HYPERBARIC MEDICINE. Manual for Healthcare Professionals

This second volume of Hyperbaric Medicine. Manual for Healthcare Professionals is entirely devoted to the analysis of the recognized clinical indications for hyperbaric oxygen therapy (HBOT). It is conceived as a reference work for physicians and other healthcare professionals seeking to understand when, why, and how HBOT should be applied in contemporary clinical practice.
Building on the foundations developed in Volume I, this volume provides a detailed examination of those conditions in which HBOT is supported by sufficient scientific evidence and international consensus, consistently integrating it as an adjunctive therapy within a comprehensive therapeutic approach. Each indication is presented through a solid pathophysiological analysis, followed by practical clinical guidance, commonly used treatment protocols, and updated decision-making algorithms, allowing the reader to place HBOT within its real-world context of application.
The content is aligned with the main international reference frameworks, particularly the Hyperbaric Medicine Indications Manual of the Undersea and Hyperbaric Medical Society (UHMS), whose 15th edition (2023/2024) expands the list of recognized indications to sixteen, formally incorporating avascular necrosis (aseptic osteonecrosis) in its early stages. In addition, the most recent consensus guidelines developed by the leading international reference bodies-both medical and surgical-have been taken into account, specifically addressing the various clinical entities analyzed in this volume.
A central theme of the book is the critical interpretation of the levels of evidence and grades of recommendation underpinning each indication. The text explains why, in hyperbaric medicine, many therapeutic decisions rest on a combination of pathophysiological plausibility, accumulated clinical experience, and evidence of variable quality, and how this reality compels clinicians to adopt a prudent, well-informed approach based on a careful risk-benefit assessment.
The volume concludes with a dedicated chapter on historical uses of HBOT that are currently not recommended, analyzing those indications which, despite early enthusiasm, have been gradually abandoned after higher-quality studies failed to confirm a clinically meaningful benefit.