Department of Medicine, Université Laval, Québec, Canada.
Service de Médecine Hyperbare, Hôtel-Dieu de Lévis, Québec, Canada.
Diving Hyperb Med. 2021 Sep 30;51(3):256-263. doi: 10.28920/dhm51.3.256-263.
Hyperbaric oxygen treatment (HBOT) is available to a wide spectrum of patients, many with significant co-morbidities. Considering its effects on cardiac physiology and reports of pulmonary oedema following exposure, concerns exist about the safety of patients with compromised cardiac function. Few studies have described adverse events occurring during HBOT and even fewer reports address events arising in the hours following HBOT. A relation between adverse events and cardiac function has not been established. As medical guidance is limited, we aimed to evaluate the risk for patients with reduced left ventricular ejection fraction (LVEF) receiving HBOT.
This retrospective chart review of patients receiving HBOT from April 2003 through December 2019 at our hospital was designed to describe clinical characteristics of patients and to identify adverse events during HBOT and within 24 hours after HBOT. Patients ≥ 40 years of age with a documented LVEF of ≤ 40% were included. Data are presented as mean (SD) [range] or counts, as appropriate.
A total of 23 patients were included in the final analysis, 2 (1) [0-4] patients per year. Patients received 25 (19) [1-60] treatments. Two patients had an episode of acute decompensated heart failure possibly linked to HBOT.
This study described the clinical characteristics of patients with reduced LVEF receiving HBOT and showed reassuring results, with a majority of patients with reduced LVEF tolerating HBOT well. Prospective research is required to more fully assess the risk.
高压氧治疗(HBOT)可适用于广泛的患者群体,其中许多患者伴有严重的合并症。考虑到其对心脏生理学的影响以及暴露后出现肺水肿的报道,人们对心功能受损患者的安全性存在担忧。只有少数研究描述了 HBOT 期间发生的不良事件,更少的报告涉及 HBOT 后数小时内发生的事件。尚未确定不良事件与心功能之间的关系。由于医学指南有限,我们旨在评估接受 HBOT 的左心室射血分数(LVEF)降低的患者的风险。
本研究回顾性分析了 2003 年 4 月至 2019 年 12 月期间在我院接受 HBOT 的患者的病历,旨在描述患者的临床特征,并确定 HBOT 期间和 HBOT 后 24 小时内的不良事件。纳入标准为年龄≥40 岁且有记录的 LVEF≤40%的患者。数据以平均值(标准差)[范围]或计数形式呈现,具体视情况而定。
最终共有 23 例患者纳入最终分析,每年(1)[0-4]例患者。患者接受了 25(19)[1-60]次治疗。有 2 例患者发生了可能与 HBOT 相关的急性失代偿性心力衰竭。
本研究描述了接受 HBOT 的 LVEF 降低患者的临床特征,并取得了令人安心的结果,大多数 LVEF 降低的患者能够很好地耐受 HBOT。需要前瞻性研究来更全面地评估风险。