Hyperbaric oxygen therapy in preventing mechanical ventilation in COVID-19 patients: a retrospective case series

Abstract

A pandemic afflicts the entire world. The highly contagious SARS-CoV-2 virus originated in Wuhan China in late 2019 and rapidly spread across the entire globe. According to the World Health Organization (WHO), the novel Corona virus has infected more than 2 million people world-wide causing over 160 thousand deaths. Patients with COVID-19 disease present with a wide array of symptoms ranging from mild flu-like complaints to life threatening pulmonary and cardiac complications. The elderly and patients with underlying disease have an increased risk of developing severe acute respiratory syndrome (SARS) requiring mechanical ventilation. Once intubated mortality increases exponentially. A number of pharmacologic regimens, including hydroxychloroquineazithromycin, antiviral therapy (e.g.remdesevir), and anti-IL-6 agents (e.g. toclizumab), have been highlighted by investigators over the course of the pandemic based on the therapy’s potential to interrupt the viral life-cycle of SARS-CoV-2 or preventing cytokine storm. At present, there have no conclusive series of reproducible randomised clinical trials demonstrating the efficacy of any one drug or therapy for COVID-19. Case: We treated five COVID positive patients at a single institution received hyperbaric oxygen therapy (HBOT) between April 13 and April 20 2020. All the patients had tachypnea and low oxygen saturation despite receiving high FiO2. HBOT was added to prevent the need for mechanical ventilation. A standard dive profile of 2.0ATA for 90 minutes was employed. Patients received between one and six treatments in one of two dedicated monoplace hyperbaric chambers. Results: All the patients recovered without the need for mechanical ventilation. Following HBOT, oxygen saturation increased, tachypnea resolved and inflammatory markers fell. At the time of this writing, three of the five patients have been discharged from the hospital and two remain in stable condition. Conclusion: This small sample of patients exhibited dramatic improvement with HBOT. Most importantly, HBOT potentially prevented the need for mechanical ventilation. Larger studies are likely to define the role of HBOT in the treatment of this novel disease.

Related in Hyperbaric Oxygen Studies

• Comparing near infrared spectroscopy and transcutaneous oxygen measurement in hard-to-heal wounds: a pilot study
• Guidelines for the use of topical oxygen therapy in the treatment of hard to heal wounds based on a delphi consensus.
• Molecular Biomarkers of Oxygen Therapy in Patients with Diabetic Foot Ulcers