Hyperbaric oxygen therapy and Covid19
Posted on April 21, 2020
The Undersea & Hyperbaric Medical Society's comment on treating Covid19 Coronavirus patients with hyperbaric oxygen therapy (HBOT)
We are not currently treating any patients with Covid19 at American Hyperbaric Center. We recommend the treatment of COVID-19 patients with HBOT be confined to hospital-based programs comfortable with the management of critically ill patients, and as part of an IRB-approved clinical trial.
UHMS Hyperbaric Oxygen Therapy Committee, UHMS Executive Committee, and collaborative input from multiple senior UHMS members and researchers' statement on Covid19 and HBOT:
"The current COVID-19 pandemic has stretched medical systems and created considerable anxiety among health care workers and the general population. The search for novel treatments in an effort to reduce mortality and morbidity associated with COVID-19 is intense. The clinical findings of severe hypoxia and overwhelming inflammation have prompted questions around the use of HBOT.
A recent case-series of five patients in China1 has prompted multiple discussions related to the possible utility of HBO2 for COVID-19 patients. The mechanisms through which HBO2 may be beneficial are outlined below and include support of oxygenation and attenuation of pulmonary inflammation.
Support of Oxygenation
Patients with COVID-19-associated lung injury can develop severe hypoxemia, requiring increasing fractions of inspired oxygen. HBO2 is likely to raise arterial PO2 for the relatively brief period in which it can be realistically administered. However, arterial and tissue PO2 rapidly decrease to baseline at the end of hyperbaric exposure. It is hypothesized that COVID-19 patients have an accumulated oxygen debt, and that HBO2 offers a reprieve from this debt and possibly initiates recovery. There is also a concern about exacerbating pulmonary oxygen toxicity, especially in patients receiving high oxygen concentrations for prolonged periods before and after HBO2. Pulmonary oxygen toxicity was not reported in the case series in China . It is unknown what effects (beneficial or adverse ) HBO2 will have on the COVID-19-affected lung.
Attenuation of Pulmonary Inflammation
HBO2 has demonstrated anti-inflammatory effects in other organs, but this has not been tested for COVID-19-associated lung injury. We are not aware of data supporting antiviral effects of HBO2."