Hyperbaric oxygen therapy effects on pulmonary functions: a prospective cohort study

Background: Oxygen toxicity is one potential side effect of hyperbaric oxygen therapy (HBOT). Previous smallstudies showed mild reductions in pulmonary functions reflecting reductions in small airway conductance afterrepetitive hyperbaric oxygen sessions. However, there are no updated data with well performed pulmonary teststhat address the pulmonary effect of the currently used HBOT protocols.The aim of this study was to evaluate the effect of HBOT on pulmonary functions of patients receiving the currentlyused HBOT protocol.Methods: Prospective analysis included patients, 18 years or older, scheduled for 60 daily HBOT sessions between2016 and 2018. Each session was 90 min of 100% oxygen at 2 ATA with 5 min air breaks every 20 min, 5 days perweek. Pulmonary functions, measured at baseline and after HBOT, included forced vital capacity (FVC), forcedexpiratory volume in 1 sec (FEV1) and peak expiratory flow rate (PEF).Results: The mean age was 60.36 ± 15.43 and 62.5% (55/88) were males. Most of the patients (83/88, 94.3%) didnot have any pulmonary disease prior to inclusion and 30.7% (27/88) had a history of smoking.Compared to baseline values, at the completion of 60 HBOT sessions, there were no significant changes in FEV1(0.163), FEV1/FVC ratio (0.953) and FEF25–75% (0.423). There was a statistically significant increase though notclinically relevant increase in FVC (0.1 ± 0.38 l) and PEF (0.5 ± 1.4 l) with a 0.014 and 0.001 respectively.Conclusion: Regarding pulmonary functions, repeated hyperbaric oxygen exposure based on the currently usedHBOT protocol is safe. Surprisingly, there was a modest non clinically significant though statistically significantimprovement in PEF and FVC in the current cohort of patients who were without chronic lung disease