title: Middle ear barotrauma in hyperbaric oxygen therapy.
abstract: BACKGROUND
  Middle ear barotrauma (MEB) is a common complication of hyperbaric oxygen (HBO2) therapy. The purpose of this study was to determine the overall incidence of MEB and evaluate for differences in the incidence of MEB at different rates of compression (ROC). The study also sought to identify other potential risk factors for MEB.
  
  
  METHODS
  A retrospective chart review was performed on patients undergoing HBO2 at an academic regional level 1 trauma center. The MEB overall incidence as well as incidence at different ROC were determined.
  
  
  RESULTS
  236 patients representing 4,981 treatments were analyzed. The overall incidence of MEB was 43.2%. There was no statistically significant difference in the incidence of MEB at different ROC. There was a statistically significant higher incidence of TEED 4 MEB in intubated patients (p < 0.0001). The vast majority of MEB was minor when considering severity based on overall lower TEED scores of 1 or 2 (84%).
  
  
  CONCLUSIONS
  The overall incidence of MEB in this study is consistent with those previously reported. It is important to note that a vast majority of MEB was minor. This supports HBO2 as a safe treatment modality with minimal overall risk. The current study supports standardization of most treatment protocols to a ROC of 2 psi/minute.
authors.affiliation: Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, NY, USA. heyboerm@upstate.edu
authors.forename: Marvin
authors.initials: M
authors.lastname: Heyboer
authors.forename: Susan M
authors.initials: SM
authors.lastname: Wojcik
authors.forename: William D
authors.initials: WD
authors.lastname: Grant
authors.forename: Patrick
authors.initials: P
authors.lastname: Chambers
authors.forename: Shane
authors.initials: S
authors.lastname: Jennings
authors.forename: Patrick
authors.initials: P
authors.lastname: Adcock
mesh_terms: D001274:Atmospheric Pressure; D001469:Barotrauma / Q000453:epidemiology* / Q000209:etiology; D016292:Procedural Sedation; D003243:Consciousness; D004432:Ear, Middle / Q000293:injuries*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects* / Q000706:statistics & numerical data; D015994:Incidence; D007440:Intubation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011312:Pressure / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors