Related Experiment Videos
Delivery of hyperbaric oxygen therapy to critically ill, mechanically ventilated children
H T Keenan1, S L Bratton, D M Norkool
1Department of Anesthesiology, University of Washington School of Medicine, Seattle, USA.
Insights
Mechanical ventilation and hyperbaric oxygen therapy (HBO2) can be safely administered to critically ill children. Close monitoring is key, as complications during HBO2 treatment are manageable with expert care.
Area of Science:
- Pediatric Critical Care Medicine
- Hyperbaric Medicine
- Respiratory Therapy
Background:
- Critically ill children often require mechanical ventilation.
- Hyperbaric oxygen therapy (HBO2) offers therapeutic benefits for various conditions.
- Safe administration of HBO2 to ventilated pediatric patients requires specialized protocols.
Purpose of the Study:
- To detail the methods for mechanical ventilation and monitoring during HBO2 in critically ill children.
- To review complications encountered during transport and HBO2 treatment in this population.
Main Methods:
- A case series design was employed.
- Data were collected from a university-affiliated children's hospital and hyperbaric facility.
- Included were all mechanically ventilated children receiving HBO2 between 1985 and 1995.
Main Results:
- Thirty-two children (3 days to 11.3 years) received mechanical ventilation during HBO2.
- Common indications included necrotizing infections, carbon monoxide poisoning, and air embolism.
- Complications included hypotension (63%), bronchospasm (34%), and hemotympanum (13%).
Conclusions:
- HBO2 can be safely delivered to critically ill, ventilated children in multiplace chambers with close monitoring.
- While complications occur, they are generally manageable by experienced teams.
- This approach supports the use of HBO2 in pediatric critical care settings.
Purpose:
The purpose of this article is (1) to describe our method of mechanical ventilation and monitoring of critically ill children during administration of hyperbaric oxygen therapy (HBO2) in a multiplace chamber; and (2) to review the complications they experienced during transport to the HBO2 chamber and HBO2 treatment.
Materials And Methods:
A case series from a university-affiliated children's hospital and regional hyperbaric medicine treatment facility. Patients studied included all children who required HBO2 therapy while mechanically ventilated at any time between April 1985 and June 1995.
Results:
Thirty-two children were treated with HBO2 while mechanically ventilated. Ages ranged from 3 days to 11.3 years (mean 4.8+/-3.5 years). There were 22 males. Twenty-one children had necrotizing infections, 9 had carbon monoxide (CO) poisoning, and 2 had iatrogenic arterial air embolism. Complications or events occurring during HBO2 therapy included hypotension (63%), bronchospasm (34%), hemotympanum (13%), and progressive hypoxemia (6%). The only complication during transport was one accidental extubation (3%).
Conclusion:
Hyperbaric oxygen therapy can be administered safely to most critically ill children in a multiplace chamber if they are monitored closely. Although complications are not uncommon, most can be managed easily by a team skilled in treating ill children and knowledgeable of possible complications of HBO2 therapy.