Emerging Indications for Hyperbaric Oxygen Treatment: Registry Cohort Study

Abstract

Background: Hyperbaric oxygen (HBO2) treatment is used across a range of medical specialties for a variety of applications, particularly where hypoxia and inflammation are important factors. HBO2 may be useful for new indications not currently approved by the Undersea and Hyperbaric Medical Society (UHMS) because of its hypoxia-relieving effects. Identifying these new applications for HBO2 is difficult because individual centers may only treat a few cases and not track outcomes in a consistent way. The web-based International Multicenter Registry for Hyperbaric Oxygen Therapy captures outcomes data for patients treated with hyperbaric oxygen (HBO2) therapy. These data can then be used to identify new applications for HBO2.Objective: Identify cases where HBO2 is used for indications other than the current UHMS approved indications and present existing outcome data for them.Methods: This is a descriptive study based on a web-based, multi-center, international, registry of patients treated with HBO2. Centers agree to collect data on all patients treated using standard outcome measures and send deidentified data from individual centers to the central registry. HBO2 treatment programs in the United States, United Kingdom, and Australia participated. Demographic, outcome, complication, and treatment data, including pre-and post-treatment quality of life questionnaires (EQ-5D-5L) were collected on individuals referred for HBO2 treatment.Results: Out of 7545 patient entries, 354 individuals were treated for 44 emerging indications. Post-acute COVID syndrome (PACS) (148), ulcerative colitis (45), and Crohn's disease (34), accounted for 64% of total cases. Calciphylaxis (18) and peripheral-vascular-disease related wounds (11) accounted for a further 8%. PACS patients reported significant improvement on the Neurobehavioral Symptom Inventory. Crohn's disease patients reported significantly improved fistula drainage and ulcerative colitis patients reported lower scores on a bowel questionnaire examining frequency, blood, pain, and urgency. A subset of calciphylaxis patients also improved.Conclusions: HBO2 is being used for a wide range of possible applications across various medical specialties for its hypoxiarelieving and anti-inflammatory effects. Results show significant improvements in patient reported outcomes for inflammatory bowel disease and PACS. Clinical Trial