TY - JOUR

T1 - Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation

AU - Bartek, Jiri

AU - Skyrman, Simon

AU - Nekludov, Michael

AU - Mathiesen, Tiit

AU - Lind, Folke

AU - Schechtmann, Gaston

N1 - © 2018 S. Karger AG, Basel.

PY - 2018

Y1 - 2018

N2 - BACKGROUND: In neuromodulation therapies, hardware-related infections are a major challenge often leading to hardware removal.OBJECTIVE: To investigate the role of adjuvant hyperbaric oxygen therapy (HBOT) in hardware-related infections.METHODS: Fourteen hardware-related infection events in 12 consecutive patients between 2002 and 2015 were treated with antibiotics and adjuvant HBOT at the Karolinska University Hospital (Stockholm, Sweden). Two time-independent infection events related to hardware replacements occurred in 2 patients. Infection resolution and the need for hardware removal were assessed.RESULTS: Twelve out of 14 events of hardware-related infection were successfully treated without hardware removal (86%). The 2 patients treated twice with HBOT on 2 time-independent occasions could retain their hardware in both cases. Hardware was removed following HBOT failure in 2 infection events, with long-term infection control achieved in all patients. Further, an intrathecal pump malfunction caused by HBOT at 2.8 bars was observed, leading to a change in the manufacturer's guidelines.CONCLUSIONS: This study indicates a potential benefit of adjuvant HBOT in the treatment of hardware-related infections in neuromodulation, diminishing the need for hardware removal and treatment interruption. Prospective studies are warranted to establish the role of adjuvant HBOT in the treatment of hardware-related infections in neuromodulation.

AB - BACKGROUND: In neuromodulation therapies, hardware-related infections are a major challenge often leading to hardware removal.OBJECTIVE: To investigate the role of adjuvant hyperbaric oxygen therapy (HBOT) in hardware-related infections.METHODS: Fourteen hardware-related infection events in 12 consecutive patients between 2002 and 2015 were treated with antibiotics and adjuvant HBOT at the Karolinska University Hospital (Stockholm, Sweden). Two time-independent infection events related to hardware replacements occurred in 2 patients. Infection resolution and the need for hardware removal were assessed.RESULTS: Twelve out of 14 events of hardware-related infection were successfully treated without hardware removal (86%). The 2 patients treated twice with HBOT on 2 time-independent occasions could retain their hardware in both cases. Hardware was removed following HBOT failure in 2 infection events, with long-term infection control achieved in all patients. Further, an intrathecal pump malfunction caused by HBOT at 2.8 bars was observed, leading to a change in the manufacturer's guidelines.CONCLUSIONS: This study indicates a potential benefit of adjuvant HBOT in the treatment of hardware-related infections in neuromodulation, diminishing the need for hardware removal and treatment interruption. Prospective studies are warranted to establish the role of adjuvant HBOT in the treatment of hardware-related infections in neuromodulation.

KW - Aged

KW - Aged, 80 and over

KW - Anti-Bacterial Agents/administration & dosage

KW - Child

KW - Device Removal/methods

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hyperbaric Oxygenation/methods

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Prosthesis-Related Infections/diagnosis

KW - Retrospective Studies

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1159/000486684

DO - 10.1159/000486684

M3 - Journal article

C2 - 29614489

VL - 96

SP - 100

EP - 107

JO - Stereotactic and Functional Neurosurgery

JF - Stereotactic and Functional Neurosurgery

SN - 1011-6125

IS - 2

ER -