Dr. Jeffrey Gladden explains two types of oxygen toxicity in hyperbaric medicine: acute CNS toxicity from sudden oxygen excess, and cumulative pulmonary toxicity from repeated exposure. He's never seen CNS toxicity in his clinic because he starts patients at low pressures and builds gradually. Neurological treatments use 1.3–1.5 atmospheres to protect the brain, which is vulnerable to over-oxidation despite high metabolic demand.
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There's also central nervous system oxygen toxicity, which is, it's different. It's not a cumulative threat to lung tissue over time. It's just an absolute too much oxygen in a moment that really can short circuit the nervous system. Have you seen that happen? Quite honestly, no, in my office I've never seen it, but we always start low. We build people a tolerance. We, we go through the steps and then we don't, we don't treat everybody at 2 to 2.5 atmospheres. We treat different tissues at different pressures, like a lot of neurological treatments we do at like 1.5, even 1.3, because we know that the brain is going to be the most fragile, even though it, even though it's one of the most metabolically active and needs a lot of oxygen, it's also the most susceptible to over-oxidation. So like you were saying earlier, there's a, there's a balance point that, that needs to be found. If you're practicing it responsibly and you learn the things you need to learn to use hyperbaric, you'd see that oxygen toxicity is— both pulmonary and central nervous system oxygen toxicity are very easy to avoid, but you just have to know where the goalposts are and how to keep people, you know, away from the edges.
