Contents

### **Preface XI**


Preface

Ali Erdal Gunes.

The aim of this book, "Hyperbaric Oxygen Treatment in Research and Clinical Practice - Mechanisms of Action in Focus", is to present the current knowledge of the hyperbaric oxy‐ gen treatment in experimental research and clinical practice. There have been many controversies related to the HBO2 protocols and indications, and our understanding on the mechanisms of HBO2 action is still emerging. In April 2017, the Tenth European Consensus Conference on Hyperbaric Medicine was held, bringing consensus on accepted and non-ac‐ cepted clinical indications and practices of hyperbaric oxygen treatment. Femoral neck ne‐ crosis is one of the indications for treatment with HBO2 that received consensual Type 2 recommendation. This condition is described in the chapter "Therapeutic Mechanisms of Action for Hyperbaric Oxygen on Femoral Head Necrosis" by Gerardo Bosco et al. in this book. Sanja Pekovic et al. in the chapter "Hyperbaric Oxygen Therapy in Traumatic Brain Injury: Cellular and Molecular Mechanisms" describe HBO2 as a potentially neuroprotective treatment and review a number of experimental and clinical studies on the mechanisms of traumatic brain injury. This indication receives Type 3 recommendation by the 10th EU Con‐ sensus Conference on Hyperbaric Medicine and is currently a field of intensive investigation

Reduced microvascular perfusion is seen in many diseases, and hyperbaric oxygen treat‐ ment (HBO2) has potentially beneficial effects on the microcirculatory environment. This topic is covered in the chapter "Microcirculation and Hyperbaric Oxygen Treatment" by Fe‐ thi Gul and co-authors. The chapter "Cell Culture Effects of Altered Oxygen Levels and Hy‐ perbaric Treatment *In Vitro*" by Edit Gara deals with cell culture responses to HBO2 and generally demonstrates the beneficial role of HBO2 on proliferation and viability of most cell types. Furthermore, functional characteristics of the investigated cell types, e.g. angiogenesis by endothelial cell, are improved in response to HBO2. Since oxygen is a highly reactive mol‐ ecule and can induce upregulation of many various enzymatic systems in the cell, at the cellular, genetic and molecular level it can affect many cell functions. Particularly, vascular/ endothelial function is affected by HBO2. The chapter "Mechanisms of HBO-Induced Vascu‐ lar Functional Changes in Diabetic Animal Models" by Ivana Jukic et al. describes the vascu‐

And finally, as well as exhibiting beneficiary effects on the tissue perfusion, it is known that HBO2 demonstrates high toxicity at higher pressures, due to increased oxidative stress and barotrauma. This is presented in the chapter "Toxic Effects of Hyperbaric Conditions" by

lar functional changes affected by HBO2 in animal model of diabetes mellitus.

both in basic medical sciences and in clinical trials.
