PMID- 36100931
OWN - NLM
STAT- MEDLINE
DCOM- 20230420
LR  - 20231001
IS  - 1833-3516 (Print)
IS  - 2209-1491 (Electronic)
IS  - 1833-3516 (Linking)
VI  - 52
IP  - 3
DP  - 2022 Sep 30
TI  - The role of routine pulmonary imaging before hyperbaric oxygen treatment.
PG  - 197-207
LID - 10.28920/dhm52.3.197-207 [doi]
AB  - Respiratory injury during or following hyperbaric oxygen treatment (HBOT) is 
      rare, but associated pressure changes can cause iatrogenic pulmonary barotrauma 
      with potentially severe sequelae such as pneumothoraces. Pulmonary blebs, bullae, 
      and other emphysematous airspace abnormalities increase the risk of respiratory 
      complications and are prevalent in otherwise healthy adults. HBOT providers may 
      elect to use chest X-ray routinely as a pre-treatment screening tool to identify 
      these anomalies, particularly if a history of preceding pulmonary disease is 
      identified, but this approach has a low sensitivity and frequently provides false 
      negative results. Computed tomography scans offer greater sensitivity for 
      airspace lesions, but given the high prevalence of incidental and insignificant 
      pulmonary findings among healthy individuals, would lead to a high false positive 
      rate because most lesions are unlikely to pose a hazard during HBOT. Post-mortem 
      and imaging studies of airspace lesion prevalence show that a significant 
      proportion of patients who undergo HBOT likely have pulmonary abnormalities such 
      as blebs and bullae. Nevertheless, pulmonary barotrauma is rare, and occurs 
      mainly in those with known underlying lung pathology. Consequently, routinely 
      using chest X-ray or computed tomography scans as screening tools prior to HBOT 
      for low-risk patients without a pertinent medical history or lack of clinical 
      symptoms of cardiorespiratory disease is of low value. This review outlines 
      published cases of patients experiencing pulmonary barotrauma while undergoing 
      pressurised treatment/testing in a hyperbaric chamber and analyses the 
      relationship between barotrauma and pulmonary findings on imaging prior to or 
      following exposure. A checklist and clinical decision-making tool based on 
      suggested low-risk and high-risk features are offered to guide the use of 
      targeted baseline thoracic imaging prior to HBOT.
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 - Brenna, Connor Ta
AU  - Brenna CT
AD  - Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, 
      ON, Canada.
AD  - Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
FAU - Khan, Shawn
AU  - Khan S
AD  - Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
FAU - Djaiani, George
AU  - Djaiani G
AD  - Department of Anesthesia, University Health Network, Toronto, ON, Canada.
FAU - Buckey, Jay C Jr
AU  - Buckey JC Jr
AD  - Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
FAU - Katznelson, Rita
AU  - Katznelson R
AD  - Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, 
      ON, Canada.
AD  - Department of Anesthesia, University Health Network, Toronto, ON, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
RN  - Cystic Disease Of Lung
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Barotrauma/complications/etiology
MH  - *Hyperbaric Oxygenation/adverse effects
MH  - *Lung Diseases/diagnostic imaging/etiology/therapy
MH  - *Lung Injury/complications
PMC - PMC9731143
OTO - NOTNLM
OT  - Arterial gas embolism
OT  - Lung
OT  - Pneumothorax
OT  - Pulmonary barotrauma
OT  - Radiological imaging
OT  - Risk assessment
COIS- Conflict of interest and funding: The Multicenter Registry for Hyperbaric Oxygen 
      Therapy (International Registered Report Identifier RR2-10.2196/18857) received 
      support from the Dartmouth-Hitchcock Medical Center Department of Medicine 
      Scholarship Enhancement in Academic Medicine (SEAM) Award Program. No conflicts 
      of interest were declared.
EDAT- 2022/09/14 06:00
MHDA- 2022/09/16 06:00
PMCR- 2023/09/30
CRDT- 2022/09/13 23:38
PHST- 2022/04/19 00:00 [received]
PHST- 2022/08/05 00:00 [accepted]
PHST- 2022/09/13 23:38 [entrez]
PHST- 2022/09/14 06:00 [pubmed]
PHST- 2022/09/16 06:00 [medline]
PHST- 2023/09/30 00:00 [pmc-release]
AID - 10.28920/dhm52.3.197-207 [doi]
PST - ppublish
SO  - Diving Hyperb Med. 2022 Sep 30;52(3):197-207. doi: 10.28920/dhm52.3.197-207.