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From Louisiana to Long Island, hyperbaric chambers, once used only to treat divers suffering from the bends, are increasingly being used to treat COVID-19 patients with surprising success.
While the numbers are small, doctors at more than a dozen hospitals across the country say hyperbaric oxygen therapy (HBOT) is saving the lives of even the most critically ill coronavirus patients.
"The results thus far are pretty impressive," Dr. Thomas Serena, founder and director of the SerenaGroup, a family of wound, hyperbaric and research companies, said in a recent interview.
At NYU Winthrop Hospital in Mineola, New York, Dr. Scott Gorenstein, the director of hyperbaric medicine, said, "I'm encouraged that hyperbaric oxygen could be a benefit."
[...] Their study compared 20 COVID-19 patients who received HBOT to 60 similar patients who did not. While their study is being peer-reviewed and has yet to be published, the results they shared are stunning.
Of the 60 patients who did NOT receive HBOT, half of them needed to be placed on ventilators and 13 died. That's a mortality rate of 22%. At the same time, the 20 patients who did receive HBOT, only two needed to be placed on ventilators and both died, which is a much lower mortality rate of 10%.
"It's small numbers," Dr. Lee noted in a cautious tone but added, "The findings suggest that hyperbaric oxygen could reduce the mortality of this disease by half."
(Score: 2) by looorg on Monday July 27 2020, @01:06PM (26 children)
Everything that works is nice I guess. But if this is the thing that worked one might be in even more trouble then with the ventilators, cause there are a lot more of them then there are hyperbaric (or diving) chambers available. It probably won't be very efficient either if you just send one patient in at a time cause you can't just show all the sick people in as a group, I guess.
(Score: 2) by HiThere on Monday July 27 2020, @01:56PM (2 children)
Yes. Hyperbaric chambers are a lot more expensive than ventilators. And require more room to use/store.
OTOH, I suspect that the benefit would be obtained with a very mild increase in pressure, it's not like they're treating the bends.
OTTH, there's a question of how long the patients would need to be kept under pressure. One of the reasons ventilators were so deadly was the amount of time patients had to be one them.
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(Score: 3, Insightful) by JoeMerchant on Monday July 27 2020, @07:40PM (1 child)
Between ventilator and HBOT, I'd 1000% prefer to be treated with HBOT.
Modern ventilators are still crude devices which can easily, and often do, cause internal injuries... while they are saving your life.
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(Score: 0) by Anonymous Coward on Monday July 27 2020, @08:26PM
Yes, there are anecdotes of covid patients asking to go back in the HBOT chambers because it was so calm and peaceful. No one has ever said that about a ventilator.
(Score: 2) by c0lo on Monday July 27 2020, @02:03PM (5 children)
I suspect that the treatment is limited in time, pure oxygen is toxic [sciencefocus.com] in prolonged exposures.
This means there could be 10-15 patients/day in round robin allocation per chamber.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 2) by looorg on Monday July 27 2020, @02:15PM
Perhaps, but for interest I looked up how many chambers was available in my region and for the civilian medical sector it wasn't exactly a lot of them -- which is reasonable. I suspect that the military naval base might have some that are suited for more then one patient (or diver) at a time. The normal treatment took 2h and had to be repeated multiple times. So it's hard to say how long this would require but say if you can cut out at least a few minutes on each the question might be if they have to do it over and over again. Then there really is very limited availability if a lot of people would need this. But I guess some is better then none.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @02:28PM (3 children)
Hmm. How about using hyperbaric air instead of hyperbaric oxygen? Or use a concentration of oxygen less than 100%.
(Score: 2) by sjames on Monday July 27 2020, @05:16PM (2 children)
If you have an inert gas in the hyperbaric atmosphere, you have to follow a decompression protocol to avoid giving the patient the bends.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @05:57PM (1 child)
A 2 atm chamber is like a 10 meter dive. Decompression isn't needed for that: https://www.scubadivingearth.com/how-deep-can-you-dive-without-decompression-no-decompression-stop-limits/. [scubadivingearth.com]
Nevertheless I'm sure they do gradually reduce the pressure over the course of a few minutes.
(Score: 2) by sjames on Wednesday July 29 2020, @03:31AM
True for a 2 ATM chamber for someone in reasonable health. Some treatments call for greater pressure, and I'm not sure if there's a problem when the patient is hypercoagulable (a problem with COVID).
Of course, many chambers use air but provide 100% O2 through a mask.
(Score: 2) by Immerman on Monday July 27 2020, @02:06PM (15 children)
>cause you can't just show all the sick people in as a group, I guess.
Why not?
I mean obviously it depends on the size of the chamber, but so long as the chamber is big enough I don't see a problem - social distancing isn't relevant to people who are already infected, and having at least one functional person in the chamber could be a good idea in case anyone needs urgent medical attention* - it's not like you can just open the door and help out if someone has problems. Though I suspect a lot of chambers are single-patient sized since there's not normally a huge amount of demand.
Perhaps we can get SpaceX to build a bunch of stainless steel chambers - they've already got the production facilities for large pressure chambers capable of withstanding much higher pressures, and there's a lot fewer medically sensitive fiddly bits than in ventilators.
*come to think of it, given the number of people who never develop life-threatening symptoms, but still have a long recovery time before they stop being contagious, it seems like there's a huge opportunity to recruit them as assistants to relieve the strain on the professionals - they can be simultaneously quarantined while moving freely amongst the incapacitated patients without fear of infection. You probably wouldn't want them giving injections or engaging in other activities that are potentially lethal without proper training, but a whole lot of caring for sick people is basically cleaning and room service.
(Score: 2) by looorg on Monday July 27 2020, @02:18PM (14 children)
Fair point. I found it somewhat interesting so I looked up how many of these the region I'm in have for civilian medical use -- it seems they are all single person chambers and there was not a lot of them. But I suspect the Naval base might have at least one or two that could take more then one diver at a time. But still it's a very limited quantity of spaces available if this works, but I guess some is better then none.
(Score: 2, Touché) by Anonymous Coward on Monday July 27 2020, @02:44PM (13 children)
You could also pressurize airplanes and roll the patients in there.
(Score: 2) by looorg on Monday July 27 2020, @02:50PM (3 children)
If that could done one could more or less have solved the scalability factor of the problem, cause if you can treat 100+ people at a time then you might be in business so to speak. Considering how air travel companies are now seeing massive downturns in travel and flying I guess there shouldn't be to many issues finding suitable aircrafts to use either. It should be easier to find a suitable aircraft then say a submarine.
(Score: 2) by DECbot on Monday July 27 2020, @08:11PM (1 child)
I like the idea, but avoid the 737 and 777 as those have a proven track records for generating engineering case studies. Perhaps the older 747 air frames would work better, especially the double-decker versions as you can designate the upper level for staff only.
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(Score: 2) by Immerman on Monday July 27 2020, @09:15PM
Shouldn't be much of an issue sitting on the ground. Cabins very rarely spontaneously lose pressure, and if they do... then you've got what, a mild case of bends? Heck, if you've been breathing nearly pure oxygen I don't think even that's an issue, since you haven't been dissolving pressurized nitrogen into your bloodstream.
(Score: 0) by Anonymous Coward on Tuesday July 28 2020, @10:57AM
Hey, a use for the Boeing 737 Max where it won't dive into the ground.
(Score: 2) by Runaway1956 on Monday July 27 2020, @03:15PM (2 children)
I don't know if that's genius level thinking or not - but it certainly deserves a touche mod. I'd have never thought of it!!
(Score: 1, Interesting) by Anonymous Coward on Monday July 27 2020, @03:19PM
People have been talking about doing that for awhile: https://www.theengineer.co.uk/aircraft-hbot-hyperbaric-oxygen-chambers/ [theengineer.co.uk]
(Score: -1, Offtopic) by Anonymous Coward on Monday July 27 2020, @11:57PM
Classic Runaway!
May I suggest an "off-topic"? Possibly an "apropos of nothing", if we had such a mod.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @03:25PM (5 children)
Nice idea and could be helpful, but imo there aren't any pressurized aircraft that can take 3 atmospheres (as quoted elsewhere). So you could raise the fraction of O2, but not at very high pressures. This https://en.wikipedia.org/wiki/Cabin_pressurization [wikipedia.org] suggests that the remaining Concorde SSTs (at various museums?) would be good candidates, they operated at higher altitude and thus higher pressurization than sub-sonic jets.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @03:49PM
They use 1.5-2 atm from what Ive read.
(Score: 2) by looorg on Monday July 27 2020, @03:57PM (3 children)
How about a submarine? Wouldn't that stand up to said pressure. You just have to disconnect and remove all the secret equipment first.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @08:14PM (2 children)
The problem I see for that is that planes and subs are made to be crushed by higher pressures on the outside. Hyperbaric chambers would blow out with the higher pressures on the inside. The forces and strains on the materials involved are much different.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @08:32PM (1 child)
Planes at altitude have higher pressure inside than outside. And the pressures we are talking about are equivalent to a 10 meter dive (2 atm), so pretty sure subs would be accidentally designed to handle this despite being meant to have higher pressure outside.
In this interview they say the planes are routinely pressurized on the ground as part of maintenance: https://www.hbotnews.org/dr-ted-fogarty-makes-his-case-to-trump-for-his-covid-19-solution/ [hbotnews.org]
(Score: 2) by Immerman on Monday July 27 2020, @09:21PM
I'm pretty sure most modern subs operate at atmospheric pressures (operating at ambient pressures would mean taking many, many hours to surface to prevent sailors getting the bends).
However, *all* subs are designed to dive, and they only have to dive a few dozen meters to ensure the external pressure exceeds whatever internal pressure they want. Might be some issues with some sealed equipment imploding under the pressure though.
(Score: 0) by Anonymous Coward on Monday July 27 2020, @02:30PM
Luckily the hyperbaric treatment has caught on as a health fad, so that there are more facilities around the country.