亞洲
高壓氧
中心
適用對象
This supportive protocol is for people with an intracranial abscess — a cerebral abscess, subdural empyema, or epidural empyema — whose neurosurgical team recommends hyperbaric oxygen as an adjunct to drainage and antibiotics.
The UHMS selection criteria are explicit, and we follow them exactly [1]. Hyperbaric oxygen is considered when at least one of the following applies:
Multiple abscesses — in one or both hemispheres.
Deep or dominant location — abscesses sitting in areas where surgery carries high risk, such as regions controlling speech or movement.
Compromised host — immune suppression, including HIV, malignancy, or diabetes.
Surgery contraindicated or high risk — when the safest operation is no operation, or a limited one.
Failure to respond — continued deterioration despite appropriate antibiotics and one or two surgical aspirations.
If none of these apply, standard neurosurgical care is usually enough — and we will say so. A doctor's referral is required, and for this condition it comes from the neurosurgical or infectious disease team managing the case.
This is not a first-line protocol, and the page will never pretend otherwise. Drainage and culture-directed antibiotics come first. Hyperbaric oxygen enters when the standard path narrows [1] [2].
It should be discussed with the neurosurgical team when:
Imaging shows multiple abscesses, or an abscess in a deep or eloquent location where every surgical pass costs brain.
The person cannot safely undergo extensive surgery — because of the abscess location, their general condition, or their immune status [1].
One or two aspirations plus appropriate antibiotics have not stopped the deterioration — the explicit "refractory" trigger in the UHMS criteria [1].
Perifocal swelling is driving intracranial pressure, where reducing oedema without high-dose steroids is valuable — because steroids can impede antibiotic penetration into the very tissue being treated [2].
There is associated skull osteomyelitis, where hyperbaric oxygen carries additional evidence [1].
何時考慮高壓氧療程
What Pressure Does Inside an Infected Skull
An abscess is a pocket of infection cut off from the body's defences. The tissue inside and around it is severely hypoxic — and that single fact explains most of why brain abscesses resist treatment [1] [2].
Inside the chamber, we change the physics. At 2.0 to 2.5 ATA, 99.5% medical-grade oxygen dissolves directly into the blood plasma, raising oxygen tension in the abscess region far beyond what compromised vessels can deliver. Four mechanisms follow, each documented in the literature [1] [2].
First, direct suppression of the bacteria. The organisms found most often in brain abscesses are anaerobes — bacteria that cannot tolerate oxygen. Hyperbaric oxygen tensions inhibit their growth and their toxin production directly [1].
Second, immune chemistry restored. Neutrophils kill bacteria through oxygen-dependent reactions. In the hypoxic abscess environment, that machinery stalls; restoring oxygen tension switches it back on, and improves the activity of several antibiotic classes that are themselves oxygen-dependent [1] [2].
Third, swelling reduced — without steroids. High oxygen tension constricts healthy cerebral vessels, reducing blood flow into the swollen region while the plasma still delivers abundant oxygen. Perifocal oedema falls. This matters doubly: it lowers intracranial pressure, and it does so without high-dose steroids, which can shield the infection by hindering antibiotic penetration across the blood-brain barrier [2].
Fourth, help for the bone. When the infection involves the skull itself — concomitant osteomyelitis — hyperbaric oxygen brings its own evidence base from refractory bone infection [1].
科學實證
We do not make promises. The research does that — and on this page, context matters: intracranial abscess is rare, life-threatening, and impossible to study in randomized trials. The evidence is case series and controlled comparisons, and it is strikingly consistent.
The conventional baseline is sobering. Across historical series, intracranial abscess carried roughly 20% mortality, with persistent neurological deficits in nearly half of survivors [1] [3]. Against that baseline, the adjunctive hyperbaric oxygen literature reports:
4.3% vs 19.2% — mortality across 230 patients from seven hyperbaric centres, with adjunctive hyperbaric oxygen versus conventional management alone. — Lampl et al., multi-centre case series analysis [4]
0% mortality, 73% complete recovery — in 25 consecutive patients treated with adjunctive hyperbaric oxygen, with no cerebral oxygen toxicity across 348 sessions. — Lampl et al., consecutive series [5]
Fewer reoperations, better long-term recovery — a Swedish controlled study of 40 patients found adjunctive hyperbaric oxygen associated with less treatment failure and repeat surgery, and better long-term outcomes. — Bartek et al., 2016 [6]
60% vs 30% symptom-free at one year — the largest comparative study to date found patients treated with adjunctive hyperbaric oxygen twice as likely to be fully symptom-free at 12 months (mRS 0, P = .046), with lower mortality (12% vs 20%). — Brunner et al., 2025 [3]
Where we are honest with you: none of this is randomized evidence, and none ever will be — the condition is too rare and too lethal for a placebo arm [2] [3]. Numbers like 0% mortality come from small consecutive series and should not be read as guarantees. The UHMS position is measured: given the severity of these infections and the low complication rate of hyperbaric oxygen, the risk-benefit balance favours adding it in selected patients [1] [2]. Selected is the operative word — and your neurosurgical team makes the selection.
Our protocols follow UHMS guidance for intracranial abscess [1]. Every session is coordinated with the neurosurgical and infectious disease teams — imaging schedule, antibiotic course, and any operative plan.
Oxygen Purity: 99.5% Medical-Grade Oxygen — pharmaceutical-grade purity certified under the Pharmacy and Poisons Ordinance (Cap. 138) [7].
Chamber Pressure: 2.0 to 2.5 ATA (Atmospheres Absolute) — the range used across the published series [1] [5].
Session Duration: 60 to 90 minutes at depth [1].
Frequency: Once daily; twice daily in life-threatening phases, per the published protocols [1] [5].
Total Course: Individualised by clinical and radiological response — the largest series averaged about 13 sessions where bone infection was absent, with formal review after 20 [1] [2]. Surveillance MRI or CT, not the calendar, sets the stop.
療程方案
療程體驗
我們理解首次進入高壓艙可能會感到陌生。我們的專業團隊將全程陪伴，確保您在整個過程中感到舒適、安全與安心。
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Step 1 — 諮詢與準備： 在首次療程前，我們的技術專員會詳細解釋安全守則。您將換上我們提供的100%純棉衣物，以消除靜電風險。高壓艙內嚴禁攜帶任何電子產品、手錶或塗抹油性化妝品。
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Step 2 — 升壓階段： 在起初的10至15分鐘升壓過程中，您的耳朵會產生類似飛機降落時的微脹感。專員會指導您簡單的吞嚥或捏鼻鼓氣動作以平衡耳壓。達到治療壓力（2.0-2.5 ATA）後，您將透過舒適的專用面罩或吸氧帳吸入99.5%醫療級純氧。在90分鐘的療程中，您可以看書、休息或觀看屏幕。
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Step 3 — 減壓與後續： 療程結束前，艙內會於10至15分鐘內緩慢減壓。出艙後，您可以立即恢復日常活動。我們的專員會評估您的傷口狀況，並與您的主治傷口護理團隊保持溝通，以追蹤修復進度。
FAQ
How many sessions before I notice a difference?
The largest published series averaged about 13 sessions, with formal review after 20 — but the honest answer is that your team measures this on surveillance MRI or CT, not on how you feel on a given day [1] [2]. In the published cases, radiological improvement tracked ahead of full neurological recovery, which itself continued consolidating over 6 to 12 months [3].
Can hyperbaric oxygen replace surgery for a brain abscess?
It is not a replacement — drainage and antibiotics remain the foundation for every patient who can undergo them [1]. Where hyperbaric oxygen changes the picture is exactly where surgery cannot go: multiple abscesses, deep or dominant locations, poor surgical candidates, and infections that keep worsening despite standard care. In those situations the UHMS recognises it as an established adjunct [1] — and that is the only way we present it to your team.
The studies are small. How should I weigh them?
Exactly as your neurosurgeon will: promising, consistent, and limited. There will never be a large randomized trial for this condition — it is too rare and too serious [2] [3]. What exists is a multi-centre mortality comparison (4.3% vs 19.2%), consecutive series with remarkable outcomes, the largest comparative study showing doubled rates of complete recovery at one year, and a clear mechanism [3] [4] [5] [6]. Against a baseline where one in five patients dies and nearly half of survivors keep deficits, the risk-benefit balance favours selected use [1] [3]. Selected, by your team — that is the honest frame.
UHMS. Intracranial Abscess. UHMS Hyperbaric Oxygen Therapy Indications, 15th Edition (patient selection criteria; mechanism review; baseline mortality ~20% across 21 studies). Undersea and Hyperbaric Medical Society. UHMS Official Indications
Tomoye EO, Moon RE. Hyperbaric oxygen for intracranial abscess (evidence-based review; utilization review after 20 treatments; risk-benefit conclusion). Undersea Hyperb Med. 2021;48(1). UHMS Journal
Brunner A, et al. Hyperbaric oxygen therapy for brain abscesses: a useful adjuvant treatment for a faster recovery (largest comparative study; 60% vs 30% mRS 0 at 12 months, P = .046; mortality 12% vs 20%; baseline mortality 10–15% and deficit rates per Brouwer et al. meta-analysis). Neurosurg Rev. 2025. Springer
Lampl L, Frey G, et al. Adjunctive hyperbaric oxygen in intracranial abscess: seven-centre case series analysis (230 patients; mortality 4.3% vs 19.2%). As presented: EUBS 2018; in Kindwall & Whelan, Hyperbaric Medicine Practice, 4th ed. [UNVERIFIED — full citation to be confirmed before publication]
Lampl L, Frey G, et al. Adjunctive hyperbaric oxygen in 25 consecutive intracranial abscess patients (0% mortality; 73% complete recovery; 348 sessions, no cerebral oxygen toxicity). As reviewed in Tomoye & Moon, UHM 2021 [2]. [UNVERIFIED — full citation to be confirmed before publication]
Bartek J, et al. Hyperbaric oxygen as an adjunct to surgery and antibiotics in intracranial abscess: retrospective consecutive controlled study, 40 patients (fewer reoperations, better long-term outcome). Sweden, 2016. As reviewed in Tomoye & Moon, UHM 2021 [2]. [UNVERIFIED — full citation to be confirmed before publication]
Hong Kong e-Legislation. Pharmacy and Poisons Ordinance (Cap. 138). Cap. 138 on e-Legislation
