• emergency care systems

Dr Cannellotto and colleagues have published a prospective, multi-centred, open-label randomised controlled study of hyperbaric oxygen (HBO₂) as an adjuvant treatment for patients with COVID-19 who have severe hypoxemia. The study included 40 patients, 20 in the HBO₂ treatment arm and 20 in a control (no HBO₂) arm who were unable to achieve an oxygen saturation of 90% despite oxygen supplementation. In the current era—both in terms of well conducted research and especially given the COVID-19 pandemic—this is a deceptively difficult challenge to overcome. HBO research is often hobbled by preconceptions about its utility and the costs of performing it appropriately. I would also point out that this was done in Argentina even though the majority of patients with COVID-19, if not the majority of HBO₂ chambers themselves, lie outside of that country. This group of interested, committed clinicians were trying to improve the care of their patients with COVID-19 in a time of a pandemic and also managed to write up their work on behalf of all. Bravo.

The study by Cannellotto and colleagues1 balanced many factors relating to COVID-19 so as to be maximally safe for the enroled participants. The authors selected a very low treatment pressure, 1.45 ATA, and by doing so attempted to minimise any haemodynamic risks for the enroled patients. Those less familiar with HBO₂ should know that 1.4 ATA is the minimum …