Hyperbaric oxygen treatment in a patient with Guillain-Barré syndrome receiving mechanical ventilation

The mortality rate of patients with Guillain-Barré syndrome (GBS) who develop respiratory muscle paralysis and need mechanical ventilation is increased. Though an unestablished indication, hyperbaric oxygen treatment (HBOT) has been used to treat patients with mild GBS who do not have respiratory muscle paralysis. The use of HBOT in severe cases has not been reported. We present a patient with severe GBS who received HBOT while ventilated in a multiplace hyperbaric chamber. Three courses of HBOT (one session per day, 10 sessions per course) were administered with a 2-day rest period between each course. The HBOT protocol was 40 minutes at 220 kPa with 25 minutes of compression and decompression. Following weeks of gradual deterioration, motor function improved after the first HBOT session. After eight HBOT sessions, the patient was successfully discontinued from mechanical ventilation and after 10 sessions the patient’s muscle strength was significantly improved. After 30 HBOT sessions, the patient had normal breathing and speech, and did not cough when eating. Upper limb muscle strength was graded as 4 on the Medical Research Council (MRC) scale, lower limb muscle strength was graded as MRC 3. The patient was successfully discharged. Mechanically ventilated GBS patients may benefit from HBOT but studies are required to separate spontaneous recovery rates from treatment benefit.

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S33. Two case reports of ganglioside-associated Guillain-Barré syndrome with onset of respiratory muscle paralysis

Clinical Neurophysiology ◽

10.1016/j.clinph.2018.04.393 ◽

2018 ◽

Vol 129 ◽

pp. e154

Author(s):

Suhong Wang

Keyword(s):

Respiratory Muscle ◽

Case Reports ◽

Guillain Barre Syndrome ◽

Muscle Paralysis ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Efficacy and safety of hyperbaric oxygen treatment in SARS-COV-2 (COVID-19) pneumonia: a systematic review

Diving and Hyperbaric Medicine Journal ◽

10.28920/dhm51.3.271-281 ◽

2021 ◽

Vol 51 (3) ◽

pp. 271-281 ◽

Cited By ~ 1

Author(s):

Sylvain Boet ◽

◽

Cole Etherington ◽

George Djaiani ◽

Andrea C Tricco ◽

...

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Cohort Study ◽

Hyperbaric Oxygen ◽

Case Reports ◽

Grey Literature ◽

Hyperbaric Oxygen Treatment ◽

Invasive Treatment ◽

Serious Adverse Events ◽

Oxygen Treatment

Introduction: The need for intubation and mechanical ventilation among COVID-19 patients is associated with high mortality rates and places a substantial burden on the healthcare system. There is a strong pathophysiological rationale suggesting that hyperbaric oxygen treatment (HBOT), a low-risk and non-invasive treatment, may be beneficial for COVID-19 patients. This systematic review aimed to explore the potential effectiveness and safety of HBOT for treating patients with COVID-19. Methods: Medline, Embase, Scopus, and Google Scholar were searched from December 2019 to February 2021, without language restrictions. The grey literature was searched via an internet search engine and targeted website and database searches. Reference lists of included studies were searched. Independent reviewers assessed studies for eligibility and extracted data, with disagreements resolved by consensus or a third reviewer. Risk of bias was assessed using the Newcastle Ottawa Scale. Data were summarised descriptively. Results: Six publications (one cohort study, five case reports/series) met the inclusion criteria with a total of 37 hypoxaemic COVID-19 patients treated with HBOT. Of these 37 patients, the need for intubation and mechanical ventilation and in-hospital survival were assessed for 26 patients across three studies. Of these 26 patients, intubation and mechanical ventilation were not required for 24, and 23 patients survived. No serious adverse events of HBOT in COVID-19 patients were reported. No randomised trials have been published. Conclusions: Limited and weak evidence from non-randomised studies including one propensity-matched cohort study suggests HBOT is safe and may be a promising intervention to optimise treatment and outcomes in hypoxaemic COVID-19 patients. Randomised controlled studies are urgently needed.

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Postoperative Hyperbaric Oxygen Treatment of Peripheral Nerve Damage,

10.21236/ada255842 ◽

1992 ◽

Author(s):

Zhao Dewei ◽

Cui Zhenjiang

Keyword(s):

Peripheral Nerve ◽

Hyperbaric Oxygen ◽

Nerve Damage ◽

Hyperbaric Oxygen Treatment ◽

Peripheral Nerve Damage ◽

Oxygen Treatment

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Method for Estimating the Remaining Capacity of the Carbon Dioxide Scrubber in the Hyperbaric Oxygen Treatment Pack

10.21236/ada442777 ◽

2002 ◽

Author(s):

Dan E. Warkender ◽

John R. Clarke

Keyword(s):

Carbon Dioxide ◽

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Treatment ◽

Oxygen Treatment ◽

Remaining Capacity

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Hyperoxic myopia: a case series of four divers

Undersea and Hyperbaric Medicine ◽

10.22462/04.06.2020.12 ◽

2020 ◽

pp. 261-265

Author(s):

Jonathan W. Brügger ◽

Glenn A. Rauscher ◽

John P. Florian ◽

Keyword(s):

Hyperbaric Oxygen ◽

Prolonged Exposure ◽

Case Series ◽

Oxygen Toxicity ◽

Hyperbaric Oxygen Treatment ◽

Subjective Data ◽

Residual Symptoms ◽

Oxygen Treatment ◽

Blurry Vision ◽

Record Review

Hyperoxic myopia is a phenomenon reported in individuals who have prolonged exposure to an increased partial pressure of oxygen (PO2) and subsequently have a myopic (nearsighted) change in their vision. To date, there are numerous accounts of hyperoxic myopia in dry hyperbaric oxygen treatment patients; however, there have been only three confirmed cases reported in wet divers. This case series adds four confirmed cases of hyperoxic myopia in wet divers using 1.35 atmospheres (ATM) PO2 at the Navy Experimental Diving Unit (NEDU). The four divers involved were the first author’s patients at NEDU. Conditions for two divers were confirmed via record review, whereas the other two divers were diagnosed by the first author. All subjects were interviewed to correlate subjective data with objective findings. Each subject completed five consecutive six-hour hyperoxic (PO2 of 1.35 ATM) dives with 18-hour surface intervals. Each individual was within the U. S. Navy Dive Manual’s standards for general health. Visual acuity was measured prior to diving. Within three to four days after diving, the individuals reported blurry vision with an associated myopic refraction shift. Each diver had spontaneous resolution of his myopia over the next two to three weeks, with no significant residual symptoms. The divers in this case series were exposed to an increased PO2 (1.35 ATM for 30 hours over five days), a lesser exposure than that in other reports of hyperoxic myopia in wet divers diagnosed with hyperoxic myopia (1.3-1.6 ATM for 45-85 hours in 12-18 days). Furthermore, this pulse of exposure was more concentrated than typically seen with traditional hyperbaric oxygen therapy. Hyperoxic myopia continues to be a risk for those conducting intensive diving with a PO2 between 1.3-1.6 ATM. Additional investigation is warranted to better define risk factors and PO2 limits regarding ocular oxygen toxicity.

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