Study on the safety of ventilator support for critical patients in hyperbaric oxygen chamber_West China Medical Journal

Authors：

LIANG Heng ¹ , LIU Changwen ¹ , CHEN Lei ¹ , ZHANG Qiang ¹ , CHEN Xiaolu ¹ ,  LIN jianqiang ²

1. Department of Critical Care Medicine, Zhejiang Mingzhou Rehabilitation Hospital, Hangzhou, Zhejiang 310006, P. R. China;
2. Rehabilitation Center, Zhejiang University Mingzhou Hospital, Ningbo, Zhejiang 315000, P. R. China;

Corresponding?author：

LIN jianqiang, Email: 13605808796@163.com

Keywords：

Hyperbaric oxygen chamber; Ventilator; Intensive care unit

DOI：

10.7507/1002-0179.202003470

Video：

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Objective To explore the safety of ventilator support in hyperbaric oxygen chamber and the prevention of related complications.Methods From July 2016 to December 2018, there were 127 intensive care unit patients underwent hyperbaric oxygen therapy with ventilator. Medical professionals in hyperbaric medicine or intensive care medicine were arranged to accompany the patients in the treatment process, to observe the patients’ condition changes closely, monitor their heart rate, respiration, blood pressure, and oxygen saturation, and perform sputum suction at any time if needed and monitor the airway peak pressure change to prevent pneumothorax.Results During the process of hyperbaric oxygen therapy, 13 patients (10.24%) were treated with analgesia/sedation for patient-ventilator asynchrony, 4 patients (3.15%) exited the champer emergently for acute left heart failure, 3 patients (2.36%) had epileptic seizures, 3 patients (2.36%) had aspiration, and 1 patient (0.79%) had breath and cardiac arrest. After emergency treatment, all the patients returned to the ward safely.Conclusion During the treatment of hyperbaric oxygen therapy for intensive care unit patients with ventilator, the accompany of qualified professionals in hyperbaric medicine or intensive care medicine in the hyperbaric oxygen chamber can treat the patients’ symptoms timely and reduce the risk greatly.

Citation： LIANG Heng, LIU Changwen, CHEN Lei, ZHANG Qiang, CHEN Xiaolu, LIN jianqiang. Study on the safety of ventilator support for critical patients in hyperbaric oxygen chamber. West China Medical Journal, 2020, 35(5): 555-558. doi: 10.7507/1002-0179.202003470 Copy

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2.	高春華, 侯嵐, 武蘭萍, 等. 高壓氧治療持續性植物狀態50例. 中國危重病急救醫學, 1999, 11(3): 184.
3.	潘曉雯, 胡慧軍, 魏建芬, 等. 國產QS-100型高壓艙內氣動變壓式呼吸機的臨床應用. 中華結核和呼吸雜志, 2001, 24(11): 697.
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5.	Hadanny A, Efrati S. Oxygen - a limiting factor for brain recovery. Crit Care, 2015, 19(1): 307.
6.	Micarelli A, Jacobsson H, Larsson SA, et al. Neurobiological insight into hyperbaric hyperoxia. Acta Physiologica, 2013, 20(9): 69-76.
7.	Zorowitz R, Brainin M. Advances in brain recovery and rehabilitation 2010. Stroke, 2011, 42(2): 294-297.
8.	Ratzenhofer-Komenda B, Offner A, Ofner P, et al. Arterial oxygen tension increase 2-3 h after hyperbaric oxygen therapy: a prospective observational study. Acta Anaesthesiol Scand, 2007, 51(1): 68-73.
9.	李進元, 劉永麗. 急診高壓氧對急性一氧化碳中毒治療的臨床療效觀察. 華西醫學, 2009, 24(11): 3051-3052.
10.	Mrsi?-Pelci? J, Pelci? G, Vitezi? D, et al. Hyperbaric oxygen treatment: the influence on the hippocampal superoxide dismutase and Na⁺, K⁺-ATPase activities in global cerebral ischemia-exposed rats. Neurochem Int, 2004, 44(8): 585-594.
11.	Badr AE, Yin W, Mychaskiw K, et al. Effect of hyperbaric oxygen on striatal metabolites: a microdialysis study in awake freely moving rats after MCA occlusion. Brain Res, 2001, 916(1/2): 85-90.
12.	楊玉, 蔡宏斌, 范禎禎, 等. 高壓氧對腦缺血模型兔腦前后循環血管內皮素-1、內皮型一氧化氮合酶及內皮素A受體表達的影響. 中華航海醫學與高氣壓醫學雜志, 2018, 25(2): 75-80.
13.	Mathieu D, Ratzenhofer-Komenda B, Kot J. Hyperbaric oxygen therapy for intensive care patients: position statement by the European Committee for Hyperbaric Medicine. Diving Hyperb Med, 2015, 45(1): 42-46.
14.	Bessereau J, Aboab J, Hullin T, et al. Safety of hyperbaric oxygen therapy in mechanically ventilated patients. Int Marit Health, 2017, 68(1): 46-51.
15.	Jain KK. Textbook of hyperbaric medicine. 6th Ed. Cham, Switzerland: Springer International Publishing AG, 2017: 82.

1. 徐志波, 謝基彥. 高壓氧治療早中期重度顱腦外傷患者46例臨床療效觀察. 中華航海醫學與高氣壓醫學雜志, 2012, 19(2): 116-117.
2. 高春華, 侯嵐, 武蘭萍, 等. 高壓氧治療持續性植物狀態50例. 中國危重病急救醫學, 1999, 11(3): 184.
3. 潘曉雯, 胡慧軍, 魏建芬, 等. 國產QS-100型高壓艙內氣動變壓式呼吸機的臨床應用. 中華結核和呼吸雜志, 2001, 24(11): 697.
4. Geng FY, Ma YH, Tao X, et al. Effects of hyperbaric oxygen therapy on inflammasome signaling after traumatic brain injury. Neuroimmunomodulation, 2016, 23(2): 122-129.
5. Hadanny A, Efrati S. Oxygen - a limiting factor for brain recovery. Crit Care, 2015, 19(1): 307.
6. Micarelli A, Jacobsson H, Larsson SA, et al. Neurobiological insight into hyperbaric hyperoxia. Acta Physiologica, 2013, 20(9): 69-76.
7. Zorowitz R, Brainin M. Advances in brain recovery and rehabilitation 2010. Stroke, 2011, 42(2): 294-297.
8. Ratzenhofer-Komenda B, Offner A, Ofner P, et al. Arterial oxygen tension increase 2-3 h after hyperbaric oxygen therapy: a prospective observational study. Acta Anaesthesiol Scand, 2007, 51(1): 68-73.
9. 李進元, 劉永麗. 急診高壓氧對急性一氧化碳中毒治療的臨床療效觀察. 華西醫學, 2009, 24(11): 3051-3052.
10. Mrsi?-Pelci? J, Pelci? G, Vitezi? D, et al. Hyperbaric oxygen treatment: the influence on the hippocampal superoxide dismutase and Na⁺, K⁺-ATPase activities in global cerebral ischemia-exposed rats. Neurochem Int, 2004, 44(8): 585-594.
11. Badr AE, Yin W, Mychaskiw K, et al. Effect of hyperbaric oxygen on striatal metabolites: a microdialysis study in awake freely moving rats after MCA occlusion. Brain Res, 2001, 916(1/2): 85-90.
12. 楊玉, 蔡宏斌, 范禎禎, 等. 高壓氧對腦缺血模型兔腦前后循環血管內皮素-1、內皮型一氧化氮合酶及內皮素A受體表達的影響. 中華航海醫學與高氣壓醫學雜志, 2018, 25(2): 75-80.
13. Mathieu D, Ratzenhofer-Komenda B, Kot J. Hyperbaric oxygen therapy for intensive care patients: position statement by the European Committee for Hyperbaric Medicine. Diving Hyperb Med, 2015, 45(1): 42-46.
14. Bessereau J, Aboab J, Hullin T, et al. Safety of hyperbaric oxygen therapy in mechanically ventilated patients. Int Marit Health, 2017, 68(1): 46-51.
15. Jain KK. Textbook of hyperbaric medicine. 6th Ed. Cham, Switzerland: Springer International Publishing AG, 2017: 82.

West China Medical Journal

Study on the safety of ventilator support for critical patients in hyperbaric oxygen chamber

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