Commonly associated with divers, CAGE is a frequent iatrogenic event in modern medical practice. It results in significant morbidity and mortality and remains grossly underdiagnosed. It occurs without component hypoxia, and is helpful in managing intermediate compartment syndrome and other acute ischemias in injured extremities, and reducing interstitial edema in grafted tissue. Studies in burn wound applications have indicated a significant decrease in fluid resuscitation requirements when hyperbaric oxygen therapy is added to standard burn wound management protocols. Much of the damage associated with reperfusion is brought about by the inappropriate activation of leukocytes.
Hyperbaric oxygen reduces the indirect component of injury by preventing such activation.
The net effect is the preservation of marginal tissues that may otherwise be lost to ischemia-reperfusion injury. Besides the beneficial effects discussed above, hyperbaric oxygen can produce noticeable toxic effects if administered indiscriminately. Safe time-dose limits have been established for hyperbaric oxygen exposure, and these profiles form the basis for today's treatment protocols. It is only quite recently that disease-specific hyperoxic dosing has been introduced. Emergency cases, such as carbon monoxide poisoning or cerebral arterial gas embolism may only require one or two treatments.