Hyperbaric Oxygen as an Adjuvant Treatment for Patients with Covid-19 Severe Hypoxemia: Randomized Controlled Trial

CANNELLOTTO, MARIANA; DUARTE, MARIANO; KELLER, GUILLERMO; LARREA, RAMIRO; CUNTO, ELEONORA; CHEDIACK, VIVIANA; MANSUR, MARIELA; BRITO, DANIELA; GARCÍA, ELIZABETH; DI-SALVO, HÉCTOR; DOMÍNGUEZ, CECILIA; VERDINI, FABRIZIO; DI GIROLAMO, GUILLERMO; JORDA-VARGAS, LILIANA; ROBERTI, JAVIER; ESTRADA, ESTEBAN

EMERGENCY MEDICINE JOURNAL

B M J PUBLISHING GROUP

Lugar: Londres; Año: 2021

1472-0205

Background: Hyperbaric oxygen (HBO2) therapy has been proposed to treat hypoxemia and reduce inflammation in COVID-19. Our objective was to analyse safety and efficacy of HBO2 in treatment of hypoxemia in patients with COVID-19 and evaluate time to hypoxemia correction.Methods: This was a multi-centre, open-label randomised controlled trial conducted in Buenos Aires, Argentina, between July to November 2020. Patients with COVID-19 and severe hypoxemia (SpO2 ≤90% despite oxygen supplementation) were assigned to receive either HBO2 treatment or the standard treatment for respiratory symptoms for seven days. HBO2 treatment was planned for ≥5 sessions (1/day) for 90 minutes at 1.45. ATA. Outcomes were time to normalize oxygen requirement to SpO2 ≥93%, need for mechanical respiratory assistance, development of acute respiratory distress syndrome (ARDS) 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 hypoxemia 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