HBOT and Pulmonary Disease
Many smokers end up with COPD as a sequel of Long term tobacco abuse. Likewise a large number of these patients suffer head and neck cancers with subsequent radiation therapy and surgery. It is a certainty that patients with chronic obstructive pulmonary disease will present for Hyperbaric management.
Several of the care issues which relate to the management of these patients include secretion control, chronic bronchitis, bronchospasm, risk of mucus plugging as well as compliance. The question of possible CO2 retention with suppression of respiratory drive during treatment in the Hyperbaric chamber should be addressed. Chronic infection and management of long-term bronchi tic processes to prevent mucus plugging and secondary barotrauma should be considered.
At times Tension Pneumothorax could be a possibility. The Hyperbaric technician needs to be very vigilant about the occurrence of Pneumothorax as it can even develop later after the Hyperbaric treatment session.
A second concern often raised by individuals not well versed in hyperbaric therapy is the question of hypoxic ventilator drive and causing respiratory arrest from therapeutic hyperoxia. Any patients who manifest significant exertional dyspnea and heart failure should be monitored closely if HBOT is required.
Use of inhaled topical bronchodilators either prior to hyperbaric treatment or prior to decompression may be beneficial in minimizing the risk of air trapping. The majority of patients with COPD do not have significant irreversible bronchospastic processes which preclude hyperbaric treatment. The slow rates of decompression are generally well tolerated and usually COPD patients tolerate Hyperbaric treatment without difficulty.
Information for this article has been taken from Hyperbaric Medicine Procedures – the Kindwall HBO Handbook by Aurora St. Luke’s Medical Center.