Effect of hyperbaric oxygen treatment on patients with reduced left ventricular ejection fraction

Abstract

Introduction: Hyperbaric oxygen treatment (HBOT) is available to a wide spectrum of patients, many with significant co-morbidities. Considering its effects on cardiac physiology and reports of pulmonary oedema following exposure, concerns exist about the safety of patients with compromised cardiac function. Few studies have described adverse events occurring during HBOT and even fewer reports address events arising in the hours following HBOT. A relation between adverse events and cardiac function has not been established. As medical guidance is limited, we aimed to evaluate the risk for patients with reduced left ventricular ejection fraction (LVEF) receiving HBOT.

Methods: This retrospective chart review of patients receiving HBOT from April 2003 through December 2019 at our hospital was designed to describe clinical characteristics of patients and to identify adverse events during HBOT and within 24 hours after HBOT. Patients ≥ 40 years of age with a documented LVEF of ≤ 40% were included. Data are presented as mean (SD) [range] or counts, as appropriate.

Results: A total of 23 patients were included in the final analysis, 2 (1) [0-4] patients per year. Patients received 25 (19) [1-60] treatments. Two patients had an episode of acute decompensated heart failure possibly linked to HBOT.

Conclusions: This study described the clinical characteristics of patients with reduced LVEF receiving HBOT and showed reassuring results, with a majority of patients with reduced LVEF tolerating HBOT well. Prospective research is required to more fully assess the risk.

Keywords: Adverse effects; Cardiovascular; Heart failure; Hyperbaric medicine; Pulmonary oedema; Safety.

Figure 1

Patient selection paradigm