Clinical Hyperbaric Medicine and the WWW Question

Abstract

There is a revival of interest in the literature for clinical hyperbaric medicine^1,2,3,4 and even new horizons are recognized.^5,6 This phenomenon may be a new development, or could it be a matter of history repeating itself? In 1885, E.T. Williams from the Brompton Hospital at London wrote in the British Medical Journal: “The use of atmospheric air under different degrees of atmospheric pressure, in the treatment of disease is one of the most important advances in modern medicine, and when we consider the simplicity of the agent, the exact methods by which it may be applied, and the precision with which it can be regulated to the requirements of each individual, we are astonished that in England this method of treatment has been so little used”. In that period doctors practised modern medicine and nowadays doctors do claim to do the same. However, there is a difference. Today we know that oxygen is not a simple agent. Furthermore, expected linearity effects of increased ambient pressure and/or FiO₂ are attenuated by regulatory networks within the vascular bed and heterogeneity of perfusion. In fact to unravel the complicated path-way of oxygen from the ambient air to the mitochondrium is one of the fundamental drives for the ISOTT.