How Safe is Hyperbaric Oxygen Therapy for Ostomy Patients? A Pilot Case Series

Background

Hyperbaric Oxygen Therapy (HBOT) delivers 100% oxygen at a pressure higher than sea level. HBOT is approved for a number of indications such as refractory osteomyelitis, soft tissue radionecrosis, compromised graft/flap, osteoradionecrosis, diabetic lower extremity wounds, decompression sickness, carbon monoxide poisoning and air embolism [1]. Ostomy patients in need of HBOT are often left untreated because of the lack of published data about the safe utilization of this therapy for these patients. In this case series we report the effects of HBOT on 5 ostomy patients.

Case

Sixty-two HBOT patient records were reviewed from 2012 to 2013.  Out of these patients 5 had ostomies during HBOT, 3 female and 2 male.  They ranged in age from 20 to 72 years.  Type of ostomies included colostomy (3), ileostomy (1) and gastrostomy (1) with duration ranging from 1 year to over 30 years.  Reasons for ostomies consisted of ovarian cancer (1), colon cancer (2), ulcerative colitis (1) and unknown (1). Adverse effects from ostomies included stoma bleeding (1), painful abdominal gas (1) and skin irritation (1). HBOT pressures ranged from 2.0 to 2.5 atmospheres absolute for 90 minutes duration for 30 to 60 treatments. Diagnoses for HBOT were all unrelated to their ostomies and consisted of compromised graft (2), refractory osteomyelitis (1) and soft tissue radionecrosis (2). Reported adverse effects from HBOT included claustrophobia (1) and ear pain (1), none of which required terminating the HBOT course.  Positive effects reported by patients undergoing HBOT were reduction of stoma bleeding (1) and improvement in vision (1).  There were zero mortalities related to HBOT. 

Conclusions

HBOT was well tolerated by these ostomy patients as indicated by lack of mortalities or serious adverse effects.  A larger case series is warranted to further study the relationship between ostomy patients and their tolerance of HBOT.