Hyperbaric oxygen treatment in children: experience in 329 patients

Abstract

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.