Hyperbaric oxygen as an adjuvant treatment for patients with COVID-19 severe hypoxaemia: a randomised controlled trial. Issue 2 (14th December 2021)

• Record Type: Journal Article
• Authors: Cannellotto, Mariana; Duarte, Mariano; Keller, Guillermo; Larrea, Ramiro; Cunto, Eleonora; Chediack, Viviana; Mansur, Mariela; Brito, Daniela M; García, Elizabeth; Di Salvo, Héctor E; Verdini, Fabrizio; Domínguez, Cecilia; Jorda-Vargas, Liliana; Roberti, Javier; Di Girolamo, Guillermo; Estrada, Esteban
• Is Part Of: Emergency medicine journal. Volume 39:Issue 2(2022)
• Page Start: 88
• Page End: 93
• Publication Date: 2021-12-14
• Subjects: COVID-19 -- hyperbaric medicine -- respiratory; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emermed-2021-211253
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Background: Hyperbaric oxygen (HBO2 ) therapy has been proposed to treat hypoxaemia and reduce inflammation in COVID-19. Our objective was to analyse safety and efficacy of HBO2 in treatment of hypoxaemia in patients with COVID-19 and evaluate time to hypoxaemia correction. Methods: This was a multicentre, open-label randomised controlled trial conducted in Buenos Aires, Argentina, between July and November 2020. Patients with COVID-19 and severe hypoxaemia (SpO2 ≤90% despite oxygen supplementation) were assigned to receive either HBO2 treatment or the standard treatment for respiratory symptoms for 7 days. HBO2 treatment was planned for ≥5 sessions (1 /day) for 90 min at 1.45 atmosphere absolute (ATA). Outcomes were time to normalise oxygen requirement to SpO2 ≥93%, need for mechanical respiratory assistance, development of acute respiratory distress syndrome and mortality within 30 days. A sample size of 80 patients was estimated, with a planned interim analysis after determining outcomes on 50% of patients. Results: The trial was stopped after the interim analysis. 40 patients were randomised, 20 in each group, age was 55.2±9.2 years. At admission, frequent symptoms were dyspnoea, fever and odynophagia; SpO2 was 85.1%±4.3% for the whole group. Patients in the treatment group received an average of 6.2±1.2 HBO2 sessions. Time to correct hypoxaemia was shorter in treatment group versus control group; median 3 days (IQR 1.0–4.5) versus median 9 days (IQR 5.5–12.5), respectively (p<0.010). OR for recovery from hypoxaemia in the HBO2 group at day 3 compared with the control group was 23.2 (95% CI 1.6 to 329.6; p=0.001) Treatment had no statistically significant effect on acute respiratory distress syndrome, mechanical ventilation or death within 30 days after admission. Conclusion: Our findings support the safety and efficacy of HBO2 in the treatment of COVID-19 and severe hypoxaemia. Trial registration number: NCT04477954 .