open access

Vol 68, No 1 (2017)
Original article
Submitted: 2017-01-06
Accepted: 2017-02-13
Published online: 2017-03-30
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Safety of hyperbaric oxygen therapy in mechanically ventilated patients

Jacques Bessereau, Jérôme Aboab, Thomas Hullin, Anne Huon-Bessereau, Jean-Luc Bourgeois, Pierre-Marie Brun, Sylvie Chevret, Djillali Annane
·
Pubmed: 28357836
·
IMH 2017;68(1):46-51.

open access

Vol 68, No 1 (2017)
HYPERBARIC/UNDERWATER MEDICINE Original papers
Submitted: 2017-01-06
Accepted: 2017-02-13
Published online: 2017-03-30

Abstract

Background: To evaluate the epidemiology of patients who require mechanical ventilation during hyperbaric oxygen therapy.

Materials and methods: One-hundred-fifty patients who required mechanical ventilation during hyperbaric oxygen therapy were prospectively studied during a 6-year period in a French university hyperbaric centre. We analysed the indication of hyperbaric oxygen therapy, agent used for sedation, presence of a chest tube, need for vasopressor agents and tolerance and appearance of side effects. Finally, we compared the outcomes of patients according to the presence or absence of acute respiratory distress syndrome (ARDS).

Results: Eleven children and 139 adult patients were included (n = 150) in the study. In both populations, carbon monoxide poisoning (51%) and iatrogenic gas embolism (33%) were the two main causes of intubation and mechanical ventilation. The combination of midazolam and sufentanil was used in 85 (67%) patients. All of the patients were given a bolus of a neuromuscular blocker during the hyperbaric session, despite the presence of ARDS in 35 patients. Patient-ventilator asynchrony was the most frequent side effect in 6 (5%) patients and was often the consequence of suboptimal sedation. Mortality was higher in the group with ARDS (23%).

Conclusions: Carbon monoxide poisoning and iatrogenic gas embolism are the two main diseases of the patients who required mechanical ventilation during hyperbaric oxygen therapy in this study. Mechanical ventilation is a safe method for patients during hyperbaric oxygen therapy. Sedation needs to be perfected to avoid patient-ventilator asynchrony.  

Abstract

Background: To evaluate the epidemiology of patients who require mechanical ventilation during hyperbaric oxygen therapy.

Materials and methods: One-hundred-fifty patients who required mechanical ventilation during hyperbaric oxygen therapy were prospectively studied during a 6-year period in a French university hyperbaric centre. We analysed the indication of hyperbaric oxygen therapy, agent used for sedation, presence of a chest tube, need for vasopressor agents and tolerance and appearance of side effects. Finally, we compared the outcomes of patients according to the presence or absence of acute respiratory distress syndrome (ARDS).

Results: Eleven children and 139 adult patients were included (n = 150) in the study. In both populations, carbon monoxide poisoning (51%) and iatrogenic gas embolism (33%) were the two main causes of intubation and mechanical ventilation. The combination of midazolam and sufentanil was used in 85 (67%) patients. All of the patients were given a bolus of a neuromuscular blocker during the hyperbaric session, despite the presence of ARDS in 35 patients. Patient-ventilator asynchrony was the most frequent side effect in 6 (5%) patients and was often the consequence of suboptimal sedation. Mortality was higher in the group with ARDS (23%).

Conclusions: Carbon monoxide poisoning and iatrogenic gas embolism are the two main diseases of the patients who required mechanical ventilation during hyperbaric oxygen therapy in this study. Mechanical ventilation is a safe method for patients during hyperbaric oxygen therapy. Sedation needs to be perfected to avoid patient-ventilator asynchrony.  

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Keywords

mechanical ventilation, critically ill, hyperbaric oxygen therapy, hyperbaric chambers, ventilators, acute respiratory distress syndrome

About this article
Title

Safety of hyperbaric oxygen therapy in mechanically ventilated patients

Journal

International Maritime Health

Issue

Vol 68, No 1 (2017)

Article type

Original article

Pages

46-51

Published online

2017-03-30

Page views

3473

Article views/downloads

5630

DOI

10.5603/IMH.2017.0008

Pubmed

28357836

Bibliographic record

IMH 2017;68(1):46-51.

Keywords

mechanical ventilation
critically ill
hyperbaric oxygen therapy
hyperbaric chambers
ventilators
acute respiratory distress syndrome

Authors

Jacques Bessereau
Jérôme Aboab
Thomas Hullin
Anne Huon-Bessereau
Jean-Luc Bourgeois
Pierre-Marie Brun
Sylvie Chevret
Djillali Annane

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