxygen therapy, continuing the therapy is not recommended.
(2) Pyoderma gangrenosum (B, 3b).
(3) Pressure ulcers (C, 4).
(4) Burns (C, 4)
(Note: Hyperbaric oxygen is recommended as an adjunct therapy for second- and third-degree burns). (5) Chronic venous ulcers (D, 5).
7. Other conditions:
(1) Sudden sensorineural hearing loss (B, 2b).
(2) Central retinal artery occlusion (B, 3b).
(3) Traumatic brain injury (C, 4).
(4) Acoustic trauma/noise-induced hearing loss (D, 5).
(5) Acute central retinochoroiditis (D, 5).
(6) Acute fundus circulatory disturbance (D, 5).
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