Indications, therapeutic modalities and clinical outcomes of hyperbaric oxygen therapy in Italy, the ITA-OTI Study: a multicentre prospective observational study

Background: Real-world data describing contemporary hyperbaric oxygen therapy (HBOT) practice in Italy are limited. This study aimed to describe current clinical indications and therapeutic modalities of HBOT at the national level. Methods: We conducted a multicentre, prospective, observational national study, promoted by Italian Society of Anesthesia Analgesia, Resuscitation and Intensive Care (SIAARTI). We included consecutive patients who underwent HBOT in 10 study centres within a period of 12 weeks, for any treatment indication. The primary outcome of the study was the proportion of treatments by clinical indication and urgency of treatment. Results: Overall, 327 patients were included across 10 centres, of which 73.7% (n = 241) received elective and 26.3% (n = 86) urgent treatments. The most frequent indication was sudden hearing loss (35.8%), followed by carbon monoxide poisoning (19.9%) and soft tissue infection (12.2%). Treatments were delivered at a median of 2.5 ATA, with two oxygen cycles for session and a median of 16 sessions for patients. No serious adverse events occurred. Conclusions: In Italy, HBOT is applied in accordance with national and international guidelines. The most frequent indications to treatment were sudden hearing loss, carbon monoxide poisoning, and soft tissue infections. Treatments had similar characteristics across the centres, with heterogeneity mainly regarding the number of sessions per patient. Clinical trial number: Not applicable.