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Have there been reports of hyperbaric oxygen therapy contributing to worsening pulmonary hypertension. I had a patient earlier this year that we were treating for Wagner grade 3 diabetic foot ulcer. We stopped at treatment 25 due to progressive shortness of breath.. Echo showed worsening Pulmonary Hypertension for an echo done two years previous. Is it possible that the HBO exacerbated the Pulmonary Hypertension. I have another patient interested in HBO for radiation cystitis with COPD and elevated pulmonary arterial pressures. I am a bit hesitant. Thanks
Nov 9, 2021 by Jad Roeske, MD
5 replies
Eugene Worth
MD, M.Ed., FABA, ABPM/UHM
Hello, Jad! Thank you for this interesting question.

My short answer is: "I've searched PubMed and can find nothing relating to pulmonary hypertension and hyperbaric oxygen therapy."

That said, I have some friends who are pulmonologists and subspecialty certified in hyperbaric medicine. I'll run this by them.

Any idea of the etiology of the pulmonary hypertension? I'm sure that I will be asked that question. I'm assuming idiopathic, since that is the most common.
Nov 9, 2021
Eugene Worth
MD, M.Ed., FABA, ABPM/UHM
Jad: I just heard from two pulmonologists. They both feel that pulmonary hypertension is not worsened during HBOT ... except ... if there is worsening left ventricular function. Otherwise, they see no physiologic reason for pulmonary hypertension to change.
Nov 9, 2021
Thanks so much for the rapid response. I appreciate you going above and beyond. The patient also had multiple comorbid conditions including biventricular heart failure, sleep apnea, B cell lymphoma, previous pulmonary emboli and early vascular dementia. He was unable to tolerate treatment of his sleep apnea because of his dementia. Kept taking off the mask. He ultimately expired at the end of September. I was just concerned because of the worsening pulmonary hypertension and dyspnea after initiation of HBO.
Nov 10, 2021
Eugene Worth
MD, M.Ed., FABA, ABPM/UHM
Ah ... a conscientious physician wanting to make sure he didn't hasten the patient's demise.

I applaud your concern and desire to improve care in your department. In this case, I think HBOT did not worsen his condition. You can rest assured. Unfortunately, this patient had so many co-morbidities. The clinical picture is certainly difficult.

gene
Nov 10, 2021
Thanks so much! I appreciate your assistance and reassurance.
Jad
Nov 10, 2021
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