Hyperbaric Oxygen in Severe Anemia

A patient presents to the ED with chronic symptomatic severe anemia (now with chest pain). His Hb is 2 g/dL. He is a Jehovah’s Witness and refuses transfusion. Is hyperbaric oxygen an option?

Turns out that hyperbaric oxygen is FDA approved for use in severe anemia.

Under normal circumstances the amount of dissolved O₂ in plasma is negligible relative to the amount carried by Hb.

With a typical hyperbaric session (2.5 and 3.0 atm, lasting 45 to 300 min), the PaO₂ can be increased to 2000 mmHg and this is actually enough to move the patient past the critical DO₂ threshold so that O₂ delivery > O2 consumption.

References:

1. Ortega MA et al. Medicina (Kaunas). 2021 Aug 24;57(9):864.
2. Graffeo C. Am J Emerg Med. 2013 Apr;31(4):756.e3-4.
3. Van Meter KW. Undersea Hyperb Med. 2005 Jan-Feb;32(1):61-83.