ABSTRACT

Cracchiolo AN, Palma DM, Saporito EFG, Palazzolo C, Mannino SM, Genco F, Vitale F, Profera L, Raineri SM, Accurso G. Safety Of Hyperbaric Oxygen Therapy In Patients Aged 75 And Older: A Multicenter Retrospective Study. Undersea Hyperb Med. 2025 Fourth Quarter; 52(4):495-506.

Background: The increasing life expectancy presents new challenges in managing elderly patients requiring hyperbaric oxygen (HBO2) therapy. This retrospective study evaluates the safety and adherence to HBO2 guidelines in patients aged 75 years and older, focusing on side effects and adverse events.

Methods: Data from 69 elderly patients treated between 2019 and 2023 at two Sicilian hyperbaric centres were analyzed. Demographics, indications for HBO2, comorbidities, treatment protocols, and side effects were collected. Pre-treatment evaluations included ENT checkups, ECG, chest X-rays, and laboratory tests. Patients underwent HBO2 sessions at 2.4–2.8 ATA, with clinical monitoring pre-and post-treatment.

Results: 1,799 HBO2 sessions were performed in 69 patients (mean age 78 years; 59.4% male). The most common indications were progressive necrotizing infections (33.3%), sudden sensorineural hearing loss (17.3%), and chronic radiation-induced tissue injuries (14.5%). Side effects occurred in 14 patients (20.3%), primarily middle ear barotrauma (8.7%), sinus barotrauma (4.3%), confinement anxiety (4.3%), hypoglycemia (1.4%), and chest pain (1.4%). Most side effects were resolved with prompt care, and

no life-threatening events were recorded. Adherence to guidelines and meticulous pre-treatment evaluations minimized risks.

Conclusions: HBO2 is a safe therapeutic option for elderly patients when strict pre-treatment evaluations and monitoring protocols are implemented. Despite this population's increased vulnerability, the incidence of side effects was comparable to that in younger cohorts. Future research is warranted to optimize treatment protocols and explore outcomes in larger elderly populations.

Keywords: adverse events; elderly patients; guidelines; hyperbaric oxygen therapy; safety,