SUMMARY

Increasingly widespread use of HBO to treat critically ill patients has created a demand for individuals skilled in using this technology. Planning and design of monitoring capabilities will enable optimal control of hemodynamics and oxygenation. Careful attention to detail will maximize patient safety in this environment. Optimized treatment schedules will evolve from further studies of the mechanism of action. Advances in prevention and treatment of O₂ toxicity may allow more prolonged therapy than can currently be safely administered and hence permit a more aggressive approach to ischemic and infectious syndromes.

The reduction in ambient pressure and ensuing hypoxia associated with acute high-altitude exposure result in well-described physiologic changes that are often associated with clinical symptoms. Methods for prophylaxis and treatment have been described. Safe anesthesia at high altitude requires some modification of sea-level techniques, not only because of the hypoxia and reduced ambient pressure but also because suboptimal equipment may be available under mountain conditions.

Anesthesia in space poses unique challenges that may extend even beyond landing back on earth.