Landspitali - University Hospital
Hyperbaric and Dive Medicine Department
Indications for Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is a medical treatment and is prescribed in the same way as other medications.
It has defined dosage, pressure, and treatment duration and requires a clear medical indication.
Medical Guidelines and Patient Safety
Our department follows internationally recognized standards to ensure patient safety and high-quality care.
Approved indications are based on guidelines from:
the European Committee for Hyperbaric Medicine (ECHM)
the Undersea and Hyperbaric Medical Society (UHMS)
In selected cases, other national or international guidelines may be applied when clinically appropriate.
"Indications highlighted in bold” below are medical emergencies and require immediate treatment.
Approved Indications (European Consensus – ECHM)
Hyperbaric oxygen therapy may be indicated for conditions including, but not limited to:
CO poisoning
Open fractures with crush injury
Prevention of osteoradionecrosis after dental extraction
Osteoradionecrosis (mandible)
Soft tissue radionecrosis (cystitis, proctitis)
Decompression illness
Gas embolism
Anaerobic or mixed bacterial infections
Sudden deafness
Interstitial cystitis
Diabetic foot lesions
Femoral head necrosis
Compromised skin grafts and musculo- cutaneous
Central retinal artery occlusion (CRAO)
Crush Injury without fracture
Osteoradionecrosis (bones other than mandible)
Radio-induced lesions of soft tissues (other than cystitis and proctitis)
Surgery and implant in irradiated tissue (preventive treatment)
Ischemic ulcers
Refractory chronic osteomyelitis
Burns, 2nd degree more than 20% BSA
Pneumatosis cystoides intestinalis
Neuroblastoma, stage IV
Brain injury (acute and chronic TBI, chronic stroke.
Post anoxic encephalopathy, in highly selected patients
Radio-induced lesions of larynx
Radio-induced lesions of the CNS
Post-vascular procedure reperfusion syndrome
Limb replantation
Selected non-healing wounds secondary to systemic processes
Sickle cell disease
Approved Indications (UHMS – United States)
UHMS-approved indications largely overlap with European guidelines and include:
Air Or Gas Embolism
Carbon Monoxide Poisoning
Clostridial Myositis And Myonecrosis (Gas Gangrene)
Crush Injury, Compartment Syndrome And Other Acute Traumatic Ischemia
Decompression Sickness
Arterial Insufficiencies
Severe Anemia
Intracranial Abscess
Necrotizing Soft Tissue Infections
Osteomyelitis (Refractory)
Delayed Radiation Injury (Soft Tissue And Bony Necrosis)
Compromised Grafts And Flaps
Acute Thermal Burn Injury
Idiopathic Sudden Sensorineural Hearing Loss
Off-label Use
Long Covid (in selected cases)