Complication of hyperbaric oxygen therapy

A 27-year-old man with a history of a 10-hour coma due to carbon monoxide poisoning was transferred for hyperbaric oxygen therapy (HBOT). His oxygen saturation was 99% while on mechanical ventilation. When he was removed from the chamber, vomiting and nosebleeds occurred, and within 1 minute his heart rate fell to 42 beats per minute and his oxygen saturation dropped to 69%. The patient then developed cyanosis of the head and neck, generalized subcutaneous emphysema (Fig 1), absent bilateral breath sounds, and abdominal distension.