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HBO raises tissue oxygen levels, which enhances leukocyte oxidative killing of bacteria. Adequate oxygen is essential for phagocytosis, particularly in hypoxic or infected tissues.

Henry’s Law states that the amount of gas dissolved in a liquid is proportional to its partial pressure. Under HBO, oxygen dissolves in plasma at levels sufficient to meet tissue demands even when hemoglobin is impaired (e.g., carbon monoxide poisoning).

If TcPO₂ fails to improve during oxygen breathing, tissues are not oxygen responsive, and wound healing potential with HBO therapy is low. This helps clinicians decide if HBO is justified.

Untreated pneumothorax is the only absolute contraindication to HBO therapy. Expanding trapped air during decompression can lead to tension pneumothorax, which is life-threatening. A chest tube ensures safe pressure equalization. Atelectasis, effusion, and fibrosis are relative considerations but do not require chest tube insertion. CHTs must always confirm lung integrity through medical evaluation before pressurization.

ASME PVHO-1 (Pressure Vessels for Human Occupancy) defines engineering and testing requirements for chamber design. NFPA 99 governs fire safety, OSHA regulates workplace safety, and UHMS defines medical use guidelines.