PMID- 29888378
OWN - NLM
STAT- MEDLINE
DCOM- 20190522
LR  - 20190627
IS  - 1833-3516 (Print)
IS  - 2209-1491 (Electronic)
IS  - 1833-3516 (Linking)
VI  - 48
IP  - 2
DP  - 2018 Jun 30
TI  - Audit of practice in Australasian hyperbaric units on the incidence of central 
      nervous system oxygen toxicity.
PG  - 73-78
LID - 10.28920/dhm48.2.73-78 [doi]
AB  - INTRODUCTION: Central nervous system oxygen toxicity (CNS-OT) is an uncommon 
      complication of hyperbaric oxygen treatment (HBOT). Different facilities have 
      developed local protocols in an attempt to reduce the risk of CNS-OT. This audit 
      was performed to elucidate which protocols might be of benefit in mitigating 
      CNS-OT and to open discussion on adopting a common protocol for Treatment Table 
      14 (TT14) to enable future multicentre clinical trials. METHODS: Audit of CNS-OT 
      events between units using different compression profiles for TT14, performed at 
      243 kPa with variable durations of oxygen breathing and 'air breaks', to assess 
      whether there is a statistical diference between protocols. Data were collected 
      retrospectively from public and private hyperbaric facilities in Australia and 
      New Zealand between 01 January 2010 and 31 December 2014. RESULTS: Eight of 15 
      units approached participated. During the five-year period 5,193 patients 
      received 96,670 treatments. There were a total of 38 seizures in 33 patients when 
      all treatment pressures were examined. In the group of patients treated at 243 
      kPa there were a total of 26 seizures in 23 patients. The incidence of seizure 
      per treatment was 0.024% (2.4 per 10,000 treatments) at 243 kPa and the risk per 
      patient was 0.45% (4.5 in 1,000 patients). There were no statistically 
      significant differences between the incidences of CNS-OT using different TT14 
      protocols in this analysis. CONCLUSION: HBOT is safe and CNS-OT is uncommon. The 
      risk of CNS-OT per patient at 243 kPa was 1 in 222 (0.45%; range 0-1%) and the 
      overall risk irrespective of treatment table was 0.6% (range 0.31-1.8%). These 
      figures are higher than previously reported as they represent individual patient 
      risk as opposed to risk per treatment. The wide disparity of facility protocols 
      for a 243 kPa table without discernible influence on the incidence of CNS-OT 
      rates should facilitate a national approach to consensus.
CI  - Copyright: This article is the copyright of the authors who grant Diving and 
      Hyperbaric Medicine a non-exclusive licence to publish the article in electronic 
      and other forms.
FAU - Sherlock, Susannah
AU  - Sherlock S
AD  - Corresponding author: Hyperbaric Medicine Unit and Anaesthesia, Royal Brisbane 
      and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia. 
      susannah.sherlock@health.qld.gov.au.
AD  - Hyperbaric Medicine Unit and Anaesthesia, Royal Brisbane and Women's Hospital, 
      Herston, Queensland, Australia.
AD  - Faculty of Medicine, The University of Queensland, Brisbane, Queensland.
FAU - Way, Mandy
AU  - Way M
AD  - QIMR Berghofer, Biostatistics, Herston, Queensland.
FAU - Tabah, Alexis
AU  - Tabah A
AD  - Faculty of Medicine, The University of Queensland, Brisbane, Queensland.
AD  - Intensive Care Unit, Redcliffe Hospital, Redcliffe, Queensland.
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Australia
MH  - Central Nervous System/*drug effects
MH  - Female
MH  - Humans
MH  - *Hyperbaric Oxygenation/adverse effects
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - New Zealand
MH  - Oxygen/*toxicity
MH  - Retrospective Studies
MH  - Seizures/epidemiology/*etiology
PMC - PMC6156828
OTO - NOTNLM
OT  - Central nervous system
OT  - Clinical audit
OT  - Diving tables
OT  - Hyperbaric oxygen therapy
OT  - Toxicity
COIS- Funding and conflicts of interest: nil.
EDAT- 2018/06/12 06:00
MHDA- 2019/05/23 06:00
PMCR- 2019/06/27
CRDT- 2018/06/12 06:00
PHST- 2018/03/17 00:00 [received]
PHST- 2018/04/12 00:00 [accepted]
PHST- 2018/06/12 06:00 [entrez]
PHST- 2018/06/12 06:00 [pubmed]
PHST- 2019/05/23 06:00 [medline]
PHST- 2019/06/27 00:00 [pmc-release]
AID - 10.28920/dhm48.2.73-78 [doi]
PST - ppublish
SO  - Diving Hyperb Med. 2018 Jun 30;48(2):73-78. doi: 10.28920/dhm48.2.73-78.