Sylvain Boet1,2,3,4, Cole Etherington2, George Djaiani5, Andrea C Tricco6,7, Lindsey Sikora8, Rita Katznelson5. 1. Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada. 2. Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada. 3. Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada. 4. Dr Sylvain Boet, Department of Anesthesiology and Pain Medicine, Hyperbaric Medicine Unit, The Ottawa Hospital, 501 Smyth Rd, Critical Care Wing 1401, Ottawa, K1H 8L6, Ontario, Canada, sboet@toh.ca. 5. Department of Anesthesia and Pain Management, University Health Network, Toronto, Canada. 6. Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada. 7. Epidemiology Department and Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 8. Health Sciences Library, University of Ottawa, Ottawa, Canada.
Abstract
INTRODUCTION: The need for intubation and mechanical ventilation among COVID-19 patients is associated with high mortality rates and places a substantial burden on the healthcare system. There is a strong pathophysiological rationale suggesting that hyperbaric oxygen treatment (HBOT), a low-risk and non-invasive treatment, may be beneficial for COVID-19 patients. This systematic review aimed to explore the potential effectiveness and safety of HBOT for treating patients with COVID-19. METHODS: Medline, Embase, Scopus, and Google Scholar were searched from December 2019 to February 2021, without language restrictions. The grey literature was searched via an internet search engine and targeted website and database searches. Reference lists of included studies were searched. Independent reviewers assessed studies for eligibility and extracted data, with disagreements resolved by consensus or a third reviewer. Risk of bias was assessed using the Newcastle Ottawa Scale. Data were summarised descriptively. RESULTS: Six publications (one cohort study, five case reports/series) met the inclusion criteria with a total of 37 hypoxaemic COVID-19 patients treated with HBOT. Of these 37 patients, the need for intubation and mechanical ventilation and in-hospital survival were assessed for 26 patients across three studies. Of these 26 patients, intubation and mechanical ventilation were not required for 24, and 23 patients survived. No serious adverse events of HBOT in COVID-19 patients were reported. No randomised trials have been published. CONCLUSIONS: Limited and weak evidence from non-randomised studies including one propensity-matched cohort study suggests HBOT is safe and may be a promising intervention to optimise treatment and outcomes in hypoxaemic COVID-19 patients. Randomised controlled studies are urgently needed. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: The need for intubation and mechanical ventilation among COVID-19 patients is associated with high mortality rates and places a substantial burden on the healthcare system. There is a strong pathophysiological rationale suggesting that hyperbaric oxygen treatment (HBOT), a low-risk and non-invasive treatment, may be beneficial for COVID-19 patients. This systematic review aimed to explore the potential effectiveness and safety of HBOT for treating patients with COVID-19. METHODS: Medline, Embase, Scopus, and Google Scholar were searched from December 2019 to February 2021, without language restrictions. The grey literature was searched via an internet search engine and targeted website and database searches. Reference lists of included studies were searched. Independent reviewers assessed studies for eligibility and extracted data, with disagreements resolved by consensus or a third reviewer. Risk of bias was assessed using the Newcastle Ottawa Scale. Data were summarised descriptively. RESULTS: Six publications (one cohort study, five case reports/series) met the inclusion criteria with a total of 37 hypoxaemic COVID-19 patients treated with HBOT. Of these 37 patients, the need for intubation and mechanical ventilation and in-hospital survival were assessed for 26 patients across three studies. Of these 26 patients, intubation and mechanical ventilation were not required for 24, and 23 patients survived. No serious adverse events of HBOT in COVID-19 patients were reported. No randomised trials have been published. CONCLUSIONS: Limited and weak evidence from non-randomised studies including one propensity-matched cohort study suggests HBOT is safe and may be a promising intervention to optimise treatment and outcomes in hypoxaemic COVID-19 patients. Randomised controlled studies are urgently needed. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Authors: Lowell Ling; Christina So; Hoi Ping Shum; Paul K S Chan; Christopher K C Lai; Darshana H Kandamby; Eunise Ho; Dominic So; Wing Wa Yan; Grace Lui; Wai Shing Leung; Man Chun Chan; Charles D Gomersall Journal: Crit Care Resusc Date: 2020-04-06 Impact factor: 2.159
Authors: Scott A Gorenstein; Michael L Castellano; Eric S Slone; Brian Gillette; Helen Liu; Cindy Alsamarraie; Alan M Jacobson; Stephen P Wall; Samrachana Adhikari; Jordan L Swartz; Jenica J S McMullen; Marcela Osorio; Christian A Koziatek; David C Lee Journal: Undersea Hyperb Med Date: 2020 Third Quarter Impact factor: 0.698