Evaluation of the efficacy of modified low-dose HBO2 therapy

ABSTRACT

Introduction: The COVID-19 pandemic, being an airborne disease, posed a challenge in providing Hyperbaric Oxygen (HBO2) Therapy in multiplace chambers by increasing the risk of cross-infectivity while on air break inside the chamber. The standard regimen consisting of two air breaks was modified, and a new low-dose HBO2 therapy regimen with no air breaks was introduced to mitigate the risk of cross-infection. This study aimed to evaluate the efficacy of the modified HBO2 therapy regimen compared to the standard HBO2 therapy regimen for patients with soft tissue radiation injury. 

Methods: A retrospective observational study compared the modified low-dose HBO2 therapy regimen of 2.4 Atmosphere Absolute (ATA) for 60 minutes without air-break vis-a-vis the standard regimen of 2.4 ATA for 100 minutes with two air breaks of five minutes each. Patients with soft tissue radiation injury in the form of radiation cystitis and radiation proctitis were selected for comparison in the study. Data was retrieved from patients who underwent the standard and modified regimen during the COVID-19 pandemic. Late Effects Normal Tissue (LENT)/ Subjective Objective Management Analytic (SOMA) questionnaire-based scoring was compared for 30 sessions of HBO2 therapy. Standard biostatistical methodology was used to compare the outcomes of both regimens. 

Results: The mean LENT SOMA score decreased from the baseline to the end of 30 sessions in the HBO2 therapy protocols. Overall, mean values decreased more for the patients who were offered the standard regimen of HBO2 therapy. 

Conclusion: A modified low-dose HBO2 therapy treatment regimen achieved statistically significant therapeutic benefits. However, the results were statistically more promising for the patients who underwent the standard HBO2 therapy regimen.

Keywords: COVID-19; HBO2; hyperbaric regimen; LENT SOMA; radionecrosis