Current status and development direction of hyperbaric medicine in Korea

ABSTRACT

The indications of hyperbaric oxygen therapy (HBOT) covered by the health insurance in Korea increased to 16 in 2019, which includes acute central retinal artery obstruction within 24 hours of vision loss; anemia due to excessive bleeding, since blood transfusion is impractical; chronic refractory osteomyelitis (Wagner grade ≥3); and intracranial abscess.Current Concepts: HBOT affects the treatment in the primary and secondary mechanisms. According to the Boyle’s law, the primary mechanism is important in treating decompression sickness and intravascular air embolism by decreasing the volume of air bubbles when pressure increases, whereas the secondary mechanism involves hyperoxygenation of the primary mechanism and various effects, such as vasoconstriction, angiogenesis, immune function enhancement, reperfusion injury prevention, antimicrobial action, and gas washout effect, occur. In the past 5 years, domestic HBOT has made significant progress. However, there are many non-therapeutic lowpressure HBOT facilities that are limited by insurance coverage issues, quality equipment management, and medical personnel in HBOT facilities.Discussion and Conclusion: To solve the problem, the introduction of the definition of therapeutic hyperbaric pressure and certification system of HBOT facilities must be initiated. Moreover, the system should be improved so that insurance can be applied for a more indication of HBOT.