What are considerations for use of hyperbaric oxygen therapy (HBOT) in pediatric patients?

Updated: Nov 16, 2020
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Pediatric patients also have special concerns. The proportion of surface area to body mass is much greater in children than in adults. As temperature in the chamber can fluctuate, care must be taken to ensure the child remains warm without causing hyperthermia. This can be more difficult in a monoplace chamber because the patient cannot be physically reached from outside the chamber to provide blankets or warmed water as heat sources. Unless children can focus and equalize their ears, consideration for placement of tympanostomy tubes should be discussed with the parents to prevent middle ear barotrauma.

Oxygen administration is easy in a monoplace chamber because the chamber is pressurized with oxygen. Multiplace chambers can fashion equipment to fit the child. A neck ring can be fitted over the child’s torso, or, if the child is small enough, 2 hoods can be placed together to form a capsule around the child. Care must be taken when treating patients with ductal dependent lesions, as oxygen is a signal for ductus arteriosus closure. This has not been a documented problem in pregnancy. Bronchopulmonary dysplasia in a preterm infant, as is associated with mechanical ventilation and elevated oxygen tensions, can be accelerated with HBOT. [2]

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