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Published on: May 4, 2021
Hyperbaric oxygen therapy for paediatric patients: an unintended consequence of the COVID-19 pandemic
Areeg A Abu El Hawa1, Jenna C Bekeny1, Nituna W Phillips2
1Georgetown University School of Medicine, Washington, District of Columbia, US.
Insights
Paediatric patients can safely receive hyperbaric oxygen therapy (HBOT) in monoplace chambers. Modifications to existing HBOT centers ensure safe and effective treatment for children, addressing pandemic-related challenges.
Area of Science:
- Medical Sciences
- Hyperbaric Medicine
- Pediatric Care
Background:
- Hyperbaric oxygen therapy (HBOT) is an adjunctive treatment for complex wounds.
- The COVID-19 pandemic disrupted HBOT service delivery, particularly for pediatric patients.
- Existing HBOT centers faced challenges in accommodating younger patients.
Purpose of the Study:
- To outline modifications for adapting a monoplace HBOT center for pediatric patient treatment.
- To ensure the safe and effective delivery of HBOT to children during the pandemic.
Main Methods:
- Retrospective review of pediatric patients (≤18 years) referred for HBOT in 2020.
- Documentation of implemented practice changes for pediatric treatment.
- Collection of patient demographics, referral diagnoses, and HBOT complications.
Main Results:
- Six of seven evaluated pediatric patients were treated.
- Mean age was four years; diagnoses included hearing loss, graft compromise, and radiation necrosis.
- All pediatric patients tolerated HBOT in monoplace chambers without significant complications.
Conclusions:
- Pediatric patients can be safely treated in a monoplace hyperbaric environment.
- Adaptations in clinical practice, including patient grounding and anxiety reduction, are crucial.
- Monoplace HBOT centers can be modified to safely treat pediatric populations.
Objective:
Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients.
Method:
A retrospective review was performed to identify patients 18 years of age or younger referred for HBOT during 2020. Patient characteristics, referral indications and HBOT complications were collected. Changes implemented to the HBOT centre to accommodate the treatment of paediatric patients were documented.
Results:
A total of seven paediatric patients were evaluated for HBOT and six were treated. The mean patient age was four years (range: 1-11 years). Referral diagnoses included sudden sensorineural hearing loss, skin flap or graft compromise, and radiation-induced soft tissue necrosis. All patients tolerated HBOT treatment in monoplace chambers without significant complications noted. Enhancements made to our clinical practice to facilitate the safe and effective treatment of paediatric patients included ensuring the availability of acceptable garments for paediatric patients, maintaining uninterrupted patient grounding (in relation to fire safety), and enhancing social support for anxiety reduction.
Conclusion:
The results of our review show that paediatric patients can be safely treated within the monoplace hyperbaric environment.
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