PMID- 27044458
OWN - NLM
STAT- MEDLINE
DCOM- 20160505
LR  - 20160405
IS  - 1833-3516 (Print)
IS  - 1833-3516 (Linking)
VI  - 46
IP  - 1
DP  - 2016 Mar
TI  - Tympanic membrane bleeding complications during hyperbaric oxygen treatment in 
      patients with or without antiplatelet and anticoagulant drug treatment.
PG  - 22-5
AB  - INTRODUCTION: Middle ear barotrauma (MEBt) is a frequently occurring complication 
      of hyperbaric oxygen treatment (HBOT). High-grade MEBt may involve tympanic 
      membrane (TM) haemorrhaging. Although many patients undergoing HBOT use 
      antiplatelet or anticoagulant drugs, it is unknown whether these drugs increase 
      the risk of MEBt and particularly TM bleeding complications. METHODS: This 
      multicentre, prospective cohort study investigates the prevalence of MEBt and TM 
      bleeding during HBOT in patients using antiplatelet/anticoagulant drugs, compared 
      with control patients not on such medications. MEBt was assessed by video 
      otoscopy of the TM pre and post HBOT and scored according to the modified Teed 
      score. Any complications from previous HBOT sessions were retrospectively 
      documented. RESULTS: Of 73 patients receiving HBOT, 34 used 
      antiplatelet/anticoagulant drugs. Mild MEBt (Teed score 1 or 2) occurred in 23 of 
      these 34 patients and in 31 of the 39 controls. Teed score 3 MEBt occurred in 
      only two of the control-group patients and none of the patients using 
      antiplatelet/anticoagulant drugs. Two patients using anticoagulant drugs reported 
      epistaxis during a previous HBOT session, epistaxis was not reported by any 
      control patients. CONCLUSION: Low-grade MEBt is common during HBOT, however, 
      high-grade barotrauma is rare with current chamber operating procedures. Patients 
      using antiplatelet/anticoagulant drugs potentially may be prone to 
      MEBt-associated haemorrhagic complications, but we did not observe any such 
      increase in this cohort. Only mild epistaxis occurred in patients using 
      anticoagulant drugs.
FAU - Fijen, Valerie A
AU  - Fijen VA
AD  - Diving Medical Centre, Royal Netherlands Navy, Den Helder, The Netherlands, 
      Phone: +31-(0)65-220-2206, E-mail: va.fijen@mindef.nl.
FAU - Westerweel, Peter E
AU  - Westerweel PE
AD  - Albert Schweitzer Hospital, Dept. Internal Medicine, Dordrecht, The Netherlands.
FAU - van Ooij, Pieter Jan A M
AU  - van Ooij PJ
AD  - Diving Medical Centre, Royal Netherlands Navy, Den Helder, The Netherlands.
FAU - van Hulst, Rob A
AU  - van Hulst RA
AD  - Diving Medical Centre, Royal Netherlands Navy, Den Helder, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*adverse effects
MH  - Barotrauma/epidemiology/*etiology
MH  - Case-Control Studies
MH  - Ear Diseases/epidemiology/*etiology
MH  - Ear, Middle/injuries
MH  - Female
MH  - Hemorrhage/epidemiology/*etiology
MH  - Humans
MH  - Hyperbaric Oxygenation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Otoscopy/methods
MH  - Platelet Aggregation Inhibitors/*adverse effects
MH  - Prospective Studies
MH  - Sample Size
MH  - Surveys and Questionnaires
MH  - Tympanic Membrane/*injuries
OTO - NOTNLM
OT  - Middle ear
OT  - barotrauma
OT  - cardiovascular
OT  - haematology
OT  - hyperbaric oxygen therapy
OT  - medication
OT  - risk factors
EDAT- 2016/04/06 06:00
MHDA- 2016/05/06 06:00
CRDT- 2016/04/06 06:00
PHST- 2016/01/11 00:00 [received]
PHST- 2016/01/18 00:00 [accepted]
PHST- 2016/04/06 06:00 [entrez]
PHST- 2016/04/06 06:00 [pubmed]
PHST- 2016/05/06 06:00 [medline]
PST - ppublish
SO  - Diving Hyperb Med. 2016 Mar;46(1):22-5.