Oxygen Toxicity and Common Uses of HBOT in Small Animal Patients: A Retrospective Analysis of 2,756 Treatment Sessions

Hyperbaric oxygen therapy (HBOT) is commonly utilized for various human conditions with a low incidence of major adverse effects (0.002-0.035%). Despite growing use in veterinary patients, there remains a paucity of literature describing its use and associated complications. The purpose of this study was to report clinical use of HBOT in small animals, identify the rate of major adverse events, and assess clinical improvement in a large subset of patients with intervertebral disc disease (IVDD) receiving HBOT following decompressive surgery. Electronic medical records from an academic teaching hospital were searched for small animals receiving HBOT between November 2012 and February 2020. Data extracted from the medical records included signalment, treatment indication, and adverse events. For cases with IVDD undergoing decompressive surgery, the duration of clinical signs and outcomes were also collected. Treatment sessions totaled 2,756 in 542 dogs and 24 cats. Common indications included neurologic injuries (50.4%), tissue healing (31.4%), control of oomycete infection (5.5%), neoplasia or post-radiation injury (5.4%), and various miscellaneous conditions (7.4%). Oxygen toxicity, manifesting as tremors or generalized seizures, occurred in 0.7% of treatment sessions, with increasing age (p=0.009) and female sex (p=0.008) identified as risk factors. Patients with IVDD (n=156) were younger (p=0.004) and underwent fewer treatment sessions than other indications (p=0.049). In conclusion, HBOT appeared safe across various indications, although oxygen toxicity affecting the central nervous system was higher than reports in humans. Future prospective, randomized, controlled trials should evaluate specific clinical indications and outcomes. <br>

高压氧治疗（Hyperbaric Oxygen Therapy, HBOT）常被应用于多种人类疾病的治疗，其严重不良反应发生率较低（0.002%~0.035%）。尽管该疗法在兽医临床患者中的应用日益增多，但目前描述其应用及相关并发症的文献仍较为匮乏。本研究旨在报告高压氧治疗在小型动物中的临床应用情况，明确严重不良事件的发生率，并评估大量接受减压手术后行高压氧治疗的椎间盘疾病（Intervertebral Disc Disease, IVDD）患者的临床改善效果。本研究检索了某教学医院2012年11月至2020年2月期间收治的接受高压氧治疗的小型动物的电子病历。从病历中提取的数据包括个体基本信息、治疗适应证及不良事件。对于接受减压手术的椎间盘疾病患者，本研究同时收集了其临床症状持续时长及转归情况。本次研究共纳入542只犬和24只猫，累计实施治疗2756次。常见治疗适应证包括神经系统损伤（50.4%）、组织修复（31.4%）、卵菌感染控制（5.5%）、肿瘤或放射治疗后损伤（5.4%），以及其他各类杂项病症（7.4%）。以震颤或全身性癫痫发作为表现的氧中毒在0.7%的治疗疗程中出现，研究发现年龄增长（p=0.009）与雌性性别（p=0.008）为该不良事件的危险因素。椎间盘疾病患者队列（n=156）相较于其他适应证患者更为年轻（p=0.004），且接受的治疗疗程更少（p=0.049）。综上，高压氧治疗在各类适应证中均表现出良好的安全性，但累及中枢神经系统的氧中毒发生率高于人类相关研究报道。未来应开展前瞻性随机对照试验，以评估高压氧治疗在特定临床适应证中的应用效果及转归。