Hyperbaric oxygen: its application in cardiology: a historical perspective and personal journey.

Hyperbaric oxygen (HBO) was first used by placing a patient with the "bends" in a pressure chamber and increasing the pressure to 3 atm with 100% oxygen. It was soon recognized that HBO could also facilitate wound healing in infected ischemic extremities. Before the pump oxygenator was developed, it was also shown to facilitate corrective surgery, especially in congenital heart disease. In 1997, after encouraging animal work, HBO therapy was used in conjunction with thrombolytics to reduce the magnitude of injury in patients with acute myocardial infarction. The benefit is probably due to the decrease in reperfusion injury, which has been shown to be a major cause of myocardial cell death when the culprit artery is opened with a catheter. The most recent development is to infuse saline saturated with HBO into the opened coronary artery immediately after angioplasty. An advantage of this treatment has been demonstrated in experimental animals and in man. Future applications of HBO treatment in cardiovascular disease await more research, but at this time it seems to have considerable promise.