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Hyperbaric oxygen therapy in the pediatric patient: the experience of the Israel Naval Medical Institute
1Department of Neonatology, Carmel Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Insights
Hyperbaric oxygen (HBO) therapy is effective for pediatric patients, with 93% experiencing favorable outcomes for various conditions. Specialized care and collaboration are crucial for optimal results in treating critically ill children.
Area of Science:
- Pediatric Medicine
- Hyperbaric Medicine
- Emergency Medicine
Background:
- Hyperbaric oxygen (HBO) therapy is utilized globally for pediatric patients with life-threatening and chronic diseases.
- The Israel Naval Medical Institute has accumulated experience in treating pediatric patients with HBO.
Purpose of the Study:
- To review the experience of the Israel Naval Medical Institute in treating pediatric patients with HBO therapy.
Main Methods:
- Retrospective analysis and review of medical records.
- Inclusion criteria: patients younger than 18 years.
Main Results:
- 139 pediatric patients (2 months to 18 years) received HBO treatment between 1980 and 1997.
- Common indications included acute carbon monoxide poisoning (79%) and crush injuries (9.2%).
- Favorable outcomes were observed in 93% of patients (129/139), with low mortality (1.4%) and limited sequelae.
Conclusions:
- The study demonstrated a favorable experience with HBO therapy in 129 out of 139 pediatric patients.
- Adequate knowledge of HBO therapy and specialized pediatric hyperbaric care are essential.
- Close collaboration between pediatricians and hyperbaric physicians ensures optimal care for pediatric patients.
Unlabelled:
The pediatric patient is to be found in hyperbaric facilities throughout the world, receiving hyperbaric oxygen (HBO) therapy for both life-threatening and chronic diseases.
Objective:
To review the experience accumulated at the Israel Naval Medical Institute in the treatment of pediatric patients.
Design:
A retrospective analysis and review of all records of patients younger than age 18 years.
Results:
Between 1980 and 1997, 139 pediatric patients age 2 months to 18 years (mean, 7.7 years) received HBO treatment at the Israel Naval Medical Institute. Of the children, 111 (79%) suffered from acute carbon monoxide (CO) poisoning; 13 (9.2%) were treated after crush injury, traumatic ischemia, or compartment syndrome; 4 (2.8%) had clostridial myonecrosis; 1 (0.7%) had necrotizing fasciitis; 5 (3.6%) had refractory osteomyelitis; 2 (1.4%) had suffered massive air embolism; 2 (1.4%) had purpura fulminans; and 1 (0.7%) suffered from decompression sickness. Outcome, judged by neurologic sequelae, mortality, and extent of soft tissue loss and limb amputation, was favorable in 129 patients (93%). Two patients (1.4%) died, 1 as a result of CO poisoning and the other, gas gangrene; 2 of the patients in the CO group (1.4%) remained with neurologic sequelae, and 6 patients in the acute traumatic ischemia group (4.3%) underwent limb amputation.
Conclusions:
We had a favorable experience with 129 of a total 139 pediatric patients treated at our facility for the indications listed. A basic knowledge of HBO therapy is needed to refer the pediatric patient for treatment when indicated. The needs of the pediatric patient, especially the critically ill, require specific skills and equipment inside the hyperbaric chamber. Close collaboration between the pediatrician and the hyperbaric medicine physician is essential to ensure adequate care for infants and children.