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Related Experiment Videos

Tension pneumothorax associated with hyperbaric oxygen therapy.

D G Murphy1, E P Sloan, R G Hart

  • 1Department of Emergency Medicine, Cook County Hospital, Chicago, IL 60612.

The American Journal of Emergency Medicine
|March 1, 1991
PubMed
Summary

Three patients developed tension pneumothorax after hyperbaric oxygen therapy for carbon monoxide poisoning. Vigilance is crucial for detecting and managing pneumothorax in obtunded patients before hyperbaric treatment.

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Area of Science:

  • Emergency Medicine
  • Hyperbaric Medicine
  • Pulmonology

Background:

  • Acute carbon monoxide poisoning requires emergent treatment, often including hyperbaric oxygen therapy.
  • Patients may require intubation and cardiopulmonary resuscitation prior to hyperbaric oxygen therapy.
  • Hyperbaric oxygen therapy involves exposure to increased atmospheric pressure.

Observation:

  • Three patients undergoing emergent hyperbaric oxygen therapy for carbon monoxide poisoning developed tension pneumothorax.
  • Pneumothorax was not apparent before hyperbaric treatment but was detected shortly after decompression.
  • All patients had received intubation and chest compressions before therapy.

Findings:

  • Emergent hyperbaric oxygen therapy can precipitate tension pneumothorax in critically ill patients.

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  • Obtunded patients with carbon monoxide poisoning are at risk for developing pneumothorax during hyperbaric treatment.
  • The development of tension pneumothorax occurred despite the absence of pre-existing signs.

    • Implications:

    • Increased vigilance is necessary to detect and manage pneumothorax in obtunded patients before hyperbaric decompression.
    • Serial physical examinations, arterial blood gas analysis, and chest radiographs are recommended.
    • A high index of suspicion for pneumothorax is crucial in patients receiving emergent hyperbaric therapy.