Hyperbaric oxygen therapy in preventing mechanical ventilation in COVID-19 patients: a retrospective case series

2020 ◽  
Vol 29 (Sup5a) ◽  
pp. S4-S8 ◽  
Author(s):  
Kerry Thibodeaux ◽  
Marcus Speyrer ◽  
Amer Raza ◽  
Raphael Yaakov ◽  
Thomas E Serena
Keyword(s):  
Mechanical Ventilation ◽  
Oxygen Saturation ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Small Sample ◽  
World Health ◽  
Cardiac Complications ◽  
Dramatic Improvement ◽  
Increased Risk

Objective: A pandemic afflicts the entire world. The highly contagious SARS-CoV-2 virus originated in Wuhan, China in late 2019 and rapidly spread across the entire globe. According to the World Health Organization (WHO), the novel Coronavirus (COVID-19)has infected more than two million people worldwide, causing over 160,000 deaths. Patients with COVID-19 disease present with a wide array of symptoms, ranging from mild flu-like complaints to life threatening pulmonary and cardiac complications. Older people and patients with underlying disease have an increased risk of developing severe acute respiratory syndrome (SARS) requiring mechanical ventilation. Once intubated, mortality increases exponentially. A number of pharmacologic regimens, including hydroxychloroquine-azithromycin, antiviral therapy (eg, remdesevir), and anti-IL-6 agents (e.g., toclizumab), have been highlighted by investigators over the course of the pandemic, based on the therapy's potential to interrupt the viral life-cycle of SARS-CoV-2 or preventing cytokine storm. At present, there have been no conclusive series of reproducible randomised clinical trials demonstrating the efficacy of any one drug or therapy for COVID-19. Cases: COVID-19 positive patients (n=5) at a single institution received hyperbaric oxygen therapy (HBOT) between 13 and 20 April 2020. All the patients had tachypnoea and low oxygen saturation despite receiving high FiO2. HBOT was added to prevent the need for mechanical ventilation. A standard dive profile of 2.0ATA for 90 minutes was employed. Patients received between one and six treatments in one of two dedicated monoplace hyperbaric chambers. Results: All the patients recovered without the need for mechanical ventilation. Following HBOT, oxygen saturation increased, tachypnoea resolved and inflammatory markers fell. At the time of writing, three of the five patients have been discharged from the hospital and two remain in stable condition. Conclusion: This small sample of patients exhibited dramatic improvement with HBOT. Most importantly, HBOT potentially prevented the need for mechanical ventilation. Larger studies are likely to define the role of HBOT in the treatment of this novel disease.

Hyperbaric Oxygen Therapy and Its Suitability as an Adjuvant for Treatment of Covid-19 Patients: A Review

2021 ◽  
Vol 12 (4) ◽  
pp. 2548-2556
Author(s):  
Sameera Dawar ◽  
Meena Jain
Keyword(s):  
Mechanical Ventilation ◽  
Oxygen Saturation ◽  
Hyperbaric Oxygen ◽  
Basic Principle ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Delivery ◽  
Atmospheric Pressure ◽  
Oxygen Therapy ◽  
Tissue Oxygenation ◽  
The Body

The outbreak of the SARS CoV2 ' pandemic' is believed to have originated in Wuhan in 2019 as a spread from bats to humans. It is a highly communicable infection-causing rapid human to human transmission of the virus by virtue of its infectious and nature. The virus has affected millions of people worldwide, with numbers still rising with each passing day. Depleting oxygen saturation levels is amongst the prime concerns in the majority of infected patients. Nasal prongs, face masks, mechanical ventilation and membrane (ECMO) are the commonly used modes of oxygen delivery in such patients. These methods though mostly successful, at times fail to restore the depleting oxygen levels to normal. oxygen therapy (HBOT) involves the administration of 100% O2 in a special chamber whose pressure is maintained at a level greater than 1 ATP. The main purpose for raising the pressure within the chamber is that as the atmospheric pressure increases, the saturation levels of oxygen in the blood also increase, which eventually result in increased overall tissue oxygenation. This article provides a systematic and wholesome review on the basic principle of oxygen therapy, its effects on the body at a microscopic and macroscopic level, its various uses and its suitability as an for the treatment of select COVID-19 infected patients.

Experience in Applying Hyperbaric Oxygen Therapy Using Portable Pressure Chambers for the Treatment of Patients with the Novel Coronavirus Infection COVID-19

Biomeditsina ◽  
2020 ◽  
pp. 39-46
Author(s):  
A. S. Samoilov ◽  
Yu. D. Udalov ◽  
M. V. Sheyanov ◽  
A. V. Gholinsky ◽  
A. B. Litvinenko
Keyword(s):  
Oxygen Saturation ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Capillary Blood ◽  
Blood Hemoglobin ◽  
Patient Groups ◽  
Radiological Changes ◽  
Coronavirus Infection ◽  
Novel Coronavirus

This communication presents the experience of using mobile pressure chambers in patients with the confi rmed novel coronavirus infection in hospital settings. The obtained preliminary results indicate positive antihypoxic effects of hyperbaric oxygen therapy (HBO) applied in the form of increased saturation. After a session of HBO, patients demonstrated an increase in the oxygen saturation of capillary blood hemoglobin at the average level of 3.71 points. Differences between SatO2 levels prior to and following HBO treatment were signifi cant in the CT2, CT3 and CT4 groups (p0.05). As expected, the effi cacy of HBO in terms of the oxygen saturation of capillary blood hemoglobin was the greatest in the patient groups showing pronounced clinical and radiological changes in the lungs.

scholarly journals Impact of Hyperbaric Oxygen Therapy on Subsequent Neurological Sequelae Following Carbon Monoxide Poisoning

2018 ◽  
Vol 7 (10) ◽  
pp. 349 ◽  
Author(s):  
Chien-Cheng Huang ◽  
Chung-Han Ho ◽  
Yi-Chen Chen ◽  
Chien-Chin Hsu ◽  
Yi-Fong Wang ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Carbon Monoxide Poisoning ◽  
Population Based ◽  
Chronic Obstructive ◽  
Monthly Income ◽  
Neurological Sequelae ◽  
Increased Risk

The purpose of this study was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on reducing neurological sequelae (NS) in patients with carbon monoxide poisoning (COP). Using a nationwide database of insurance claims in Taiwan, we conducted a population-based cohort study to identify 24,046 patients with COP diagnosed between 1999 and 2012, including 6793 (28.2%) patients who received HBOT and 17,253 (71.8%) patients who did not. We followed the two cohorts of patients and compared the occurrence of NS. The two cohorts had similar sex ratios, but patients who received HBOT were younger (34.8 ± 14.8 vs. 36.1 ± 17.2 years, p < 0.001). Patients who received HBOT had a higher risk for NS (adjusted hazard ratio [AHR]: 1.4; 95% confidence interval [CI]: 1.4–1.5), after adjusting for age, sex, underlying comorbidities (hypertension, diabetes, chronic obstructive pulmonary disease, hyperlipidemia, malignancy, coronary artery disease, congestive heart failure, liver disease, renal disease, connective tissue disease, human immunodeficiency virus [HIV] infection, and alcoholism), monthly income, suicide, drug poisoning, and acute respiratory failure. We observed similar findings when we stratified the patients by age, sex, underlying comorbidities, and monthly income. The increased risk was most prominent in the first 2 weeks (AHR: 2.4; 95% CI: 2.1–2.7) and remained significant up to 6 months later (AHR: 1.6; 95% CI: 1.4–1.7). The risk for NS was higher in patients with COP who received HBOT than in those who did not, even after considering the possible impact of longer observation periods on survivors. Further studies that included the potential confounding factors we did not measure are needed to confirm findings in this study.

scholarly journals A Successful Treatment of Chronic Migraine With Hyperbaric Oxygen Therapy

EMJ Neurology ◽  
2021 ◽  
Author(s):  
Rahmah Shafee ◽  
Mohd Amirullah Hamzah ◽  
Rajesh Kumar Muniandy
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Medical Problem ◽  
World Health ◽  
Patient Reported ◽  
Health Organization ◽  
The Right ◽  
To Receive ◽  
Therapy Sessions

The World Health Organization (WHO) ranks migraine as the most prevalent and disabling neurological condition. Management of migraines can be broadly divided into lifestyle and trigger management, acute treatments, and preventive treatments. Despite pharmacological advances, this medical problem has remained undertreated. A 40-year-old male presented to the authors’ hospital and complained of severe, constant, and throbbing pain over the right side of his head. There was occasional photophobia but no visual disturbances. Oral analgesics were not helpful. After careful evaluation, he was advised to receive hyperbaric oxygen therapy sessions. He underwent one session per day, 5 days per week for 4 weeks. At the end of the 20 sessions, the patient reported an improvement in his symptoms, and did not require any oral medication. The authors concluded that hyperbaric oxygen therapy should be explored further as a treatment for pharmacologically resistant migraine.

Hyperbaric oxygen therapy for COVID-19 patients with respiratory distress: treated cases versus propensity-matched controls

2020 ◽  
pp. 405-413 ◽  
Author(s):  
Scott A. Gorenstein ◽  
◽  
Michael L. Castellano ◽  
Eric S. Slone ◽  
Brian Gillette ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Secondary Outcome ◽  
Inpatient Mortality ◽  
Oxygen Requirement ◽  
Subdistribution Hazard ◽  
Artery Disease

Objective: Given the high mortality and prolonged duration of mechanical ventilation of COVID-19 patients, we evaluated the safety and efficacy of hyperbaric oxygen for COVID-19 patients with respiratory distress. Methods: This is a single-center clinical trial of COVID-19 patients at NYU Winthrop Hospital from March 31 to April 28, 2020. Patients in this trial received hyperbaric oxygen therapy at 2.0 atmospheres of pressure in monoplace hyperbaric chambers for 90 minutes daily for a maximum of five total treatments. Controls were identified using propensity score matching among COVID-19 patients admitted during the same time period. Using competing-risks survival regression, we analyzed our primary outcome of inpatient mortality and secondary outcome of mechanical ventilation. Results: We treated 20 COVID-19 patients with hyperbaric oxygen. Ages ranged from 30 to 79 years with an oxygen requirement ranging from 2 to 15 liters on hospital days 0 to 14. Of these 20 patients, two (10%) were intubated and died, and none remain hospitalized. Among 60 propensity-matched controls based on age, sex, body mass index, coronary artery disease, troponin, D-dimer, hospital day, and oxygen requirement, 18 (30%) were intubated, 13 (22%) have died, and three (5%) remain hospitalized (with one still requiring mechanical ventilation). Assuming no further deaths among controls, we estimate that the adjusted subdistribution hazard ratios were 0.37 for inpatient mortality (p=0.14) and 0.26 for mechanical ventilation (p=0.046). Conclusions: Though limited by its study design, our results demonstrate the safety of hyperbaric oxygen among COVID-19 patients and strongly suggests the need for a well-designed, multi-center randomized control trial.

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