Risk factors for symptomatic otic and sinus barotrauma in a multiplace hyperbaric chamber

This retrospective study examines the relationship of multiplace chamber compression rates and the influence of several predisposing factors on the risk of symptomatic barotrauma. Data were reviewed from a 3-yr period for 111 patients who received 2,394 routine hyperbaric oxygen treatments. A total of 35 patients reported symptoms of barotrauma, with an overall rate of 3.05 cases per 100 treatments. Most symptoms occurred during a patient's initial three treatments and with minimal increased pressure. The most frequently affected area was the ears (95%) with objective findings noted in 18% of patients reporting fullness compared to 39% of patients reporting pain. Referral diagnosis was not related to the incidence of barotrauma. Although the overall risk of symptomatic barotrauma increased as the compression rate increased, it was not significant (RR = 1.57, CI0.95 = 0.65, 3.80). Female patients were at significantly increased risk (RR = 2.14, CI0.95 = 1.37, 3.34) compared to males, and patients less than age 40 were at higher risk than those age 40 and older (RR = 3.00, CI0.95 = 1.80, 5.03). Well-designed prospective studies are needed to more clearly define risk factors and identify compression rates with the least risk of barotrauma.