What are contraindications for the use of hyperbaric oxygen therapy (HBOT)?

Updated: Oct 22, 2018
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Table 2. Absolute Contraindications to Hyperbaric Oxygen Therapy (Open Table in a new window)

Absolute Contraindications

Reason Contraindicated

Necessary Conditions Prior to HBOT

Untreated pneumothorax

Gas emboli

Tension pneumothorax

Pneumomediastinum

Thoracostomy

Bleomycin

Interstitial pneumonitis

No treatment for extended time from use of medication

Cisplatin

Impaired wound healing

No treatment for extended time from use of medication

Disulfiram

Blocks superoxide dismutase, which is protective against oxygen toxicity

Discontinue medication

Doxorubicin

Cardiotoxicity

Discontinue medication

Sulfamylon

Impaired wound healing

Discontinue and remove medication

 

Table 3. Relative Contraindications to Hyperbaric Oxygen Therapy (Open Table in a new window)

Relative Contraindications

Reason Contraindicated

Necessary Conditions Prior to HBOT

Asthma

Air trapping upon ascent leading to pneumothorax

Must be well controlled with medications

Claustrophobia

Anxiety

Treatment with benzodiazepines

Congenital spherocytosis

Severe hemolysis

None; HBOT for emergencies only

Chronic obstructive pulmonary disease (COPD)

Loss of hypoxic drive to breathe

Observation in chamber

Eustachian tube dysfunction

Barotrauma to tympanic membrane

Training, PE tubes

High fever

Higher risk of seizures

Provide antipyretic

Pacemakers or epidural pain pump

Malfunction or deformation of device under pressure

Ensure company has pressure-tested device and learn to what depth

Pregnancy

Unknown effect on fetus (Previous studies from Russia suggest HBOT is safe.)

None, but HBOT may be used in emergencies

Seizures

May have lower seizure threshold

Should be stable on medications; may be treated with benzodiazepines

Upper respiratory infection (URI)

Barotrauma

Resolution of symptoms or decongestants


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