Tanaka HL, Rees JR, Zhang Z, Ptak JA, Hannigan PM, Silverman EM, Peacock JL, Buckey JC, Multicenter Registry for Hyperbaric Oxygen Treatment Consortium, et al.
Interactive journal of medical research. Date of publication 2024 Aug 20;volume 13():e53821.
1. Interact J Med Res. 2024 Aug 20;13:e53821. doi: 10.2196/53821.
Emerging Indications for Hyperbaric Oxygen Treatment: Registry Cohort Study.
Tanaka HL(1), Rees JR(2), Zhang Z(2), Ptak JA(3), Hannigan PM(3), Silverman
EM(3), Peacock JL(2), Buckey JC(2); Multicenter Registry for Hyperbaric Oxygen
Treatment Consortium(4).
Collaborators: Pruss B, Kacoyanis G, Bettley-Smith M, Smerdon G, Moon R, Bothma
P, Woodring R, Weaver L, Huang E, Toups G, Mathew B, Laden G, Bennett MH,
Hawkins GC, Grover I, Tanaka HL, Schroder M, Sethuraman K, Gaskill Z, Roman T,
Wright J, Robins M, Kay G, Hyperbaric W, Coker B.
Author information:
(1)Division of Undersea and Hyperbaric Medicine, Department of Emergency
Medicine, University of California at San Diego, San Diego, CA, United States.
(2)Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.
(3)Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States.
(4)see Acknowledgments, .
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 contributors. Because of its hypoxia-relieving and
anti-inflammatory effects HBO2 may be useful for new indications not currently
approved by the Undersea and Hyperbaric Medical Society. Identifying these new
applications for HBO2 is difficult because individual centers may only treat a
few cases and not track the outcomes consistently. The web-based International
Multicenter Registry for Hyperbaric Oxygen Therapy captures prospective outcome
data for patients treated with HBO2 therapy. These data can then be used to
identify new potential applications for HBO2, which has relevance for a range of
medical specialties.
OBJECTIVE: Although hyperbaric medicine has established indications, new ones
continue to emerge. One objective of this registry study was to identify cases
where HBO2 has been used for conditions falling outside of current Undersea and
Hyperbaric Medical Society-approved indications and present outcome data for
them.
METHODS: This descriptive study used data from a web-based, multicenter,
international registry of patients treated with HBO2. Participating centers
agree to collect data on all patients treated using standard outcome measures,
and individual centers send deidentified data to the central registry. HBO2
treatment programs in the United States, the United Kingdom, and Australia
participate. Demographic, outcome, complication, and treatment data, including
pre- and posttreatment quality of life questionnaires (EQ-5D-5L) were collected
for individuals referred for HBO2 treatment.
RESULTS: Out of 9726 patient entries, 378 (3.89%) individuals were treated for
45 emerging indications. Post-COVID-19 condition (PCC; also known as postacute
sequelae of COVID-19; 149/378, 39.4%), ulcerative colitis (47/378, 12.4%), and
Crohn disease (40/378, 10.6%) accounted for 62.4% (n=236) of the total cases.
Calciphylaxis (20/378, 5.3%), frostbite (18/378, 4.8%), and peripheral vascular
disease-related wounds (12/378, 3.2%) accounted for a further 13.2% (n=50).
Patients with PCC reported significant improvement on the Neurobehavioral
Symptom Inventory (NSI score: pretreatment=30.6; posttreatment=14.4; P<.001).
Patients with Crohn disease reported significantly improved quality of life
(EQ-5D score: pretreatment=53.8; posttreatment=68.8), and 5 (13%) reported
closing a fistula. Patients with ulcerative colitis and complete pre- and
post-HBO2 data reported improved quality of life and lower scores on a bowel
questionnaire examining frequency, blood, pain, and urgency. A subset of
patients with calciphylaxis and arterial ulcers also reported improvement.
CONCLUSIONS: HBO2 is being used for a wide range of possible applications across
various medical specialties for its hypoxia-relieving and anti-inflammatory
effects. Results show statistically significant improvements in patient-reported
outcomes for inflammatory bowel disease and PCC. HBO2 is also being used for
frostbite, pyoderma gangrenosum, pterygium, hypospadias repair, and facial
filler procedures. Other indications show evidence for improvement, and the case
series for all indications is growing in the registry.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/18857.
©Hideaki L Tanaka, Judy R Rees, Ziyin Zhang, Judy A Ptak, Pamela M Hannigan,
Elaine M Silverman, Janet L Peacock, Jay C Buckey, Multicenter Registry for
Hyperbaric Oxygen Treatment Consortium. Originally published in the Interactive
Journal of Medical Research (https://www.i-jmr.org/), 20.08.2024.
DOI: 10.2196/53821
PMCID: PMC11372337
PMID: 39078624
Conflict of interest statement: Conflicts of Interest: None declared.
