Hyperbaric oxygen treatment and pulmonary air-containing lesions

Introduction: Pulmonary barotrauma is a rare but serious complication of hyperbaric oxygen treatment. Pulmonary air-containing lesions may predispose pulmonary barotrauma by causing air trapping during changes in environmental pressure. This study aimed to investigate whether pulmonary air-containing lesions cause pulmonary barotrauma during hyperbaric oxygen treatment. Methods: This study retrospectively analysed data from individuals who presented to the Undersea and Hyperbaric Medicine Clinic at Gülhane Training and Research Hospital, Health Sciences University, between 2017 and 2022. The relationship between presence of pulmonary air-containing lesions on computed tomography and pulmonary barotrauma was evaluated. Results: Gas containing lesions were not associated with an increased risk of pulmonary barotrauma. The incidence of pneumothorax during hyperbaric oxygen was extremely low (0.0059% per session, 0.15% per patient). Conclusions: Pulmonary air-containing lesions, including bullae, were not associated with an increased risk under standard hyperbaric oxygen treatment protocols. Routine chest computed tomography screening is not warranted due to the low complication rate. Nevertheless, clinical evaluation and informed consent are essential, particularly for patients with underlying lung disease. Further studies are needed to improve risk assessment.