HYPERBARIC OXYGEN THERAPY IN SEVERE INTRA-ABDOMINAL INFECTIONS AND COMPLICATIONS IN CHILDREN
Uusijarvi J1, Larsson A1, Lind F1, Gullberg N2, Rutqvist J3, Svensson PJ3
1Division of Hyperbaric Medicine, Department of Anaesthesiology and Intensive Care, 2Department of Paediatric Anaesthesiology and Intensive Care, 3Department of Paediatric Surgery, Karolinska University Hospital, Solna, Sweden
BACKGROUND:
Severe widespread abdominal infection is a feared complication after surgery. We have used our protocol for severe soft tissue infections, including active and repeated diagnostics, surgical intervention, antibiotics and hyperbaric oxygen (HBO2) to treat three critically ill children.
MATERIALS AND METHODS:
We report three children with life threatening abdominal infections treated in the ICU with an open abdomen and ventilator support. They received HBO2 -therapy (initially at 2.8 ATA twice daily) with a total of 41, 20 and 93 sessions respectively. Indications for HBO2 were: (boy 10 y.o.) chronic pancreatitis due to a congenital pancreatic cyst, refractory infection following pancreatectomy with KNS and Pseudomonas spp. treated with acetic acid instillation, central vein thrombosis, sepsis and 8 months hospitalization; (boy 6 y.o.) intestinal ischemia due to spontaneous gastric perforations after a colonic interposition operation following oesophageal atresia; and (boy 4 y.o.) ischemia-reperfusion injury after colonic surgery.
RESULTS:
After achieving infection control, all three cases healed and are fully rehabilitated. The 4 y.o. boy had an early recurrence (abscess that drained spontaneously through the abdominal suture line) which was treated conservatively with HBO2 with good end result. Follow-up after HBO2 was 22, 19 and 4 months, respectively.
CONCLUSIONS:
Our three patients have clinically turned over into success due to multidisciplinary cooperation including the use of HBO2. We recommend that HBO2 is considered in clinical praxis in similar cases.
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