Talk:Hyperbaric medicine

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Controversy section?

HBOT seems a little hokey and alternative-mediciny, and the Indications paragraph does mention that there has been controversy around the treatment. But it would seem this should warrant a whole section, not just a sentence with an external link to sources. Psychlohexane (talk) 02:51, 17 November 2010 (UTC)

And Why Does It Work?

Please explain why this might be effective. —Preceding unsigned comment added by 67.241.32.110 (talk) 05:48, 23 May 2008 (UTC)

Mechanism?

Can somebody please explain which therapeutic mechanism is at work in air/gas embolism? It seems quite plausible that it is the overall pressure which would serve to minimize the volume of any given amount of gas, but I don't have any references for that. Comments, please? Kosebamse 21:08, 11 Feb 2004 (UTC)

Indeed the pressure causes a decrease in the volume and therefor surface area of the bubble. The bubble acts to stop blood flow in the vessel in which it is impacted. Decreasing the surface area causes the bubble to migrate peripherally and thus impact smaller vessels. The bubble is comprised of 79% nitrogen. Using 100% oxygen causes a nitrogen gradient which causes the bubble to dissolve over time.

eyesight

After regular treatment (for unrelated ailments), my uncle reports that he no longer needs his thick glasses for driving. 68.167.2.149

This is probably due to a side effect of hyperbaric oxygen that is poorly understood. Some people find that after usually 20-30 treatments with hyperbaric oxygen they develop short sightedness (myopia). This may infact have the effect of correcting your uncles hypermetropia (long sightedness)to a small degree "improving" his eyesight.

Unfortunately the effect is usually temporary and resolves within 6 weeks to 4 months after the end of treatment.

Suggest Defining "Hyperbaric"

This may sound obvious, but the article launches into HBOT without defining the term "hyperbaric". Many readers will not know what that means. In fact HBOT is so common that sometimes "hyperbaric" is merely assumed to mean HBOT, whereas the actual definition is "of, relating to, or utilizing greater than normal pressure". Joema 23:35, 23 December 2005 (UTC)

4.1 PSI

4.1 PSI is not the pressure at 10 ft below water

No, but it's the gauge pressure of a gauge zeroed at sea level. Whoever put in that fact meant 4.1 psi gauge pressure or overpressure, not 4.1 psi absolute (which should ring alarms right there as it's, oh, dangerously lower than the standard atmosphere). Why point out the mistake if one isn't going to take the time to fix it? --The Centipede 12:38, 5 March 2007 (UTC)

Practicing Physicians

Why are most certified physicians who use hyperbaric medicine for clinical purposes anesthesiologists?

Probably because hyperbaric oxygen therapy uses pure oxygen, there's still a debate on whether or not pure oxygen is a euphoric, and it's probably a matter of "better safe than sorry." Anesthesiologists would be expected to know the narcotic (term used very loosely) limits and toxicity of pure oxygen better than, say, a general practicioner and HBOT strikes me as a bit too ground-level for those relatively rare doctors that specialize in organic chemistry. --The Centipede 12:34, 5 March 2007 (UTC)

Reverting page that was somewhat messed up

Some recent edits seem to have broken the page structure and I have reverted to an earlier version. Some edits may have been lost. My apologies, will try to restore what's worth restoring. And please, everybody, do try and use the preview function when editing, it would really help. Kosebamse 08:56, 26 April 2007 (UTC)

Separate hyperbaric chamber from HBOT

I suggest material describing the physics and engineering of the hyperbaric chamber be split off into a separate article called Hyperbaric chamber not redirecting here, since such chambers have other uses than HBOT, in (actual) diving and decompression. I was going to direct some diving technology links to 'hyperbaric chamber' but it makes no sense to do so when they end up at an article headed HBOT. Rexparry sydney 11:32, 2 August 2007 (UTC)

As there is now a combined article for diving chambers/Hyperbaric chambers I have put in a link to that and I suggest this article in future emphasise the particular features used in or adapted for HBOT.Rexparry sydney 06:15, 6 August 2007 (UTC)

Requested move

Hyberbaric medicine seems like a much better name. Any objections? User:Hopping ^T 19:45, 3 September 2007 (UTC)

• Comment sounds weird. Does this involve increasing atmospheric pressure for uses OTHER THAN for oxygen? Hyperbaric helium therapy, hyperbaric phosgene therapy, or something? WP:COMMONANME would suggest that this is currently the proper name. 132.205.44.5 23:39, 4 September 2007 (UTC)

Reworks

I have been rewriting several parts of the article. Mostly reorganizations for logical flow and readability, and removing a lot of tangental material. I see some additional things to do as well, mainly involving references. I will try to get sources where requested, check that the present ones are reflected accurately, and unify their formatting. Baccyak4H (Yak!) 14:01, 10 October 2007 (UTC)

HBOT

The HBOT has been shown to help because it increases the amount of oxygen the blood plasma can hold, should we include this in the article?--Ngilliamdesmet (talk) 19:39, 22 October 2008 (UTC)

Yes, of course, but remember to cite reliable sources: some of the refs in Oxygen toxicity may be suitable. It would be worth mentioning the relatively small increase in total oxygen transported normally, since hemoblogin can carry far more oxygen than plasma - but this is particularly relevant when hemoglobin levels are compromised, such as in carbon monoxide poisoning. --RexxS (talk) 22:20, 22 October 2008 (UTC)

Neuro Rehab section: Only positive results of research are listed

This gives the appearance of being one sided, unless of course there have never been reports that HBOT was of no benefit. I don't mean complications such as barotrauma, I mean someone who reliably tested Neuro Rehab HBOT and saw no benefit. If they exist they should also be listed. —Preceding unsigned comment added by Chamblis (talk • contribs) 18:43, 25 October 2007 (UTC)

why does it say that it can heal cancer?

why is it that some other pages that this can help with cancer and really there is no proven fact that it can also that they know that it can't. Do you know why it says that? —Preceding unsigned comment added by 198.236.239.2 (talk) 22:23, 18 November 2008 (UTC)

The simplest answer is that this article doesn't claim that HBOT can heal cancer. Cancer is only mentioned (three times) in the section called "Contraindications" - that is, the conditions where HBOT is not appropriate. To be precise, it states that HBOT promotes growth of new blood vessels (which encourages tumours to grow) but that high oxygen levels may discourage the growth of tumours. It would be worth reading the references cited (Takenaka et al and Stubbs et al) for more information on the interaction of HBOT with cancer treatment. Hope that helps. --RexxS (talk) 04:28, 19 November 2008 (UTC)

ORN

No mention is made specifically about ORN of the mandible.

Gerlach NL, Barkhuysen R, Kaanders JH, Janssens GO, Sterk W, Merkx MA (2008). "The effect of hyperbaric oxygen therapy on quality of life in oral and oropharyngeal cancer patients treated with radiotherapy". Int J Oral Maxillofac Surg. 37 (3): 255–9. doi:10.1016/j.ijom.2007.11.013. PMID 18262761. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

Pitak-Arnnop P, Sader R, Dhanuthai K; et al. (2008). "Management of osteoradionecrosis of the jaws: an analysis of evidence". Eur J Surg Oncol. 34 (10): 1123–34. doi:10.1016/j.ejso.2008.03.014. PMID 18455907. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

--Doc James (talk · contribs · email) 04:31, 10 January 2009 (UTC)

MS section

In the neuro section, there is a paragraph giving considerable detail on the first RDB HBOT trial for MS, and then augments it by referencing a couple more studies with similar results. The following (single-sentence) paragraph gives a Cochrane review of upwards of twenty trials, which comes to the opposite conclusion.

For both prose and WEIGHT considerations, I propose to trim the first PP to only mention the 1983 study (as it was the first), but summarize much more succinctly its results - that HBOT showed promise. Then refer to the Cochrane review which "updates" that commentary to current state of affairs. This will have several advantages: reduced statisticruft, better showing the historical trajectory of the evidence, and NPOV. Baccyak4H (Yak!) 19:09, 26 January 2009 (UTC)

I would support doing just that. Although the Cochrane review has its detractors, an encyclopedia is better built on good secondary sources such as reviews, rather than the results of individual trials. The balance you suggest would seem to me to meet WP:NPOV, particularly WP:UNDUE. --RexxS (talk) 23:12, 20 May 2009 (UTC)

TCOMs

Here is an image of a TCOM machine for determining if a patient with diabetic foot ulcers is suitable for HBOT tx.

--Doc James (talk · contribs · email) 21:44, 20 May 2009 (UTC)

Difference between 80 and 100 percent oxygen

I've requested a source for the claim "Physiologically, the human body cannot tell the difference between 80% and 100% Oxygen. (The difference is clinically insignificant ...". While the difference between 80% and 100% oxygen when considering home treatment may be insignificant, the unqualified statement is false in my experience. In particular, treating gas embolism with 80% oxygen is not preferred, since it reduces the inert gas pressure gradient and reduces its effectiveness. If a reliable source exists that verifies the claim, then I'm content if it is supplied; otherwise I'd prefer the article not to make blanket statements that I don't believe are supportable. --RexxS (talk) 21:16, 25 May 2009 (UTC)

Autism

Every once in a while, content is added describing the use of HBOT to treat autism. While I have no opinion on the truth or falsehood of such claims, I do believe that content in Wikipedia must meet the requirements of verifiability from reliable sources. I've removed a paragraph from "Neuro-rehabilitation" for that reason, even though the original poster did note that they "... do not know how to link the Maia Chung art. to this one." - unfortunately Wikipedia itself is not a reliable source, so can't be used to cite claims in other articles. The article is Maia Chung Autism and Disabilities Foundation, which I've removed from "See also" as there is no verifiable reason why it should be linked from here. --RexxS (talk) 23:21, 3 July 2009 (UTC)

Well, there has been a recent study and I saw Dr. Rossignol present this at the UHMS Meeting last week. The problems with this study are many and I still have issues using the term "hyperbaric" when the paper describes what is around 31.2% O2 at 1 Bar equivalent. Is this a study of the effects from O2 alone? Unfortunately, the analysis is not one that can really answer this question but it does make me think it is something that should be evaluated with unmotivated participants and clinical sites and better objective measures.

• Rossignol DA, Rossignol LW, Smith S, Schneider C, Logerquist S, Usman A, Neubrander J, Madren EM, Hintz G, Grushkin B, Mumper EA (2009). "Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial". BMC Pediatrics. 9: 21. doi:10.1186/1471-2431-9-21. PMC 2662857. PMID 19284641. Retrieved 2009-07-04.{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link)

This kind of work is a step in the right direction. Just my $0.02... --Gene Hobbs (talk) 00:16, 4 July 2009 (UTC)

Thanks, Gene. As an area of ongoing research, it looks good. My grumble is I just wish contributors would read sources first, and add verifiable content second; rather than adding their opinions and looking for sources afterwards! --RexxS (talk) 01:58, 4 July 2009 (UTC)

I see that most of the cleanup was done already before I looked into this, but I attempted to improve the article's coverage of autism further by moving it from Home treatment (where it didn't belong) to Uses, and summarizing the result more accurately. Eubulides (talk) 07:38, 4 July 2009 (UTC)

Nice work! Having some verifiable content may dissuade further contributors who have seen a YouTube video from attempting to fill the article up with it. I also think your revision nicely meets WP:UNDUE. Given that CP & MS are covered to some extent in " Neuro-rehabilitation", should they be mentioned briefly in "Uses" as well, or is that too much? - or does the article need restructuring entirely! --RexxS (talk) 17:31, 4 July 2009 (UTC)

Please see #Neuro-rehabilitation below. Eubulides (talk) 18:15, 4 July 2009 (UTC)

Neuro-rehabilitation

I hadn't seen the Hyperbaric medicine #Neuro-rehabilitation section and agree that it overlaps with Uses. Two things:

• Why are there two sections Uses and Treatments? They cover essentially the same thing, and surely should be merged.
• A brief look at Neuro-rehabilitation suggests that it relies entirely too much on primary sources, and should be citing reviews. The overall coverage appears to be using weights assigned by Wikipedia editors rather than that of recent reliable sources. Here are the sort of sources that should be cited instead:

• Zhang 2008 (ISBN 1930536410).
• McDonagh et al. 2007 (PMID 18039243).

I'm sure there are many others; this is just from a very brief search.

Eubulides (talk) 18:15, 4 July 2009 (UTC)

This is how articles evolve, I guess, different editors add their 2 cents all over the place. Can I suggest that some thought is put into the structure of the article? My thoughts are:

• A section briefly describing what happens in HBOT, and perhaps a little history of how it started
• A section describing the known effects of HBO2 on the body
• A section describing different equipment used
• A section on uses/benefits: broken down into prescription and off-label; this would be the bulk of the article, mentioning prognosis and criticisms per use, but weighted as required by WP:UNDUE
• A section on risks, contraindications and complications

The order can be changed to make a it read better, but have I missed any key parts? or better ideas for how to structure it? I've also sought advice at WP:MEDMOS#Recomendations for sections for treatments. --RexxS (talk) 21:35, 4 July 2009 (UTC)

It's important to note that Rossignol is associated with the 'International Child Development Resource Center', a group which fleeces desperate parents of autistic children, and aids other frauds in fleecing them. The ICDRC employs other laudable paragons of modest ethical conduct like Andrew Wakefield.[1] Nevard (talk) 08:51, 3 November 2009 (UTC)

I agree that this section of the article is very seriously problematic, including clear original research and selective use of primary studies etc etc. I'll get to it soon, if somebody else doesn't. --Slp1 (talk) 12:11, 10 September 2010 (UTC)

Purely anecdotally, a friend's son who's recently started hyperbaric oxygen therpay has been 'transformed' (positively) by it, said the father. — Preceding unsigned comment added by 92.23.125.239 (talk) 09:54, 26 February 2013 (UTC)

Wikipedia Quality Scale

Against a B-class checklist, the article has some shortcomings:

1. B-Class-1: It is suitably referenced, and all major points have appropriate inline citations. - Fail

   Section "Therapeutic principles" needs more references

   Section " Structure" and its sub-sections need a lot more references

   Section " Treatments" needs references

2. B-Class-2: It reasonably covers the topic, and does not contain obvious omissions or inaccuracies. - Pass

   Could be expanded (e.g. ORN as suggested above), but major points covered

3. B-Class-3: It has a defined structure, including a lead section and one or more sections of content. - Fail

   Lead requires considerable expansion

   Structure needs improvement (perhaps as suggested above)

4. B-Class-4: It is free from major grammatical errors. - Pass
5. B-Class-5: It contains appropriate supporting materials, such as an infobox, images, or diagrams. - Pass

I've graded it C-class for WikiProject SCUBA. There is a lot of good content and getting good references should be a priority. --RexxS (talk) 19:56, 20 September 2009 (UTC)

Fire risk

I've just reverted the removal of the mention of fire risk from the sentence: "The exhaled gas must be removed from the chamber to prevent the build up of oxygen, which could provoke a fire". I agree that the statement needs sourcing, but I can only find the following online from Recognized Hyperbaric Safety Codes and Standards:

It is the position of the National Board of Diving & Hyperbaric Medical Technology that the codes and standards expressed in the American Society of Mechanical Engineers’ safety Standard for Pressure Vessels for Human Occupancy (ASME PVHO-1)* and the National Fire Protection Association 99, Health care Facilities, Chapter 20, (Hyperbaric Facilities)** be rigorously adhered to.

which refers to other documents that I can't track down online. Does anyone have access to any of these, particularly something that illustrates the procedure for keeping the fraction of O2 below 25%? --RexxS (talk) 12:01, 16 October 2009 (UTC)

We have always used 23.5% in my 14 years at Duke. I do think this reference will do what you need though:

• Sheffield Paul J, Desautels David A (1997). "Hyperbaric and hypobaric chamber fires: a 73-year analysis". Undersea & Hyperbaric Medicine. 24 (3): 153–64. PMID 9308138. Retrieved 2009-10-16. {{cite journal}}: Unknown parameter |month= ignored (help)

If you are planning to expand this section some, here are some additional items of interest. Thanks! --Gene Hobbs (talk) 02:14, 17 October 2009 (UTC)

Post-traumatic stress disorder

Spacebus57 (talk · contribs) gave the following source:

• Eovaldi, Benjamin; Zanetti, Claude (2010). "Hyperbaric oxygen ameliorates worsening signs and symptoms of post-traumatic stress disorder". Neuropsychiatric Disease and Treatment. 6 (1): 785–789. doi:10.2147/NDT.S16071. PMC 3012456. PMID 21212826. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: unflagged free DOI (link)

It may be helpful for expanding the article. --RexxS (talk) 01:17, 10 May 2011 (UTC)

Efficacy?

This article describes: the principles behind hyperbaric medicine; the list of conditions for which its use has been approved; how the treatment works; possible negative side-effects; and so on, but what seems to be missing is information about how effective it is as a treatment. The last section, 'Neuro-rehabilitation', describes the results of studies into its effectiveness for treating certain neurological conditions; but what about all the other conditions? I assume that since it is approved for use for treating carbon monoxide poisoning (for example), there is some evidence that it is actually effective at treating it, but it would be nice to see such information in the article. Robofish (talk) 21:48, 26 July 2011 (UTC)

Global perspective

We need to take care not to assume that our experience of HBOT is representative of hyperbaric medicine throughout the world. Removing an external link that is outdated or duplicates content already present is good, as long as we realise that links such as the one removed actually refer to the UK, while our article section Indications lists approved indications only for the US. As I agree that it's not ideal as an external link, I'll place this link here http://www.londonhyperbaric.com/hyperbaric-treatments to point editors towards a source that lists typical indications in the UK, in the hope that someone will expand the section at some future time. --RexxS (talk) 00:24, 22 August 2011 (UTC)

breathe out?

if there is only oxygen u dont need 2 breathe out cuz ur body uses oxygen — Preceding unsigned comment added by Fduhgide (talk • contribs) 00:59, 5 September 2011 (UTC)

But the oxygen it uses makes carbon dioxide. The carbon dioxide has to be breathed out. --RexxS (talk) 02:06, 5 September 2011 (UTC)

You can read more about carbon dioxide poisoning in this article. --Gautehuus (talk) 15:32, 30 December 2012 (UTC)

Hyperbaric Treatment for Alzheimer Sufferers

My wife has been diagnosed and treated for Alzheimer's Disease. I have heard recently that there have been recorded successes of hyperbaric treatment improving the function of some individuals diagnosed with Alzheimer's disease. Where is it possible to get these results and secondly where are the hyperbaric chambers located? — Preceding unsigned comment added by 98.244.36.175 (talk) 01:53, 14 January 2012 (UTC)

I'm sorry to hear about your wife's illness and I wish you both all the best. None of us here are the best people to ask for medical advice, but I can offer you a Google Scholar search http://scholar.google.co.uk/scholar?q=hyperbaric+oxygen+therapy+alzheimer%27s+disease&hl=en&as_sdt=0&as_vis=1&oi=scholart that is likely to turn up most of the academic studies relevant to your question. --RexxS (talk) 15:13, 14 January 2012 (UTC)

Photo of father and son in chamber

A photograph is in the article of a father and son "receiving treatment for autism". Is that not WP:undue weight? I'll await consensus before removing the image from the article.Wzrd1 (talk) 14:31, 27 July 2013 (UTC)

As there have been no objections, I was bold and removed the image that gives WP:undue weight to fringe autism "treatment" theories that have only poor studies backing said approach.Wzrd1 (talk) 03:32, 9 August 2013 (UTC)

Hyperbaric medicine = HBOT and Therapeutic recompression

The article is almost entirely about HBOT, with snippets about therapeutic recompression, many of which just confuse the issue. Before I start trying to fix this, I would like a consensus from WP:WikiProject Medicine on what the article is actually intended to be about. • • • Peter (Southwood) ^(talk): 07:02, 15 September 2015 (UTC)

• Does hyperbaric medicine include treatment of patients in a hyperbaric environment, such as saturation divers, for problems not directly caused by the hyperbaric environment? If so this should at least be mentioned in the article, and if not that should also be mentioned as it may cause confusion.
• Therapeutic recompression is logically included in hyperbaric medicine, as it is emergency medical treatment at pressure for injuries consequential to exposure to pressure.• • • Peter (Southwood) ^(talk): 08:02, 15 September 2015 (UTC)

[2] might be best to name Hyperbaric oxygen therapy (exclude therapeutic recompression for a separate article)...IMO--Ozzie10aaaa (talk) 10:57, 15 September 2015 (UTC)

Since much of the environment and function are the same for both HBOT and TR, I wouldn't suggest separate articles unless the prose size exceeded the 32K readable text that is normally suggested as a trigger for a split. It has never made sense to me to keep splitting articles into smaller and smaller sub-topics, each duplicative of much of the content of the other. I am also opposed to having an article titled Hyperbaric oxygen therapy as it acts as a magnet for the addition of fringe uses, which are so far away from mainstream evidence that they do not deserve mention (see WP:FRINGE). It's bad enough already that we have to spend half the article saying "there is no evidence that HBOT is effective in treating X, Y and Z". If the article is short of content for TR, the solution is surely to add the content. This isn't a big article and any expansion that wasn't simply refutation of crank theories would be a welcome addition. --RexxS (talk) 21:07, 15 September 2015 (UTC)

in regards to attracting WP FRINGE,via the title, you might have a point( would not be a good idea)...--Ozzie10aaaa (talk) 21:28, 15 September 2015 (UTC)

If true, could the lead confirm that Therapeutic recompression is done with normal air (N2+O2...), or what is used ? - Rod57 (talk) 12:01, 1 October 2021 (UTC)

New study suggests HBOT ineffective for diabetic ulcers

Fedorko L et al. Hyperbaric oxygen therapy does not reduce indications for amputation in patients with diabetes with nonhealing ulcers of the lower limb: A prospective, double-blind, randomized controlled clinical trial. Diabetes Care 2016 Mar; 39:392. (http://dx.doi.org/10.2337/dc15-2001) - See more at: http://webcache.googleusercontent.com/search?q=cache:SA2ovEwoAKUJ:www.jwatch.org/na40866/2016/03/24/hyperbaric-oxygen-not-effective-chronic-diabetic-foot+&cd=2&hl=en&ct=clnk&gl=us#sthash.DnGyKzhS.dpuf Paywalled so I can't read it. Someone from Wikiproject:Medicine? • • • Peter (Southwood) ^(talk): 05:59, 29 March 2016 (UTC)

It's a primary study, Peter, and not really strong evidence in itself for reaching a conclusion about the biomedical effectiveness of a treatment. A quick search on PubMed for HBOT shows almost a dozen other primary studies this year already, looking at treating non-healing pharyngocutaneous fistula, severe sudden sensorineural hearing loss, and so on. The best place to start for any well-represented topic (IMHO) is Trip Database because it's easy to filter on secondary evidence. Looking there for secondary evidence about HBOT treatment for foot ulcers suggested this systematic review from Norway:

• http://www.kunnskapssenteret.no/en/publications/Effectiveness+of+Hyperbaric+Oxygen+Therapy+in+patients+with+Late+Radiation+Tissue+Injury+or+Diabetic+Foot+Ulcer

It confirms what I thought we already knew: "no conclusion can be made with regard to number of amputations due to DFU". So HBOT doesn't seem to have any impact on amputation as a outcome (these would be severe cases) when treating diabetic foot ulcers (DFU), although HBOT does seem to contribute to regression of symptoms and improved healing of DFU in general. Does that help? --RexxS (talk) 21:09, 29 March 2016 (UTC)

So no need for change in the article about DFU? • • • Peter (Southwood) ^(talk): 06:39, 30 March 2016 (UTC)

Nah, the section Hyperbaric medicine #Chronic ulcers has it right because it uses the Cochrane Review already (Cochrane Reviews are the "Gold Standard"). I've taken the liberty of adding a cite to the systematic review I mentioned above to specifically support the conclusion about rate of amputations resulting from DFU. Cheers --RexxS (talk) 16:22, 30 March 2016 (UTC)

Your improvements are always welcome. • • • Peter (Southwood) ^(talk): 16:42, 30 March 2016 (UTC)

Revisit of quality

It is 9 years and more than 500 edits since last B-class check, so here we go again:

1. B-Class-1: It is suitably referenced, and all major points have appropriate inline citations. - currently 18 "citation needed" tags

   Section " Treatments" still needs references, and has a few dubious looking statements

2. B-Class-2: It reasonably covers the topic, and does not contain obvious omissions or inaccuracies. - Pass

   Could be expanded (e.g. ORN as suggested above), but major points covered

3. B-Class-3: It has a defined structure, including a lead section and one or more sections of content. - Pass

   Lead OK

   Structure looks OK.

4. B-Class-4: It is free from major grammatical errors. - Pass
5. B-Class-5: It contains appropriate supporting materials, such as an infobox, images, or diagrams. - Pass

Could probably be brought up to scratch with a little work, so I will see what I can do to clear the citation deficiency. • • • Peter (Southwood) ^(talk): 12:58, 22 September 2016 (UTC)

The article needs to be reworked

It is seems that author has prejudice about hyperbaric medicine, at least one section is need to be reworked. Hyperbaric medicine is shown like it is a something fake, at least in the section about cancer, meanwhile science doesn't have exact opinion in this case. Moreover, for example, this article - https://link.springer.com/article/10.1007/s11523-012-0233-x (by the way, cited in the wiki article, in THIS section, but only with negative aspect) show quite another view. Hyperbaric medicine may be perspective adjuvant therapy to chimiotherapy and radiation therapy. Actually I am rather inclined to believe this large meticulous article than in small sloppy maked section in wiki. It is seems to be like the author more willingly show to us just dark side of the coin. Anyway, the hint on alternative medicine looks ridiculously. I didn't review scrupulosly other sections of article, but, if they were done like the section of cancer, whole article is need to be reworked. It is look like author states that hyperbaric medicine is something like placebo for everything except for treatment of decompression disease, don't research it, just focus on something more promicing. At least the article makes such an impression. — Preceding unsigned comment added by 193.26.13.29 (talk) 12:20, 18 July 2017 (UTC)

It seems you don't have a clue about how Wikipedia works. There are dozens of "authors" (actually editors) who have worked on the article. Are you accusing all of us of the same prejudice? The editors report and summarise what has been published on the subject by high-quality sources.

The article that you're so keen on, Moen & Stuhr, 2012, certainly does not "show quite another view". It's conclusions are:

• (HBO and cell survival) "the picture is complex, and mechanistic studies are required before any final conclusions can be drawn"
• (HBO and angiogenesis) "there is no evidence for enhanced angiogenesis in cancerous tissue"
• (HBO and metastasis) "only observational studies have been performed, and studies of the effect of HBO on the individual steps of the metastatic process are still lacking"
• (HBO and chemotherapy) "proper randomized studies are necessary in order to be able to make any final conclusions regarding the effect of HBO in combination with chemotherapy"
• (HBO and radiotherapy) "A conclusion regarding the use of HBO in combination with radiotherapy still remains unclear"
• (HBO and breast cancer) "Despite a significant number of animal studies, no clinical trials on HBO and breast cancer per se have been performed and only one small clinical study on combined treatment is available"
• (HBO and head and neck cancer) "the conclusion within the field of HBO and radiosensitization has not yet reached a consensus"

and so on. That's hardly the ringing endorsement of HBO in treating cancer that you want it be, is it? In fact the only conclusion it reaches is that HBO is safe to use to treat a condition that it might benefit (DCS, CO poisoning, etc.) even on someone with cancer.

So, feel free to believe what you want; fortunately Wikipedia doesn't write its articles based on your beliefs nor mine, but on what has been stated in high-quality reliable sources. Take a look at WP:MEDRS for the requirements for sources to be used in our medical articles. --RexxS (talk) 13:04, 18 July 2017 (UTC)

I know how wikipedia works, I mean author like a collective face, let it be authors, it does not matter. It is a common tendence on wikipedia to show rather negative aspects of researches, than positive (that's interesting that in russian wikipedia is conversely). I agree that I exaggerate in this cause, my speech was a little bit emotional. — Preceding unsigned comment added by 37.229.32.101 (talk) 16:27, 18 July 2017 (UTC)

Okay, I understand. I tend to exaggerate as well when I'm making a point, and your criticism is well-intentioned. The problem with HBOT is this: people know that they need oxygen to live, so "oxygen is good for you", and then they make the extrapolation to "more oxygen must be even better for you" – just look at the number of oxygen bars that have sprung up, with absolutely no evidence of medical benefit whatsoever. In this case, people want HBOT to help with their condition (or that of their child), be it autism, cerebral palsy, cancer, Alzheimer's, or whatever. So there is a continuous pressure on this article to report the latest "miracle cure" for XYZ condition, based on a single anecdotal result. This results in the regular editors acquiring a jaundiced view of any new results, coupled with an innate conservatism to only report conclusions that have been demonstrated beyond doubt. I'll do a review of the article and try to see if we're getting the balance right of the sources we're using. Of course, if you know of any newer reviews or other secondary sources that we're not using, please use them, or post them here for others to make use of. Cheers --RexxS (talk) 19:36, 18 July 2017 (UTC)

Ha, now I understand the situation clearly. I had no idea that in english-language world HBOT so spread and even sometimes provided like a some kind of "panacea". Naturally, that it is cause some negative reaction and cruel critic of scientific community. I was familiar first of all with scientific literature, pubmed or cochrane, reseachgate, etc. So, now I understand some pretty critical scientific articles, that I've readen. I mean in Ukraine (my native country as you may understand) HBOT isn't so spread. Even not every regional center has HBOT chambers, it is enough fingers on my hands to count all clinics that have HBOT. So, even patients that really need it often don't receive it. I'm sorry if I was too critical, I mean it is a hard and great job to write such article, I really apreciate work that wiki editors do. But enough offtopic. I only superficially familiar with wikipedia rules and wiki CMS, so I just put some links, that you may find usefull. At the first new european guidlines Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment.. Another one -Hyperbaric oxygen therapy for intensive care patients: position statement by the European Committee for Hyperbaric Medicine. Reviews: Diabetic foot ulcers treated with hyperbaric oxygen therapy: A review of the literature, Hyperbaric, Chronic Refractory Osteomyelitis, Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified, Hyperbaric, Myopia and Cataract Formation, Hyperbaric Oxygen Therapy: A New Treatment for Chronic Pain?, Hyperbaric oxygen therapy as adjunctive treatment for diabetic foot ulcers, Does Hyperbaric Oxygen Therapy Work in Facilitating Acute Wound Healing: A Systematic Review. I tried to put only that haven't been used, but I may make a mistake. Cheers :) — Preceding unsigned comment added by 37.229.32.101 (talk) 17:40, 19 July 2017 (UTC)

Wound healing

I've restored the previous version of the article before two changes by RyanSpringer.

The first edit was the addition of:

Another Therapeutic response of HBOT is the speed up of Angiogenesis (the formation of new blood vessels). This is especially important in not only wound healing but also treating late effects of radiation. HBOT has been shown to speed up Angiogenesis through irradiated tissue to help heal and make the tissue more viable.

which may or may not be true, but was completely unsourced. WP:MEDRS requires all biomedical claims to be sourced to reliable secondary sources.

The second edit replaced a concise summary of a 2015 review with a wordy commentary on a 2009 review. Both reviews concluded that HBOT increased the rate of early healing of diabetic foot ulcers, but the later review contradicted the earlier's review's conclusion about major amputation rate. Our guidance at WP:MEDDATE is to prefer later reviews over earlier ones, and to prefer reviews less than about five years old to older ones. --RexxS (talk) 19:01, 10 November 2017 (UTC)

Use of primary sources

@Naftalig: I've reverted the addition of primary sources to contradict the conclusions of a secondary review. The article Efrati, Shai; Ben-Jacob, Eshel; Shlamkovitch, Nathan; Hoofien, Dan; Friedman, Mony; Bergan, Jacob; Volkov, Olga; Bechor, Yair; Fishlev, Gregori (2013-11-15). "Hyperbaric Oxygen Therapy Can Improve Post Concussion Syndrome Years after Mild Traumatic Brain Injury - Randomized Prospective Trial". PLOS ONE. 8 (11): e79995. doi:10.1371/journal.pone.0079995. ISSN 1932-6203. PMC 3829860. PMID 24260334.{{cite journal}}: CS1 maint: unflagged free DOI (link) is a trial and nothing more than a primary source in Wikipedia's terms. Our guidance at WP:MEDRS specifically prohibits using primary sources for "debunking, contradicting, or countering any conclusions made by secondary sources". --RexxS (talk) 12:45, 6 May 2019 (UTC)

Data granularity

@Boghog: I strongly disagree that changes like this, where you remove information such as the authors' first names is an improvement to the article. I agree that citations should be consistent, but the article has used last, first for authors for the majority of the cases in the past and should not be degraded by attempting to switch to an inferior citation style simply as a matter of personal preference. --RexxS (talk) 12:53, 6 May 2019 (UTC)

@Boghog: I don't intent to play edit-wars with you, but how can you justify hiding authors' names from the reader as an improvement to the article?

I'd be happy to go through the article and make the references consistent without losing any further information. --RexxS (talk) 13:06, 6 May 2019 (UTC)

I have selectively reinstated my edits and in all cases preserved authors first names if they were present. I have only used |vauthors= in cases where author first initials were there to begin with. The predominate style of authors if one goes back far enough was to use authors first name initials, and even very recently, at least half of the references used initials. So I am not sure that the precedence is clear cut. If you want to remove the |name-list-format=vanc parameters, I will not object. Boghog (talk) 13:22, 6 May 2019 (UTC)

I went ahead and removed |name-list-format=vanc. So now any first author full name that are present are now displayed. Boghog (talk) 13:27, 6 May 2019 (UTC)

(edit conflict) {re|Boghog}} Compare current reference 58 to reference 31:

• Bennett, Michael H.; French, Christopher; Schnabel, Alexander; Wasiak, Jason; Kranke, Peter; Weibel, Stephanie (2015-12-28).
• Chamilos G, Kontoyiannis DP (2015). "Chapter 133: Aspergillus, Candida, and other opportunistic mold infections of the lung". In Grippi MA, Elias JA, Fishman JA, Kotloff RM, Pack AI, Senior RM (eds.)

That's two different styles of demarking editors' names. Before your changes, there was only one style used in both references. The problem with our Vancouver-style is that it doesn't work well when we want to display authors' given names. Imagine how it would turn out if we had made use of the full name "Michael A Grippi" when making the editor list in the second reference - would we now have the authors separated by commas and the editors separated by colons? Incidentally, I'm very disappointed that the citation template does not produce metadata for the veditors list. That really does miss the point of supplying all the information in the wikitext in the first place. I used to spend time making citations consistent and trying to supply as much author information as was available in the source, but now it seems that I should never have bothered. --RexxS (talk) 13:43, 6 May 2019 (UTC)

There was a mix of styles before my first edit, including 45 instances of |vauthors=. And if one goes back far enough, the predominate style used first name initials. It seems overkill to use |first1=, |last1=, ... when only the first name initials are stored. |vauthors= stores a comma delimited list of author names (no loss of granularity) and the first and last names are parsed by the template produce clean meta data. I am surprised to hear that |veditors= doesn't produce clean meta data. I assumed it behaved like |vauthors=. Boghog (talk) 15:03, 6 May 2019 (UTC) (Looking at Module:Citation/CS1, it appears that veditors is split apart just like vauthors) Boghog (talk) 18:52, 6 May 2019 (UTC)

|vauthors= has at least two advantages. The first is compactness (reducing the size of bloated cite templates) and the second is consistency (enforced with error checking by the template). There are few restriction on what can be stored in |first= (initials with or without periods, first and middle initials separated or not separated by spaces, even gibberish such as "@#$%^&" is accepted ). Boghog (talk) 17:59, 6 May 2019 (UTC)

Incomplete textbook cited

One of the citations (currently #68), Rosen's Emergency Medicine: Concepts and Clinical Practice (5th ed) -- has a link to an incomplete archived textbook that only goes until chapter 132. However it is cited for chapter 194 which is inaccessible. I looked through the available chapters and they lack the cited information.

If anyone has a recommendation on where I can find the complete textbook or the proper way to mark this invalid source let me know, I'm new to Wikipedia. 35drake (talk) 16:45, 25 January 2023 (UTC)

Unclear summary of the dangers of hyperbaric medicine in the lead

The lead currently says (paragraph 6, sentence 2): Serious injury can occur at pressures as low as 2 psig (13.8 kPa) if a person in the PVHO is rapidly decompressed.[6][7]. 13.8 kPa = 138 hPa which is about 1/7th of 1013.15 hPa = 1 atm = 1 bar. I don't see that in ref [7], nor in the abstract of ref [6]. More importantly for the flow of the text, I don't see how a hypobaric (if that's a word) pressure makes sense in this context. Obviously, low pressure is a problem too (e.g. a vacuum), but this is a non sequitur. It pops up suddenly and I don't see how a very low pressure makes sense as a summary of the dangers of hyperbaric medicine. Boud (talk) 14:24, 11 May 2024 (UTC)

Request to change the infobox image

Hello. I would like to request a change to the image in the infobox. The current image is outdated. It shows a hyperbaric chamber from 30 years ago. Now they look different. Some places still use the old ones, but the world is moving forward, and new hyperbaric chambers are in sitting positions and can include a number of people at the same time (as it shows on the new image that we are submitting). Please reconsider. Thank you. Chimmychu (talk) 13:21, 7 October 2024 (UTC)