Hyperbaric oxygen as a treatment modality in cyclophosphamide‐induced hemorrhagic cystitis

Late‐onset HC is a well‐recognized complication associated with cyclophosphamide/acrolein‐induced toxicity. It poses a management challenge when hyperhydration and bladder irrigation do not result in clinical improvement as desired. The data regarding use of hyperbaric oxygen therapy (HBO2) as an ea...

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Bibliographic Details
Published in:Pediatric transplantation 2018-06, Vol.22 (4), p.e13171-n/a
Main Authors: Kaur, Dominder, Khan, Shakila P., Rodriguez, Vilmarie, Arndt, Carola, Claus, Paul
Format: Article
Language:English
Subjects:
Acrolein
Atmospheric pressure
bone marrow transplant
Cyclophosphamide
Cystitis
Hematuria
Hemorrhage
Hemorrhagic cystitis
HSCT
hyperbaric oxygen
Hyperbaric oxygen therapy
Irrigation
Patients
pediatric
Respiratory therapy
Stem cell transplantation
Toxicity
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Summary:Late‐onset HC is a well‐recognized complication associated with cyclophosphamide/acrolein‐induced toxicity. It poses a management challenge when hyperhydration and bladder irrigation do not result in clinical improvement as desired. The data regarding use of hyperbaric oxygen therapy (HBO2) as an early treatment modality in this clinical setting are limited. We present 2 cases, that were refractory to hyperhydration and bladder irrigation but responded to HBO2. They were treated with 20‐30 daily sessions over weekdays with 100% oxygen for 90 minutes at 2 atmospheric pressure units (2 atm). Both patients reported improved symptoms within the first 15 sessions, and hematuria diminished by 20 sessions. Hyperbaric oxygen is a less invasive, outpatient therapy that is effective for treatment of HC and is tolerated well by young patients.
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.13171