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Published on: May 4, 2021
Hyperbaric oxygen treatment in children: experience in 329 patients
Figen Aydin1,2
1Department of Hyperbaric Medicine, University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.
Insights
Hyperbaric oxygen treatment (HBOT) is safe for children, with most completing therapy successfully and achieving goals. Careful management minimizes complications, allowing more pediatric patients to benefit from this therapy.
Area of Science:
- Pediatric Medicine
- Hyperbaric Medicine
- Critical Care
Background:
- Hyperbaric oxygen treatment (HBOT) is utilized for both acute and chronic conditions in pediatric patients.
- Managing pediatric patients for HBOT presents unique challenges compared to adults.
- This study evaluates indications, outcomes, and complications of HBOT in a large pediatric cohort.
Purpose of the Study:
- To document the indications, results, complications, and difficulties of HBOT in pediatric patients.
- To compare pediatric HBOT data with existing adult literature.
- To discuss methods for reducing complications in children undergoing HBOT.
Main Methods:
- A 15-year retrospective review of pediatric patients (<18 years) treated with HBOT.
- Data collected from two hyperbaric centers between January 2006 and June 2021.
- Inclusion criteria: at least one HBOT session.
Main Results:
- 329 pediatric patients underwent 3,164 HBOT exposures.
- 77.2% completed treatment as planned; 66.5% achieved goals without complications.
- Low rates of complications including middle ear barotrauma; no CNS oxygen toxicity reported. Neurological sequelae in 2 CO-poisoning patients; 1 amputation for limb ischemia.
Conclusions:
- HBOT can be safely administered to pediatric patients with appropriate precautions and low complication rates.
- Collaboration between hyperbaric physicians and pediatric healthcare providers is crucial for broader patient benefit.
- Anesthesiologist involvement may be necessary for intubated pediatric patients during HBOT.
Introduction:
Paediatric patients, like adults, may undergo hyperbaric oxygen treatment (HBOT) in both life-threatening situations and chronic diseases. There are particular challenges associated with managing paediatric patients for HBOT. This paper documents the indications, results, complications, and difficulties that occur during HBOT for a large cohort of paediatric patients and compares them with adult data in the literature. Methods used to reduce these difficulties and complications in children are also discussed.
Methods:
This was a 15-year retrospective review of paediatric patients treated with HBOT at two hyperbaric centres. Between January 2006 and June 2021, patients under the age of 18 who received at least one session of HBOT were included.
Results:
Three hundred and twenty-nine paediatric patients underwent a total of 3,164 HBOT exposures. Two-hundred and fifty-four patients (77.2%) completed treatment as planned and 218 (66.5%) achieved treatment goals without complications. Two patients treated for carbon monoxide poisoning exhibited neurological sequelae. Amputation was performed in one patient with limb ischaemia. Middle ear barotrauma events occurred in five treatments. No central nervous system oxygen toxicity was recorded during the treatments.
Conclusions:
This patient series indicates that HBOT can be safely performed in pediatric patients with low complication rates by taking appropriate precautions. The cooperation of hyperbaric medicine physicians and other physicians related to paediatric healthcare is important in order for more patients to benefit from this treatment. When managing intubated patients an anaesthesiologist may need to participate in the treatment in order to perform necessary interventions.
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