Hyperbaric oxygen therapy in orthopedic conditions: An evaluation of safety

Kuo Chin Huang, Wei Hsiu Hsu, Kuo Ti Peng, Tsung Jen Huang, Robert Wen Wei Hsu

研究成果: 雜誌貢獻文章

16 引文 (Scopus)

摘要

BACKGROUND: Because of the documented cellular and biochemical benefits of hyperbaric oxygen (HBO), HBO therapy is applied now with increasing frequency to various orthopedic conditions. Many traumatologists and orthopedic surgeons might refer their patients for adjuvant HBO therapy. However, the potential risks and risk-benefit ratio have often been underemphasized in therapeutic trials. METHODS: From October 2002 to September 2004, 240 patients with a total of 4,638 treatments received HBO therapy at the hyperbaric medicine center of our institution on an identical treatment protocol. HBO therapy patient treatment logs were reviewed to analyze the incidence of complications during HBO treatment. RESULTS: The overall incidence of complications was 1.83%. Over 94% of treatment complications were mild to moderate and designated as minor complications; fewer than 6% were severe or life threatening and designated as major complications. The incidence of major complications (central nervous system [CNS] oxygen toxicity in this series) was 0.109%. There was no mortality. Two patients with unusual presentation of CNS oxygen toxicity were observed during the study period. CONCLUSIONS: HBO therapy in orthopedic conditions is considered as a safe treatment because of a very low complication rate; however, analysis of patients with CNS oxygen toxicity revealed its unpredictability and inevitability. Although it is common sense that patients who develop a seizure in the hospital need help from the medical staff, it cannot be done in a monoplace hyperbaric chamber because of pressure unequalization. Therefore, a multiplace chamber equipped with an antechamber for medical contingency is possibly the better facility in consideration of safety.
原文英語
頁(從 - 到)913-917
頁數5
期刊Journal of Trauma - Injury, Infection and Critical Care
61
發行號4
DOIs
出版狀態已發佈 - 十月 2006
對外發佈Yes

指紋

Hyperbaric Oxygenation
Orthopedics
Safety
Oxygen
Central Nervous System
Incidence
Therapeutics
Medical Staff
Clinical Protocols
Seizures
Odds Ratio
Medicine
Pressure
Mortality

ASJC Scopus subject areas

  • Surgery

引用此文

Hyperbaric oxygen therapy in orthopedic conditions : An evaluation of safety. / Huang, Kuo Chin; Hsu, Wei Hsiu; Peng, Kuo Ti; Huang, Tsung Jen; Hsu, Robert Wen Wei.

於: Journal of Trauma - Injury, Infection and Critical Care, 卷 61, 編號 4, 10.2006, p. 913-917.

研究成果: 雜誌貢獻文章

Huang, Kuo Chin ; Hsu, Wei Hsiu ; Peng, Kuo Ti ; Huang, Tsung Jen ; Hsu, Robert Wen Wei. / Hyperbaric oxygen therapy in orthopedic conditions : An evaluation of safety. 於: Journal of Trauma - Injury, Infection and Critical Care. 2006 ; 卷 61, 編號 4. 頁 913-917.
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abstract = "BACKGROUND: Because of the documented cellular and biochemical benefits of hyperbaric oxygen (HBO), HBO therapy is applied now with increasing frequency to various orthopedic conditions. Many traumatologists and orthopedic surgeons might refer their patients for adjuvant HBO therapy. However, the potential risks and risk-benefit ratio have often been underemphasized in therapeutic trials. METHODS: From October 2002 to September 2004, 240 patients with a total of 4,638 treatments received HBO therapy at the hyperbaric medicine center of our institution on an identical treatment protocol. HBO therapy patient treatment logs were reviewed to analyze the incidence of complications during HBO treatment. RESULTS: The overall incidence of complications was 1.83{\%}. Over 94{\%} of treatment complications were mild to moderate and designated as minor complications; fewer than 6{\%} were severe or life threatening and designated as major complications. The incidence of major complications (central nervous system [CNS] oxygen toxicity in this series) was 0.109{\%}. There was no mortality. Two patients with unusual presentation of CNS oxygen toxicity were observed during the study period. CONCLUSIONS: HBO therapy in orthopedic conditions is considered as a safe treatment because of a very low complication rate; however, analysis of patients with CNS oxygen toxicity revealed its unpredictability and inevitability. Although it is common sense that patients who develop a seizure in the hospital need help from the medical staff, it cannot be done in a monoplace hyperbaric chamber because of pressure unequalization. Therefore, a multiplace chamber equipped with an antechamber for medical contingency is possibly the better facility in consideration of safety.",
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N2 - BACKGROUND: Because of the documented cellular and biochemical benefits of hyperbaric oxygen (HBO), HBO therapy is applied now with increasing frequency to various orthopedic conditions. Many traumatologists and orthopedic surgeons might refer their patients for adjuvant HBO therapy. However, the potential risks and risk-benefit ratio have often been underemphasized in therapeutic trials. METHODS: From October 2002 to September 2004, 240 patients with a total of 4,638 treatments received HBO therapy at the hyperbaric medicine center of our institution on an identical treatment protocol. HBO therapy patient treatment logs were reviewed to analyze the incidence of complications during HBO treatment. RESULTS: The overall incidence of complications was 1.83%. Over 94% of treatment complications were mild to moderate and designated as minor complications; fewer than 6% were severe or life threatening and designated as major complications. The incidence of major complications (central nervous system [CNS] oxygen toxicity in this series) was 0.109%. There was no mortality. Two patients with unusual presentation of CNS oxygen toxicity were observed during the study period. CONCLUSIONS: HBO therapy in orthopedic conditions is considered as a safe treatment because of a very low complication rate; however, analysis of patients with CNS oxygen toxicity revealed its unpredictability and inevitability. Although it is common sense that patients who develop a seizure in the hospital need help from the medical staff, it cannot be done in a monoplace hyperbaric chamber because of pressure unequalization. Therefore, a multiplace chamber equipped with an antechamber for medical contingency is possibly the better facility in consideration of safety.

AB - BACKGROUND: Because of the documented cellular and biochemical benefits of hyperbaric oxygen (HBO), HBO therapy is applied now with increasing frequency to various orthopedic conditions. Many traumatologists and orthopedic surgeons might refer their patients for adjuvant HBO therapy. However, the potential risks and risk-benefit ratio have often been underemphasized in therapeutic trials. METHODS: From October 2002 to September 2004, 240 patients with a total of 4,638 treatments received HBO therapy at the hyperbaric medicine center of our institution on an identical treatment protocol. HBO therapy patient treatment logs were reviewed to analyze the incidence of complications during HBO treatment. RESULTS: The overall incidence of complications was 1.83%. Over 94% of treatment complications were mild to moderate and designated as minor complications; fewer than 6% were severe or life threatening and designated as major complications. The incidence of major complications (central nervous system [CNS] oxygen toxicity in this series) was 0.109%. There was no mortality. Two patients with unusual presentation of CNS oxygen toxicity were observed during the study period. CONCLUSIONS: HBO therapy in orthopedic conditions is considered as a safe treatment because of a very low complication rate; however, analysis of patients with CNS oxygen toxicity revealed its unpredictability and inevitability. Although it is common sense that patients who develop a seizure in the hospital need help from the medical staff, it cannot be done in a monoplace hyperbaric chamber because of pressure unequalization. Therefore, a multiplace chamber equipped with an antechamber for medical contingency is possibly the better facility in consideration of safety.

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KW - Hyperbaric oxygen therapy

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