1. Five sessions of hyperbaric oxygen for critically ill patients with COVID-19-induced ARDS: A randomised, open label, phase II trial.
- Author
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Kjellberg A, Douglas J, Pawlik MT, Hassler A, Al-Ezerjawi S, Boström E, Abdel-Halim L, Liwenborg L, Jonasdottir-Njåstad AD, Kowalski J, Catrina SB, Rodriguez-Wallberg KA, and Lindholm P
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Germany epidemiology, Treatment Outcome, Sweden, Intensive Care Units, Early Termination of Clinical Trials, SARS-CoV-2, COVID-19 therapy, COVID-19 complications, Hyperbaric Oxygenation methods, Respiratory Distress Syndrome therapy, Respiratory Distress Syndrome etiology, Critical Illness therapy
- Abstract
Background: Few treatment options exist for patients with COVID-19-induced acute respiratory distress syndrome (ARDS). Data on the benefits and harms of hyperbaric oxygen treatment (HBOT) for this condition is limited., Objective: To evaluate benefits and harms of HBOT in patients with COVID-19 induced ARDS., Methods: In this open-label trial conducted at three hospitals in Sweden and Germany, patients with moderate to severe ARDS and at least two risk factors for unfavourable outcome, were randomly assigned (1:1) to medical oxygen 100 %, 2·4 Atmospheres absolute (ATA), 80 min (HBOT) adjuvant to best practice or to best practice alone (Control). Randomisation was stratified by sex and site. The primary endpoint was ICU admission by Day 30., Results: Between June 4, 2020, and Dec 1, 2021, 34 subjects were randomised to HBOT (N = 18) or Control (N = 16). The trial was prematurely terminated for futility. There was no statistically significant difference in ICU admission, 5 (50 %) in Control vs 13 (72 %) in HBOT. OR 2·54 [95 % CI 0·62-10·39], p = 0·19., Harms: 102 adverse events (AEs) were recorded. 16 (94 %) subjects in the HBOT group and 14 (93 %) in the control group had at least one AE. Three serious adverse events (SAEs), were at least, possibly related to HBOT. All deaths were unlikely related to HBOT., Conclusions: HBOT did not reduce ICU admission or mortality in patients with COVID-19-induced ARDS. The trial cannot conclude definitive benefits or harms. Treating COVID-19-induced ARDS with HBOT is feasible with a favourable harms profile., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: KRW disclose funding from the Swedish Research Council, grant number KBF 2019–00446 for the current trial. JK disclose consulting fee for statistical work in this trial. For a full disclosure, please see Appendix A., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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