Pediatric Hyperbaric Oxygen Therapy in Victoria, 1998-2010

Objectives: The aim of this review is to identify clinical conditions currently treated in a pediatric population referred to the Alfred hyperbaric unit, to describe outcomes, and detail any complications occurring during treatment or transfer between units.

Design: Retrospective, noncontrolled, clinical study.

Setting: Adult hyperbaric unit in a university hospital.

Patients: Children aged <16 yrs referred for hyperbaric oxygen therapy between January 1998 and December 2010.

Interventions: Hyperbaric oxygen therapy at pressures from 2.0 to 3.0 atmospheres absolute.

Measurements And Main Results: Fifty-four patients with a median age at presentation of 15 yrs (range, 0.25-16 yrs) received 668 treatment sessions (mean, 12.4; 95% confidence interval, 9.2-15.5). Fourteen patients were identified as having successfully completed treatment while managed in intensive care units. There were 44 events in 668 treatments (6.6%) in the pediatric group and 12 events in 126 treatments (9.6%) in the pediatric intensive care unit group. There were two oxygen toxicity convulsion (0.3%), two episodes of progressive hypoxemia (0.3%), and four episodes of brief hypotension (0.6%).

Conclusions: Provision of hyperbaric oxygen to children with significant illness is feasible and associated with a low risk of complications. The most difficult aspect of managing pediatric hyperbaric oxygen therapy is in the coordination of the treatment with ongoing surgical and intensive care management. The lack of pediatric staff and facilities in major hyperbaric units necessitates multiple transfers for appropriate treatment.