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Treatment of children with Hyperbaric Oxygenation (HBOT): an Europe-wide survey.

BACKGROUND
Hyperbaric oxygenation therapy (HBOT) is used as emergency treatment for decompression sickness, gas embolism, carbon monoxide intoxication, necrotizing fasciitis. There is low evidence and little clinical knowledge about treating children with HBOT.


METHODS
We sent an internet-based questionnaire to HBO centers in Europe to gain information about their experience with children and HBOT.


RESULTS
Out of all HBO-centers who participated in the questionnaire 90 % treat children analogue to adults with regard to indication and HBOT protocol. Most treated children had life- threatening indications or the risk of organ loss. The reported rate of side effects was: 6.8 % anxiety, 2.4 % barotrauma, 0.9 % seizure, 0.2 % retinopathy and no case of pulmonary barotrauma or oxygen toxicity.


CONCLUSIONS
HBO therapy for children is present in European HBO centers. The rate of severe side effects is as low to the rates in adults; apart from this, oxygen-related seizures and anxiety are more frequent. A special focus seems necessary on the psychological management of the children, because anxiety is common depending on the age of the children. Especially for smaller children an adequate psychological support seems essential. Prospective observational or controlled studies in children seem necessary to create relevant clinical evidence for HBOT and to observe the rate of side-effects.