Hyperbaric Oxygen Therapy Regimens, Treated Conditions, and Adverse Effect Profile: an Undersea and Hyperbaric Medical Society Survey Study

Laspro M, Wei LW, Brydges HT, Gorenstein SA, Huang ET, Chiu ES. Hyperbaric Oxygen Therapy Regimens, Treated Conditions, and Adverse Effect Profile: an Undersea and Hyperbaric Medical Society Survey Study. Undersea Hyperb Med. 2024 Fourth Quarter; 51(4):369-376. Introduction: When administering HBO2, pressures can range from 1.4 atmospheres absolute (ATA) to 3 ATA. While different treatment profiles have been proposed, there is a paucity of literature comparing the effectiveness and risk profile associated with different pressures treating the same condition. Considering the therapeutic divergence, this study aims to survey Undersea and Hyperbaric Medical Society (UHMS) members on pressure modalities and their use in different clinical conditions. Methods: The study was a voluntary cross-sectional survey administered online and open to healthcare providers who were Undersea and Hyperbaric Medical Society members. UHMS itself distributed the survey link. The survey period lasted from November 2022 until January 2023. Data were collected utilizing the Qualtrics platform and analyzed through Microsoft Excel. Results: A total of 265 responses were recorded. The majority responded with utilizing 2.4 ATA (35.2%) as the pressure of choice, followed by 2.0 ATA only (27.1%), and those who utilized differing therapeutic pressures (26.4%). The overwhelming choice for treatment of osteoradionecrosis (ORN) of the jaw, radiation proctitis/cystitis, diabetic foot ulcer, and chronic osteomyelitis was 2.0 ATA (68.0- 74.9%). Among listed adverse effects, myopia was the most commonly reported complication at 24.4%, followed by barotrauma (14.9%) and confinement anxiety (11.5%). Conclusions: There is currently little consensus regarding the best treatment modalities for conditions treated with HBO2. As adverse effects appear non-negligible, future prospective studies must be conducted weighing the risks and benefits of higher-pressure therapies compared to safer lower-pressure options. Keywords: barometric pressure, expert witness, hyperbaric oxygen therapy, survey