Hyperbaric O2 seizures: Treatment

Advanced, Clinical Sciences: Anesthesia Procedures, Methods, and Techniques

Hyperbaric oxygen therapy (HBO) is an adjunctive therapy used to treat a number of specific conditions, including acute venous or arterial gas embolism (to reduce the gas bubble size), severe carbon monoxide or cyanide poisoning, to improve wound healing (non-healing ulcers, skin grafts, etc), decompression sickness, and acute traumatic or ischemic injuries (crush, compartment syndrome, etc). The theory behind HBO revolves around Henry’s Law, which states that at a constant temperature and at equilibrium, the amount of gas that dissolves in a liquid is directly proportional to its partial pressure. At sea level, i.e. 1 atm, the dissolved plasma oxygen concentration is 0.3 mL/dL, whereas hyperbaric oxygen delivered at 3 atm results in a dissolved plasma oxygen concentration of 6 mL/dL. 

Management of CNS oxygen toxicity seizures is terminating the HBO therapy session, decreasing the FiO2 to 0.21, giving anticonvulsant therapy, and ultimately supportive care.2


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Kathryn Kirkpatrick, MD