Scope Clarification

Departments Without Current HBOT Applications

The following departments do not currently have direct HBOT applications based on available evidence. This does not preclude future research or indirect roles in patient care pathways.

Exclusion Criteria

Departments are listed here when: (1) no peer-reviewed evidence supports direct HBOT application in their primary scope of practice; (2) the department's function is diagnostic or supportive rather than therapeutic; or (3) HBOT would be managed by a referring department rather than the listed specialty itself.

Genetics Clinic

The Genetics Clinic manages hereditary conditions, chromosomal disorders, and genetic counseling. There is currently no scientific evidence supporting the use of HBOT in the management of genetic disorders. While HBOT modulates gene expression through HIF pathways, this does not translate to therapeutic benefit for primary genetic conditions.

Role in HBOT Program:

No current or projected clinical application

Hepatology

While preclinical research is emerging on HBOT for liver regeneration and hepatic ischemia-reperfusion injury, this has not yet translated to established clinical practice. Liver transplant centers have explored HBOT as a preservation strategy, but this remains strictly investigational with no approved protocols.

Role in HBOT Program:

Preclinical research only; no established clinical protocols

Diagnostic Laboratories

Diagnostic laboratories (Microbiology, Hematology, Biochemistry) are analytical entities that process specimens and generate results. While HBOT relies on these departments for patient assessment — including transcutaneous oximetry and microbiological wound cultures — the therapy itself is not applied within these disciplines. No current evidence supports HBOT as a diagnostic modality.

Role in HBOT Program:

Supportive — provides pre/post HBOT biomarker assessment

Kidney Dialysis Unit

While emerging research explores HBOT for chronic kidney disease and diabetic nephropathy, it is not currently a treatment modality utilized within a standard dialysis unit. Dialysis patients have complex vascular access requirements and hemodynamic instability that complicate hyperbaric treatment. This remains a preclinical area of investigation.

Role in HBOT Program:

No current clinical application; preclinical research ongoing

Medical Imaging & Nuclear Medicine

Medical Imaging (CT, MRI, PET, Nuclear Medicine Theranostics) serves a purely diagnostic and interventional imaging function. HBOT does not alter imaging protocols or radiopharmaceutical uptake in any clinically meaningful way. These departments support HBOT patient selection and monitoring but are not sites of HBOT application.

Role in HBOT Program:

Supportive — pre-treatment imaging and perfusion assessment

Intensive Care Unit (ICU)

While critically ill patients may occasionally require HBOT for conditions such as gas gangrene or carbon monoxide poisoning, the logistical challenges of managing ventilated, hemodynamically unstable patients in a hyperbaric chamber are significant. Standard ICU monitoring equipment is not compatible with hyperbaric environments. Monoplace chambers limit access for emergency interventions.

Role in HBOT Program:

Occasional referral for specific indications (CO poisoning, gas gangrene)

This list reflects the evidence base as of 2025. Ongoing research may establish new indications. Departments listed here may still play important roles in patient selection, monitoring, and follow-up within a comprehensive HBOT program.