Rachel,

Thanks for your question:

Advances in patient monitoring devices give providers and clinicians the ability to remotely track trends in a diabetic patient’s blood glucose level. Specifically, the Dexcom® G6 Continuous glucose monitoring (CGM) device. This advancement will undoubtedly help us provide the highest level of care to our patients. Hyperbaric oxygen therapy has the potential to significantly lower blood glucose (BG) levels in diabetic patients. As a best practice standard, prior to and following hyperbaric oxygen therapy patients BG levels are checked to ensure they are within acceptable range. The CGM, potentially would allow for continuous BG monitoring during the entire hyperbaric treatment.

Can the Dexcom® G6 CGM be used safely in a hyperbaric chamber? Bliss et al. studied this exact question. Their findings (included below) were published in the Undersea and Hyperbaric Medicine Journal. [1] The findings identified no significant safety concerns with subjecting Dexcom G6 CGM transmitters to hyperbaric environments.

The study compared the CGM against section 14.2.9.3.17.5 of the 2018 National Fire Protection Association 99 (NFPA 99) Health Care Facilities Code requirements. Section 14.2.9.3.17.5 states the following:

14.2.9.3.17.5 Battery-Operated Devices. Battery-operated devices shall meet the following

requirements:

(1) Batteries shall be fully enclosed and secured within the equipment enclosure.

(2) Batteries shall not be damaged by the maximum chamber pressure to which they are exposed.

(3) Batteries shall be of a sealed type that does not off-gas during normal use.

(4) Batteries or battery-operated equipment shall not undergo charging while located in the chamber.

(5) Batteries shall not be changed on in-chamber equipment while the chamber is in use.

(6) The equipment electrical rating shall not exceed 12 V and 48 W.

Conclusions: The CGM transmitter meets section 14.2.9.3.17.5 of the 2018 NFPA 99 requirements for battery-operated devices allowed for use in a hyperbaric environment. This analysis revealed no significant safety concerns with subjecting Dexcom G6 CGM transmitters to hyperbaric environments.[1]

Discussion: It is important to note that the study was performed in a chamber pressurized with air (Fi02 21%). At the time of the writing, there has not been a published study regarding the safety of a CGM in a 100% oxygen hyperbaric environment. Although this technology has great potential, it is paramount to perform the required testing and risk assessment for every device before introducing it into the hyperbaric chamber. The bottom line is that without testing and documentation... the item is a hard NO GO!

References:

1. Bliss C, Huang E, Savaser D: Undersea Hyperb Med. First-Quarter 2020;47(1):13-19. doi: 10.22462/01.03.2020.2.

2. Technical Committee on Hyperbaric and Hypobaric Facilities (HEA-HYP) 2018. 14. Hyperbaric Facilities. In: (NFPA) National Fire Protection Association ed. Nfpa 99: Health Care Facilities Code Handbook. Pp 602-603.

Please let me know if you have any additional thoughts or questions.

Have a great day! Jeff