Profusely sweating in the monoplace hyperbaric chamber

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We are treating a patient for DFU. The patient has completed over 30 hyperbaric sessions in the Perry Sigma 40 monoplace chamber without issues. Over the past two sessions the patient has begun profusely sweating throughout the treatment. Pt has a normal descent to treatment depth and remains comfortable for about 30-45mins and then becomes diaphoretic. No change in medications is noted. No active infection is noted. No change in patient equipment, chamber functioning properly, pt reports climate in the chamber is comfortable and cool during these episodes. Pt has adequate blood glucose levels pre and post therapy. The patient is being treated at 2.5ATA for 90minutes, with two 5 minute air-breaks. Is it possible we are seeing CNS oxygen toxicity? Any opinion would be appreciated.

Oct 20, 2023 by Sean Finley, EMT-B, CHT

1 replies

Eugene Worth
MD, M.Ed., FABA, ABPM/UHM

Sean:

As far as OxTox causing the profuse sweating … highly unlikely. I’ve never seen this as a sole contributor to OxTox.

At the top of my list are several items (others feel free to add to the list):

1. Narcotic administration. More likely in cases that come from the OR/Recovery, but if this patient recently started a narcotic, I think you have your culprit.

2. New antibiotic. Happens, but not as frequently.

For a patient to have ‘new’ symptoms of diaphoresis … something has changed recently. My recommendation is to put on your detective hat, and find out what that ‘something’ is …

One mechanical item to the list. Be sure that your ventilation rate is adequate to high during this patient’s treatment. It could be that he/she is simply getting hot. Warmer ambient temperatures might be a component. Higher ventilation rates will cool the chamber.

Also, I would consider sending the patient into the chamber with an ice bag to put around the neck. That has worked well for me.

Sorry, I couldn’t be of more help.

Gene

Oct 20, 2023

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