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CONTRAINDICATIONStoHyperbaricOxygenTherapyTe-ChunHsiaHyperbaricOxygenTherapyCenterChinaMedicalCollegeHospital
AbsolutecontraindicationsUntreatedpneumothoraxthevolumechangesthattakeplaceinthepleuralspace,theairdoublingortriplinginvolumeasnormalatmosphericpressureisapproachedberelievedsurgicallybeforedecompressionorchesttubeismadeready
AbsolutecontraindicationsConcomitantadministrationofdoxorubicinorcisplatinaschemotherapeuticagentsforcancer.HBOanddoxorubicingiventogetherhascauseddeathinrats(probablyfromcardiactoxicity),andcisplatinwithHBOweakensthetensilestrengthofhealingwoundsinmice.
AbsolutecontraindicationsDisulfiramblockstheproductionofsuperoxidedismutase(aprotectiveantioxidant)
PrematureinfantsRetrolentalfibroplasiaFull-termbabiesmaybesafelytreatedwithHBOBabiesmayrequirepapooserestraints,andyoungchildrenmayneedmildsedation.
PrematureinfantsHBOtreatmentofpregnantwomenmightstimulateprematureclosureofthepatentductusinthefetushavebeenmitigatedbyresearchintheSovietUnioninwhichwomeninallstagesofpregnancy,whentreatedwithHBO,producednormalchildrenOverridingneedtotreatapregnantpatient;eg,incarbonmonoxidepoisoning(wherethefetussuffersmuchmorethanthemother)orgasgangrene
RelativecontraindicationsHistoryofspontaneouspneumothoraxPreviousthoracicsurgerySevereemphysemawithCO2intoxication,removalofthehypoxicdrivemaycauserespiratoryarrest.Upperrespiratoryinfectionsmaymakeitdifficultforthepatienttoequalizepressureintheearsandsinuses;decongestantsareindicated
RelativecontraindicationsHistoryofmiddleearsurgeryforotosclerosis,awireorplasticstrutmightbedisplacedifpatientcannotequalizepressureintheears;tympanostomytubesneeded.SeizuredisordersmayincreasesusceptibilitytoO2seizures,andadditionalpremedication(eg,withdiazepam)maybeadvisable.UncontrolledhighfevermaypredisposetoO2seizuresandshouldbereducedbeforeplacingpatientinthechamber
RelativecontraindicationsRespiratoryviralinfectionsmaytendtoworsenwithHBOcongenitalspherocytosis,RBCsarefragile,andhighO2partialpressuresmaycauseseverehemolysis.EricKindwallstatesthatsperocytosisdoesnotpreventsuchapatientreceivingHBOT(non-diving)butshouldalerttheoperatortothepossibilityofhaemolysis
RelativecontraindicationsOpticneuritis,evenifnotactive,sometimesassociatedwithblindnessfollowingHBOtreatmentrare,treatmentshouldbehaltedimmediatelyifthepatientcomplainsofasuddenchangeinvision.
SideEffectsO2seizuresmorethan2.4atmospheresabsolute(ATA).SomepatientsareidiosyncraticallysusceptibletohighO2partialpressuresTreatmentisdiscontinuanceoftheO2incidenceofseizureislow,beingreportedat1.3/10,000treatments.
SideEffectsPulmonaryO2toxicitysubsternalchestpain,cough,andpatchyatelectasisFingernumbnessAfter20or30treatments,somecomplainofnumbfingers,usuallyintheulnardistribution;butthissensationdisappearswithin4to6wkaftertherapy.
SideEffectsSerousotitisminorproblem;treatmentisdecongestants.LensrefractivechangesMyopiaworsensPresbyopiaimprovessuggested,butnotproved,thatpreexistingcataractsmaturemorerapidlywithHBO
