The European Committee for Hyperbaric Medicine (ECHM), is the European scientific organization focused on the field of Diving & Hyperbaric Medicine. Last agreement on the recommended indications for HBO Therapy was announced after the 10th ECHM Consensus Conference that took place in Lille, 2016. Evidence-Based Medicine methodology was used that concluded the following categories:

Type 1 Indications – Strongly Indicated. HBOT is strongly indicated as a primary treatment method, as it is supported by sufficiently strong evidence:

• Anaerobic or Mixed Bacterial Infections

• Carbon Monoxide (CO) Poisoning

• Decompression Illness

• Gas Embolism

• Open Fractures with Crush Injury

• Prevention of Osteoradionecrosis after Dental Extraction

• Osteoradionecrosis (mandible)

• Soft Tissue Radionecrosis (cystitis, proctitis)

• Sudden Deafness

Type 2 Indications – Suggested. HBOT is suggested as it is supported by acceptable level of evidence:

• Burns, 2nd degree & more than 20% of body surface area (BSA)

• Central Retinal Artery Occlusion (CRAO)

• Compromised skin grafts and musculocutaneous flaps

• Crush Injury without Fracture

• Diabetic Foot Lesions

• Femoral Head Necrosis

• Ischemic Ulcers

• Neuroblastoma, stage IV

• Osteoradionecrosis (bones other than mandible)

• Pneumatosis Cystoides Intestinalis

• Radio-induced lesions of soft tissues (other than cystitis and proctitis)

• Refractory Chronic Osteomyelitis

• Surgery and Implant in Irradiated Tissue (preventive treatment)

Type 3 Indications – Optional. HBOT can be considered as a possible/optional measure, but it is not yet supported by sufficiently strong evidence:

• Brain Injury in Highly Selected Patients (Acute and Chronic TBI, chronic stroke, Post-anoxic Encephalopathy)

• Interstitial Cystitis

• Limb Replantation

• Post-vascular Procedure Reperfusion Syndrome

• Radio-induced lesions of the Larynx

• Radio-induced lesions of the CNS

• Selected non healing Wounds secondary to Systemic Processes

• Sickle Cell Disease

Type 1 Indications for not using HBOT

• Autism Spectrum Disorders

• Cerebral Palsy

• Multiple Sclerosis

• Placental Insufficiency

• Stroke, Acute Phase

• Tinnitus