PMID- 21848108
OWN - NLM
STAT- MEDLINE
DCOM- 20110912
LR  - 20141212
IS  - 2209-1491 (Electronic)
IS  - 1833-3516 (Linking)
VI  - 41
IP  - 2
DP  - 2011 Jun
TI  - Changes in oxygenation in mechanically ventilated critically ill patients 
      following hyperbaric treatment.
PG  - 59-63
AB  - BACKGROUND: Some ventilated intensive care unit (ICU) patients may experience 
      reduced oxygenation following hyperbaric oxygen treatment (HBOT). METHODS: In a 
      prospective, single-centre, observational study, we documented changes in 
      oxygenation and the need for associated changes in ventilator settings in 25 
      consecutive, mechanically ventilated ICU patients immediately post-treatment and 
      1, 2, 3 and 6 hours following 61 HBOT sessions. The primary outcome measure of 
      oxygenation was the ratio of arterial partial pressure of oxygen (P(a)O2) against 
      the level of inspired oxygen (F(i)O2), P(a)O2/F(i)O2. RESULTS: Following HBOT, 
      the P(a)O2/F(i)O2 ratio decreased by 27% on return to ICU (P < 0.001, 95% 
      confidence intervals (CI) 20.6 to 34.2); 22% at 1 hour post-HBOT (P < 0.001, 95% 
      CI 15.1 to 28.6); and 8% at 2 hours post (P = 0.03, 95% CI 0.8 to 14.4). The 
      ratio showed no significant differences from pre-HBOT at 3 and 6 hours post-HBOT. 
      P(a)O2/F(i)O2 ratio changes necessitated adjustments to ventilation parameters 
      upon return to ICU following 30 of 61 HBOT sessions in 17 out of the 25 patients. 
      The most common ventilation parameter altered was F(i)O2 (n = 20), increased by a 
      mean of +0.17 (95% CI 0.11 to 0.23) above baseline for two hours following HBOT. 
      CONCLUSIONS: Following HBOT, oxygenation is reduced in a majority of mechanically 
      ventilated ICU patients and requires temporary alterations to mechanical 
      ventilation settings. Further study to identify predictive characteristics and to 
      determine causation for those at risk of needing ventilation alterations is 
      required.
FAU - Bingham, Gordon
AU  - Bingham G
AD  - Hyperbaric Unit, Alfred Hospital, Melbourne, Australia. g.bingham@alfred.org.au
FAU - Millar, Ian
AU  - Millar I
FAU - Koch, Susan
AU  - Koch S
FAU - Paul, Eldho
AU  - Paul E
FAU - Varma, Dinesh
AU  - Varma D
FAU - Pilcher, David
AU  - Pilcher D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cell Respiration
MH  - Confidence Intervals
MH  - Critical Illness/*therapy
MH  - Female
MH  - Humans
MH  - Hyperbaric Oxygenation/*methods
MH  - Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - Oxygen/*blood
MH  - Oxygen Consumption/*physiology
MH  - Partial Pressure
MH  - Prospective Studies
MH  - Respiration, Artificial/*methods/standards
MH  - Time Factors
EDAT- 2011/08/19 06:00
MHDA- 2011/09/13 06:00
CRDT- 2011/08/19 06:00
PHST- 2011/08/19 06:00 [entrez]
PHST- 2011/08/19 06:00 [pubmed]
PHST- 2011/09/13 06:00 [medline]
PST - ppublish
SO  - Diving Hyperb Med. 2011 Jun;41(2):59-63.