Hyperbaric oxygen therapy in patients of a pediatric rheumatology service

The hyperbaric oxygen therapy consists in the breathing of pure oxygen under pressures higher than one atmosphere and has been used in the treatment of ulcerated lesions of various etiologies. Six patients followed at the Rheumathology Unit, Instituto da Criança, Hospital das Clínicas, Faculty of Medicine, São Paulo University, between 1996 and 2002, were submitted to hyperbaric oxygen therapy. This therapy was indicated by the presence of chronic osteomyelitis and tissue ulcer (vasculitis or infection) not responsive to the usual treatment. Two patients presented cutaneous polyarteritis, two presented chronic recurrent multifocal osteomyelitis, one presented diffuse cutaneous sclerodema and one presented pyoderma gangrenosum. Five patients were girls (age range from 6 to 13.2 years-old). The sessions of hyperbaric oxygen therapy were performed under pressures that ranged from 2.4 to 2.8 absolute atmospheres and their duration were two hours. The lowest number of sessions was 18 and the highest was 80. Five patients presented complete resolution of the injuries. The patient with cutaneous sclerodema suspended the treatment after the 18th session, because she went back to her birthplace with partial improvement of the cutaneous injuries. The main adverse event during the sessions was ear pain after the first sessions, which disappeared with reduction of the pressure inside the chamber and the duration of the session. Spandrel perforation or other adverse events were not observed. The hyperbaric oxygen therapy was efficient and well tolerated by patients with rheumatic diseases and ulcerated injuries by vasculitis, infected injuries or chronic osteomyelitis.

hyperbaric oxygen therapy; scleroderma; vasculitis; osteomyelitis; children; adolescents


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