Hyperbaric Oxygen Treatment of Postoperative Neurosurgical Infections

Larsson, Agneta; Engström, Mats; Uusijärvi, Johan; Kihlström, Lars; Lind, Folke; Mathiesen, Tiit

doi:10.1227/01.neu.0000316260.67220.cf

Cited by 30 publications

(32 citation statements)

References 22 publications

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“…This is a remarkable improvement in comparison to the outcomes in previous reports [7, 23-31], where hardware removal was undertaken for infection resolution in almost every instance (see Table 3 for comparison). Our results agree with the benefit of adjuvant HBOT reported in other neurosurgical infections such as cranial bone flap osteomyelitis [12, 32, 33] and spinal implants [34]. …”

Section: Discussionsupporting

confidence: 91%

“…Hyperbaric oxygen therapy (HBOT) has been shown to have beneficial effects in the treatment of neurosurgical infections, such as spontaneous brain abscesses [11] and complicated postoperative cranial and spinal wound infections [12]. HBOT is considered safe, improving the clinical outcome in patients with surgical and nonsurgical central nervous system infections by reducing the need for reoperations, and allowing infection resolution without the removal of foreign material.…”

Section: Introductionmentioning

confidence: 99%

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Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation

Bártek

Skyrman

Nekludov

et al. 2018

Stereotact Funct Neurosurg

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Background: In neuromodulation therapies, hardware-related infections are a major challenge often leading to hardware removal. Objective: To investigate the role of adjuvant hyperbaric oxygen therapy (HBOT) in hardware-related infections. Methods: Fourteen hardware-related infection events in 12 consecutive patients between 2002 and 2015 were treated with antibiotics and adjuvant HBOT at the Karolinska University Hospital (Stockholm, Sweden). Two time-independent infection events related to hardware replacements occurred in 2 patients. Infection resolution and the need for hardware removal were assessed. Results: Twelve out of 14 events of hardware-related infection were successfully treated without hardware removal (86%). The 2 patients treated twice with HBOT on 2 time-independent occasions could retain their hardware in both cases. Hardware was removed following HBOT failure in 2 infection events, with long-term infection control achieved in all patients. Further, an intrathecal pump malfunction caused by HBOT at 2.8 bars was observed, leading to a change in the manufacturer’s guidelines. Conclusions: This study indicates a potential benefit of adjuvant HBOT in the treatment of hardware-related infections in neuromodulation, diminishing the need for hardware removal and treatment interruption. Prospective studies are warranted to establish the role of adjuvant HBOT in the treatment of hardware-related infections in neuromodulation.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation

Bártek

Skyrman

Nekludov

et al. 2018

Stereotact Funct Neurosurg

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“…The six patients with postoperative deep infections were expected to have a complicated course of their infection treatment, it was therefore decided to introduce HBO as an adjuvant without delay based on the earlier good results from the neurosurgical department of the same hospital [4]. They were not suitable candidates for plastic surgical flaps due to poor soft tissues, and unsuccessful earlier trials.…”

Section: Methodsmentioning

confidence: 99%

“…Hyperbaric oxygen therapy has been added to treatment protocols in a variety of neurosurgical and orthopaedic infections and postoperative complications in bone and soft tissues [4], [20] with successful outcomes.…”

Section: Mechanism Of Action and Rationale For Hbo Treatmentmentioning

confidence: 99%

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Hyperbaric oxygen in the treatment of postoperative infections in paediatric patients with neuromuscular spine deformity

et al. 2011

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The aim of this study is to evaluate possible benefits of hyperbaric oxygen (HBO) therapy in the treatment of deep postoperative infections in six high risk paediatric patients with neuromuscular spine deformity. The study involved review of medical records including radiology, office visits, and telephone contacts for six patients, referred for postoperative HBO therapy in [2003][2004][2005]. Infection control and healing without removal of implants or major revision surgery with a minimum of 2-year follow-up after index surgery were considered to represent success. All infections were resolved. Median time for wound healing, normalisation of blood tests and antibiotic weaning were 3 months. Radiological bony fusion, intact implants without any signs of radiolucent zones were seen in all cases at a mean follow-up of 54 months . Side effects of HBO treatment were minor. HBO is a safe and potentially useful adjuvance in the treatment of early deep postoperative infections in complex situations with spinal implants in high risk paediatric patients.

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Hyperbaric oxygen therapy prevents vascular derangement during zymosan-induced multiple-organ-failure syndrome

Imperatore

Cuzzocrea²,

Luongo

et al. 2004

Intensive Care Medicine

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Hyperbaric Oxygen Treatment of Postoperative Neurosurgical Infections

Cited by 30 publications

References 22 publications

Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation

Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation

Hyperbaric oxygen in the treatment of postoperative infections in paediatric patients with neuromuscular spine deformity

Hyperbaric oxygen therapy prevents vascular derangement during zymosan-induced multiple-organ-failure syndrome

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