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Hyperbaric oxygen therapy is generally a safe intervention; however, clinicians must remain vigilant for potential complications. Barotrauma can affect any closed, air-filled cavity and is particularly concerning in patients with predisposing conditions or inadequate pressure equalization. Adverse events may include middle ear barotrauma, sinus discomfort, pulmonary barotrauma, and oxygen toxicity. Additional potential complications include claustrophobia or anxiety related to confinement in hyperbaric chambers. Patients with oxygen toxicity may present with pulmonary symptoms such as cough or dyspnea, neurologic manifestations including seizures, or ophthalmologic effects, including myopia. This educational activity provides an overview of current strategies for identifying, managing, and preventing complications that may arise during hyperbaric oxygen therapy. Emphasis is placed on tailoring care plans to individual risk factors and improving patient safety through early recognition of warning signs. This activity also highlights the importance of interprofessional collaboration in enhancing treatment outcomes and minimizing adverse effects. By addressing potential risks and management principles, this activity supports the safe implementation of hyperbaric therapy across diverse clinical settings. Objectives: Identify the key concerns associated with hyperbaric oxygen therapy. Assess the potential complications associated with hyperbaric oxygen therapy. Apply appropriate management strategies to prevent or mitigate the potential complications of hyperbaric oxygen therapy. Implement effective strategies to improve care coordination and interprofessional communication, promoting the safe use of hyperbaric oxygen therapy and optimizing patient outcomes. Access free multiple choice questions on this topic.

Hyperbaric oxygen therapy is considered a safe treatment for various conditions. However, as with virtually all medical treatments, there is a potential for adverse effects. A thorough understanding of these risks enables clinicians to both minimize the potential for some adverse effects and discuss the risks and benefits when offering treatment to patients. A study involving patients treated in monoplace chambers from 2009 to 2010 revealed an estimated incidence of adverse effects of around 0.4%. Among these, ear pain accounted for nearly 50% of the cases, whereas around 25% were classified as confinement anxiety. Complications associated with hyperbaric oxygen therapy can be classified into 2 categories—pressure-related or oxygen-related adverse effects. Pressure-related complications primarily involve barotrauma, which can impact any closed, air-filled cavity, including the ears, sinuses, teeth, lungs, and bowel. Oxygen-related adverse effects can be further subdivided into 3 categories—pulmonary, neurological, and ophthalmological. Alternatively, complications can be classified as primary effects—resulting from pressure and hyperoxia—or secondary effects, stemming from controlled oxidative stress mediated by reactive oxygen and nitrogen species. Confinement anxiety is caused by the physical space of the chamber and is not considered a true complication of hyperbaric oxygen therapy.[1][2][3] Additional considerations include elevated blood pressure, cardiogenic pulmonary edema, hypoglycemia, and risks of increased toxicity with specific chemotherapeutic agents, such as bleomycin and doxorubicin.[4]

Hyperbaric oxygen therapy is a safe and effective treatment for various acute and chronic conditions. However, healthcare professionals need to educate patients about the potential complications associated with this therapy. Although most complications are benign or self-limiting, there can be severe adverse reactions, such as pneumothorax or arterial gas embolism. In addition, patients who undergo multiple therapy sessions may be at risk for developing cataracts. Patients must be informed about these risks before initiating treatment.