Hyperbaric Oxygen Therapy for Necrotizing Soft Tissue Infections Reduces Mortality

However, it increases length of hospital stay and costs.


Controversy exists regarding the indications for hyperbaric oxygen therapy (HBO) in the treatment of necrotizing soft tissue infections. In a secondary analysis of 45,913 patients with necrotizing soft tissue infections who were included in the Nationwide Inpatient Sample database from 1988 to 2009, researchers compared outcomes between patients who did and those who did not receive HBO.

The 405 patients who received HBO had more comorbidities and were more likely to be in larger, urban hospitals. No HBO-related complications were documented. The authors used propensity score analysis to reduce potential bias in patient characteristics between groups. Patients who received HBO had significantly lower mortality (4.5% vs. 9.4%; odds ratio, 0.49); however, they also had longer hospital stays (adjusted median, 14.3 vs. 10.7 days) and higher hospital costs (adjusted median, US$52,205 vs. $45,464). Patients with clostridial myonecrosis did not have a survival benefit from HBO; however, the authors note that the subgroup analysis might have been underpowered.


Citation(s):

Soh CR et al. Hyperbaric oxygen therapy in necrotising soft tissue infections: A study of patients in the United States Nationwide Inpatient Sample. Intensive Care Med 2012 Jul; 38:1143.