Argentinian biochemists are betting on hyperbaric medicine to treat the hypoxaemia triggered by the virus and reduce not only the need for mechanical ventilation, but also mortality.

The pandemic caused by the Sars Cov 2 virus has collapsed health the health system woldwide. The problem with this virus is not only the speed of transmission, but also its clinical characteristics. The most serious are hypoxaemia and systemic hypoxia, caused by imbalance in pulmonary ventilation and perfusion and alveolar inflammation, which significantly increase the risk of mortality.

So far, a great deal of research has been carried out on Covid 19, its multiple characteristics and the different conditions following infection, but none has proposed Hyperbaric Oxygen Therapy as a treatment to combat the hypoxaemia produced by the virus. Therefore, a group of Argentinean biochemists from the Biobarica Network, decided to develop the first randomised clinical trial using a hyperbaric chamber with Revitalair 430F technology. 

Trial:

The main objective of this trial was to test the efficacy and effectiveness of hyperbaric oxygenation treatment in Covid 19 patients with severe hypoxaemia, to reduce the correction times of low blood oxygen level, as well as to reduce inflammation. On the other hand, they evaluated whether there was a decrease in respiratory distress, need for mechanical ventilation and mortality.

For the study, a group of 80 patients on Covid19 was selected from three public hospitals in Buenos Aires. They were randomly divided into two groups of 40. The control group received standard therapy following the guidelines of the Ministry of Health of the Argentine Republic, while the second group, in addition to traditional care, was prescribed hyperbaric oxygenation treatment at 1.45 atmospheres (HBO), consisting of a daily 90-minute session for one week.

The analysis was interrupted, with the corresponding authorisation of the Ethics Committee, when 50% of the patients showed significant improvements after the treatment.

In choosing the equipment, the professionals based their decision on the multiple benefits of the chamber in the pandemic context: chambers with Revitalair 430F Technology work at a pressure of 1.45 ATA, which makes the treatment neurologically safe and reduces the chances of lung injury as much as possible. On the other hand, working at this pressure generates less energy expenditure, thus a greater possibility of meeting the demand. The ease of operation, disinfection and transportation of the chamber was also taken into account: not only does this type of equipment offer quick installation, thus avoiding the need to move the patient to other areas, but it also reduces the risk of virus transmission.

The only adverse effects recorded in the study were ear pain and/or obstruction, significant and constant changes in heart rate after 4 hours of treatment and barotrauma.These effects are not considered significant.

Conclusions:

The study showed that patients who received hyperbaric oxygenation therapy achieved correction of hypoxaemia in only 3 days and consequently improved their arterial saturation, while the control group required 9 days to improve their hypoxic condition. In addition, it led to an increase in blood and tissue oxygen saturation, improved inflammatory response and improved cytokine levels in the patients.

In patients with more complex conditions, a decrease in the need for mechanical ventilation and mortality was observed.

The professionals concluded that hyperbaric oxygen therapy is a highly effective option to treat cases of hypoxaemia in patients with Covid 19 since, thanks to the fact that the patient breathes high concentrations of oxygen in a pressurised environment at 1.45 atmospheres, they can raise their blood oxygen levels and thus avoid the need for mechanical ventilation and reduce the risk of mortality.

In severe cases or emergency situations, this therapy could be the first step before the patient is transferred to intensive care and could even generate great improvements in just a few sessions.

On the other hand, the benefits of the chamber in this healthcare context, such as easy transportation and cleaning, are essential to meet the high demand and provide a safe and high quality service.

Although more studies are still needed to continue advancing treatments for both Covid 19 and Post-Covid symptoms, this work has been of great importance as it was the first randomised clinical trial in Argentina to use a hyperbaric chamber.

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