Huang E, Heyboer M, Savaser DJ. Hyperbaric oxygen therapy for the management of chronic wounds: patient selection and perspectives. Chronic Wound Care Management and Research. 2019; 6:27-37

Hoversten KP, Kiemele LJ, Stolp AM Prevention, diagnosis, and management of chronic wounds in older adults. Mayo Clin Proc. 2020; 95:(9)2021-2034

Neheman A, Rappaport YH, Verhovsky G Hyperbaric oxygen therapy for paediatric ‘hypospadias cripple’—evaluating the advantages regarding graft take. J Pediatr Urol. 2020; 16:(2)163.e1-163.e7

Camison L, Naran S, Lee WW Hyperbaric oxygen therapy for large composite grafts: an alternative in paediatric facial reconstruction. J Plast Reconstr Aesthet Surg. 2020; 73:(12)2178-2184

Pou JD, Graham HD. Paediatric nasal tip amputation successfully treated with nonmicrovascular replantation and hyperbaric oxygen therapy. Ochsner J. 2017; 17:(2)204-207

El Hawa AAA, Charipova K, Bekeny JC, Johnson-Arbor KK. The evolving use of hyperbaric oxygen therapy during the COVID-19 pandemic. J Wound Care. 2021; 30:S8-S11

Waisman D, Shupak A, Weisz G, Melamed Y. Hyperbaric oxygen therapy in the paediatric patient: the experience of the Israel Naval Medical Institute. Paediatrics. 1998; 102:(5)

Takac I, Kvolik S, Divkovic D Conservative surgical management of necrotic tissues following meningococcal sepsis: case report of a child treated with hyperbaric oxygen. Undersea Hyperb Med. 2010; 37:(2)95-99

Brooks JT, Butler JC. Effectiveness of mask wearing to control community spread of sars-coV-2. JAMA. 2021; 325:(10)998-999

Chapter 14: Hyperbaric facilities. 2017.

International ATMO Education. Static electricity and grounding in hyperbaric chambers. 2015. (accessed 17 August 2021)

Child life services. Paediatrics. 2014; 133:(5)e1471-e1478

Hadanny A, Meir O, Bechor Y Seizures during hyperbaric oxygen therapy: retrospective analysis of 62,614 treatment sessions. Undersea Hyperb Med. 2016; 43:(1)21-28

Samuels MP. The effects of flight and altitude. Arch Dis Child. 2004; 89:(5)448-455

Heyboer M, Wojcik SM, Grant WD Middle ear barotrauma in hyperbaric oxygen therapy. Undersea Hyperb Med. 2014; 41:(5)393-397

Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am. 2006; 39:(6)1221-1235

Buchanan BJ, Hoagland J, Fischer PR. Pseudoephedrine and air travel-associated ear pain in children. Arch Pediatr Adolesc Med. 1999; 153:(5)466-468

Hyperbaric oxygen therapy for paediatric patients: an unintended consequence of the COVID-19 pandemic

02 September 2021
Volume 5 · Issue 4



Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients.


A retrospective review was performed to identify patients 18 years of age or younger referred for HBOT during 2020. Patient characteristics, referral indications and HBOT complications were collected. Changes implemented to the HBOT centre to accommodate the treatment of paediatric patients were documented.


A total of seven paediatric patients were evaluated for HBOT and six were treated. The mean patient age was four years (range: 1–11 years). Referral diagnoses included sudden sensorineural hearing loss, skin flap or graft compromise, and radiation-induced soft tissue necrosis. All patients tolerated HBOT treatment in monoplace chambers without significant complications noted. Enhancements made to our clinical practice to facilitate the safe and effective treatment of paediatric patients included ensuring the availability of acceptable garments for paediatric patients, maintaining uninterrupted patient grounding (in relation to fire safety), and enhancing social support for anxiety reduction.


The results of our review show that paediatric patients can be safely treated within the monoplace hyperbaric environment.

Hyperbaric oxygen therapy (HBOT) involves intermittent administration of 100% oxygen to patients enclosed in a pressurised treatment chamber. HBOT is most commonly used as a wound healing adjunct, with robust evidence supporting its utility in the treatment of diabetic foot ulcers.1 HBOT is also indicated as an adjunctive treatment for several acute and chronic conditions such as carbon monoxide poisoning, acute arterial insufficiencies, and delayed radiation injury affecting bone and soft tissues. Most available literature on the use of HBOT relates to the hard-to-heal wound population, with a large percentage of patients referred for HBOT being older adults.2 In the US, paediatric patients are rarely referred for HBOT, making literature on paediatric HBOT sparse. However, HBOT has been used as an adjunctive treatment to reduce skin graft or flap failure in paediatric patients undergoing surgical procedures including hypospadias repair, facial reconstruction and nasal tip reimplantation.3,4,5

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