Uloga hiperbarične oksigenoterapije (HBOT) u liječenju oboljelih od COVID-19

Sead Žiga, Dejan Andrić, Sanja Jurić Banai, Kristina Franjić, Dragan Vujović, Eva Pleško, Dživo Ljubičić, Nevenka Piskač Živković, Marko Banić

Pandemija COVID-19 postavila je velik izazov suvremenoj medicini. Unatoč značajnim naporima medicinske i znanstvene zajednice, do trenutka pisanja ovog članka i dalje ne postoji ciljano etiološko liječenje bolesnika akutno oboljelih od COVID-19, kao i bolesnika s post-COVID sindromom. Hiperbarična oksigenoterapija (HBOT) jest medicinski i znanstveno priznat terapijski postupak u liječenju brojnih akutnih i kroničnih stanja u kojima je nedostatak kisika osnovni patofiziološki poremećaj. S obzirom na nekoliko publiciranih serija slučajeva koji su pokazali značajan povoljni učinak primjene HBOT-a u liječenju pacijenata oboljelih od infekcije COVID-19 te na osnovi višedesetljetnog iskustva u primjeni HBOT-a u drugim poljima, rodila se potreba za provođenjem kvalitetnih i dobro strukturiranih studija kojima je cilj jasno ispitati utjecaj primjene HBOT-a u liječenju oboljelih od COVID-19. Prema dostupnim izvorima trenutno se u svijetu provodi 9 takvih istraživanja. Mehanizmi učinka primjene HBOT-a u liječenju oboljelih od COVID-19 zasnivaju se na korekciji hipoksije, atenuaciji upalnog odgovora te „otplate duga kisika“ u kratkom vremenskom razdoblju, na taj način osiguravajući prozor aerobnom metabolizmu u duboko hipoksičnim tkivima i važnim organima.

The COVID-19 pandemic has posed a major challenge to modern medicine. Despite significant efforts by the medical and scientific community, at the time of writing, there is still no targeted etiological treatment for acutely ill COVID-19 patients as well as patients with post-COVID syndrome. Hyperbaric oxygen therapy (HBOT) is a medically and scientifically recognized therapeutic procedure in the treatment of a number of acute and chronic conditions in which oxygen deficiency is pathophysiologically primary disorder. Given the several published series of cases that have shown a significant beneficial effect of HBOT in the treatment of patients with COVID-19 infection, and based on decades of experience in the use of HBOT in other fields, the need to conduct quality and well-structured studies arose with the aim to clearly examine the impact of HBOT use in the treatment of COVID-19 patients. According to available sources, nine such studies are being conducted worldwide.The mechanisms of the effect of HBOT in the treatment of COVID-19 patients are based on the correction of hypoxia, attenuation of the inflammatory response and “repayment of oxygen debt” in a short period of time, thus providing a window to aerobic metabolism in deeply hypoxic tissues and important organs.