OBJECTIVE: This implementation project compared standard operating procedures, accepted preventive measures, and disinfection procedures between the initial stage of the COVID-19 pandemic (first wave: March 15 to May 31, 2020) and the later stages of the pandemic (second and third waves: September 1, 2020 to January 31, 2021). INTRODUCTION: This project sought to improve compliance with international evidence-based guidelines and clinical standards for the prevention and control of COVID-19 infection during hyperbaric oxygen therapy taking into account the conditions of the local hospital. METHODS: Guided by the JBI evidence implementation framework, seven evidence-based audit criteria were developed for the prevention and control of COVID-19 infection during hyperbaric oxygen therapy. A questionnaire was used to measure compliance in baseline and follow-up audits. RESULTS: Differences between the baseline and follow-up audits were noted for criteria 6 and 7. Criterion 6 increased from 0% to 100% as the hyperbaric facility was equipped with certified ultraviolet-C radiation for air disinfection during the later period, but this equipment was not available in the initial period of the pandemic. Criterion 7 dropped from 100% in the baseline audit to 0% in the follow-up audit because of a significant increase in the operational burden of the treatment capacity of the facility, which made it impossible to comply with the recommended distancing between patients. CONCLUSIONS: Differences were found in preventive measures, disinfection procedures, work organization, and approach to care strategy. The project objectives were met and the implementation strategies proved effective. Larger sample sizes would need be needed to confirm the reproducibility of the results.

Centre for Hyperbaric Medicine of Faculty of Medicine University of Ostrava and Ostrava City Hospital Faculty of Medicine University of Ostrava Ostrava Czech Republic

Centre of Hyperbaric Medicine Ostrava City Hospital Ostrava Czech Republic

Cochrane Czech Republic Czech Republic A JBI Centre of Excellence Czech GRADE Network Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Department of Military Surgery Faculty of Military Health Sciences University of Defence Hradec Králové Czech Republic

Institute of Aviation Medicine Prague Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Laboratory Medicine Faculty of Medicine University of Ostrava Ostrava Czech Republic

See more in PubMed

Roser M, Ritchie H, Ortiz-Ospina E, Hasell J. Coronavirus pandemic (COVID-19) [internet]. OurWorldInData.org. Available from: https://ourworldindata.org/coronavirus.

Gorenstein SA, Castellano ML, Slone ES, Gillette B, Liu H, Alsamarraie C, Jacobson AM, et al. Hyperbaric oxygen therapy for COVID-19 patients with respiratory distress: treated cases versus propensity-matched controls. Undersea Hyperb Med 2020; 47 (3):405–413.

Kjellberg A, De Maio A, Lindholm P. Can hyperbaric oxygen safely serve as an anti-inflammatory treatment for COVID-19? Med Hypotheses 2020; 144:110224.

Zhong XL, Tao XL, Tang YC, et al. Effect of hyperbaric oxygen therapy to treat hypoxia in severe novel coronavirus pneumonia patients: first case report. Chin J Nauti Hyperb Med 2020; 27https://doi.org/10.3760/cma.j.issn.1009-6906.2020.0001 DOI

Paganini M, Bosco G, Perozzo FAG, Kohlscheen E, Sonda R, Bassetto F, et al. The role of hyperbaric oxygen treatment for COVID-19: a review. In: Pokorski M, editor. Medical and biomedical updates. Advances in experimental medicine and biology, vol 1289. Springer; 2020.

Harch PG. Hyperbaric oxygen treatment of novel coronavirus (COVID-19) respiratory failure. Med Gas Res 2020; 10 (2):61–62.

Hedetoft M, Madsen MB, Hyldegaard O. Hyperbaric oxygen treatment in the management of necrotising soft-tissue infections: results from a Danish nationwide registry study. BMJ Open 2023; 13 (2):e066117.

Takac I, Kvolik S, Divkovic D, Kalajdzic-Candrlic J, Puseljic S, Izakovic S. Conservative surgical management of necrotic tissues following meningococcal sepsis: case report of a child treated with hyperbaric oxygen. Undersea Hyperb Med 2010; 37 (2):95–99.

Hedetoft M, Moser C, Jensen PØ, Vinkel J, Hyldegaard O. Soluble ICAM-1 is modulated by hyperbaric oxygen treatment and correlates with disease severity and mortality in patients with necrotizing soft-tissue infection. J Appl Physiol 19852021; 130 (3):729–736.

Millar IL, Lind FG, Jansson K-A, Hájek M, Smart DR, Fernandes TD, et al. Hyperbaric Oxygen for Lower Limb Trauma (HOLLT): an international multi-centre randomised clinical trial. Diving Hyperb Med 2022; 52 (3):164–174.

Madeja R, Pometlova J, Osemlak P, Voves J, Bialy L, Vrtková A, et al. Comparison of fluoroscopy and fluoroscopy-based 2D computer navigation for iliosacral screw placement: a retrospective study. Eur J Trauma Emerg Surg 2022; 48 (6):4897–4902.

Klugarová J, Klugar M, Marečková J, Hájek M. Methodology of systematic review development: the effectiveness of hyperbaric oxygen therapy on mortality in adults with craniotrauma. Cesk Slov Neurol N 2015; 111 (5):555–561.

Takagi G, Yagishita K. Principles of disinfectant use and safety operation in medical facilities during coronavirus disease 2019 (COVID-19) outbreak. SN Compr Clin Med 2020; 2:1041–1044.

Criado PR, Miot HA, Pincelli TPH, Fabro AT. From dermatological conditions to COVID-19: reasoning for anticoagulation, suppression of inflammation, and hyperbaric oxygen therapy. Dermatol Ther 2020; e14565.

Lo JJ, Wang SC, Lee HY, Lee SS, Lee HC, Hung CT, et al. Proactive COVID-19 infection prevention measures in a hyperbaric oxygen therapy center. Medicina (Kaunas) 2020; 56 (6):261.

Chmelař D, Kašíková A, Martineková P, Hájek M, Rozložník M, Brabec M, et al. Effect of hyperbaric air on endotoxin from Bacteroides fragilis strains. Folia Microbiol 2018; 63 (3):283–290.

Porritt K, McArthur A, Lockwood C, Munn Z, editors. JBI Manual for Evidence Implementation [internet]. JBI; 2020. Available from: https://implementationmanual.jbi.global/.

UHMS position statement: hyperbaric oxygen (HBO2) for COVID-19 patients. Undersea Hyperb Med 2020; 47 (2):297–298.

Kot J, Marroni A, Welslau W. European Committee for Hyperbaric Medicine position on hyperbaric oxygen therapy (HBOT) in multiplace hyperbaric chambers during coronavirus disease (COVID-19) outbreak [internet]. European Committee for Hyperbaric Medicine; 2020. Available from: file:///C:/Users/a1013860/Downloads/ECHMpositiononHBOTandCOVID-1916thMarch2020%20(1).pdf.

El Hawa AAA. The evolving use of hyperbaric oxygen therapy during the COVID-19 pandemic. J Wound Care 2021; 30 (Sup2):S8–S11.