Hyperbaric oxygen therapy effects on pulmonary functions: a prospective cohort study

Amir Hadanny, Tal Zubari, Liat Tamir-Adler, Yair Bechor, Gregory Fishlev, Erez Lang, Nir Polak, Jacob Bergan, Mony Friedman, Shai Efrati, Amir Hadanny, Tal Zubari, Liat Tamir-Adler, Yair Bechor, Gregory Fishlev, Erez Lang, Nir Polak, Jacob Bergan, Mony Friedman, Shai Efrati

Abstract

Background: Oxygen toxicity is one potential side effect of hyperbaric oxygen therapy (HBOT). Previous small studies showed mild reductions in pulmonary functions reflecting reductions in small airway conductance after repetitive hyperbaric oxygen sessions. However, there are no updated data with well performed pulmonary tests that address the pulmonary effect of the currently used HBOT protocols. The aim of this study was to evaluate the effect of HBOT on pulmonary functions of patients receiving the currently used HBOT protocol.

Methods: Prospective analysis included patients, 18 years or older, scheduled for 60 daily HBOT sessions between 2016 and 2018. Each session was 90 min of 100% oxygen at 2 ATA with 5 min air breaks every 20 min, 5 days per week. Pulmonary functions, measured at baseline and after HBOT, included forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1) and peak expiratory flow rate (PEF).

Results: The mean age was 60.36 ± 15.43 and 62.5% (55/88) were males. Most of the patients (83/88, 94.3%) did not have any pulmonary disease prior to inclusion and 30.7% (27/88) had a history of smoking. Compared to baseline values, at the completion of 60 HBOT sessions, there were no significant changes in FEV1 (0.163), FEV1/FVC ratio (0.953) and FEF25-75% (0.423). There was a statistically significant increase though not clinically relevant increase in FVC (0.1 ± 0.38 l) and PEF (0.5 ± 1.4 l) with a 0.014 and 0.001 respectively.

Conclusion: Regarding pulmonary functions, repeated hyperbaric oxygen exposure based on the currently used HBOT protocol is safe. Surprisingly, there was a modest non clinically significant though statistically significant improvement in PEF and FVC in the current cohort of patients who were without chronic lung diseases.

Trial registration: Clinicaltrials.gov, trial ID: NCT03754985 , (Nov 2018) Retrospectively registered.

Keywords: HBOT; Hyperbaric oxygen; Oxygen toxicity; PFT; Pulmonary function.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patients flowchart: out of 105 patients, 88 patients were included in the final analysis

References

    1. Thomson L, Paton J. Oxygen Toxicity. 2014.
    1. Clark JM, Lambertsen CJ. Pulmonary oxygen toxicity: a review. Pharmacol Rev. 1971;23(2):37–133.
    1. van Ooij PJ, Hollmann MW, van Hulst RA, Sterk PJ. Assessment of pulmonary oxygen toxicity: relevance to professional diving; a review. Respir Physiol Neurobiol. 2013;189(1):117–128. doi: 10.1016/j.resp.2013.07.014.
    1. Clark JM. Pulmonary limits of oxygen tolerance in man. Exp Lung Res. 1988;14:897–910. doi: 10.3109/01902148809064182.
    1. Clark JM, Lambertsen CJ. Rate of development of pulmonary O2 toxicity in man during O2 breathing at 2.0 Ata. J Appl Physiol. 1971;30(5):739–752. doi: 10.1152/jappl.1971.30.5.739.
    1. Clark JM, Lambertsen CJ, Gelfand R, Flores ND, Pisarello JB, Rossman MD, et al. Effects of prolonged oxygen exposure at 1.5, 2.0, or 2.5 ATA on pulmonary function in men (predictive studies V) J Appl Physiol. 1999;86(1):243–259. doi: 10.1152/jappl.1999.86.1.243.
    1. Pott F, Westergaard P, Mortensen J, Jansen EC. Hyperbaric oxygen treatment and pulmonary function. Undersea Hyperb Med. 1999;26(4):225–228.
    1. Thorsen E, Aanderud L, Aasen TB. Effects of a standard hyperbaric oxygen treatment protocol on pulmonary function. Eur Respir J. 1998;12(6):1442–1445. doi: 10.1183/09031936.98.12061442.
    1. LE W. Hyperbaric oxygen therapy indications. 13th ed. UHMS; 2008. p. 139-152, 283-287. .
    1. Boussi-Gross R, Golan H, Fishlev G, Bechor Y, Volkov O, Bergan J, et al. Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial. PLoS One. 2013;8(11):e79995. doi: 10.1371/journal.pone.0079995.
    1. Efrati S, Fishlev G, Bechor Y, Volkov O, Bergan J, Kliakhandler K, et al. Hyperbaric oxygen induces late neuroplasticity in post stroke patients--randomized, prospective trial. PLoS One. 2013;8(1):e53716. doi: 10.1371/journal.pone.0053716.
    1. Mukherjee A, Raison M, Sahni T, Arya A, Lambert J, Marois P, et al. Intensive rehabilitation combined with HBO2 therapy in children with cerebral palsy: a controlled longitudinal study. Undersea Hyperb Med. 2014;41(2):77–85.
    1. Efrati S, Golan H, Bechor Y, Faran Y, Daphna-Tekoah S, Sekler G, et al. Hyperbaric oxygen therapy can diminish fibromyalgia syndrome--prospective clinical trial. PLoS One. 2015;10(5):e0127012. doi: 10.1371/journal.pone.0127012.
    1. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–338. doi: 10.1183/09031936.05.00034805.
    1. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983;127(6):725–734.
    1. Enright PL, Beck KC, Sherrill DL. Repeatability of spirometry in 18,000 adult patients. Am J Respir Crit Care Med. 2004;169(2):235–238. doi: 10.1164/rccm.200204-347OC.
    1. Harabin AL, Survanshi SS, Weathersby PK, Hays JR, Homer LD. The modulation of oxygen toxicity by intermittent exposure. Toxicol Appl Pharmacol. 1988;93(2):298–311. doi: 10.1016/0041-008X(88)90130-5.
    1. Arieli R, Yalov A, Goldenshluger A. Modeling pulmonary and CNS O (2) toxicity and estimation of parameters for humans. J Appl Physiol. 2002;92(1):248–256. doi: 10.1152/japplphysiol.00434.2001.
    1. Singha Roy A, Bandyopadhyay A. Pulmonary function of young Muslim males during the month of Ramadan. Am J Mens Health. 2018;12(4):828–836. doi: 10.1177/1557988316643292.

Source: PubMed

3
订阅