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Medicine Grand Rounds - Under Pressure: Should We Give Hyperbaric Oxygen to COVID-19 Patients?

Dr. Harlan describes how hyperbaric oxygen therapy (HBOT) affects peripheral and organ oxygen perfusion by delivering 100% oxygen at increased atmospheric pressures. HBOT has been effective in many clinical settings where tissue oxygenation and improved cellular metabolism are compromised. She then reviews the hallmark COVID-19 findings of diffuse alveolar damage, necrosis of the alveolar lining, microthrombi in the intraalveolar spaces, and general immune dysregulation. Anecdotally and in some journals, using HBOT has been shown to avoid mechanical ventilation and reduce some morbidity. However, until more studies and data are available, it remains a treatment possibility without documented harm but without proven benefit.

Activity Details

Start Date:  August 21, 2020
End Date:  August 21, 2023

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Learning Outcome

Participants will be able to discuss the physiology and risks of pulmonary oxygen toxicity in hyperbaric oxygen therapy, and examine the feasibility and effectiveness of using hyperbaric oxygen therapy in COVID-19.

  • Nicole P. Harlan, MD, MS
    Assistant Professor of Medicine
    Geisel School of Medicine at Dartmouth
    Dartmouth-Hitchcock Medical Center

    About our presenter: 
    Dr. Nicole Harlan is a native of Maryland who grew up diving in the Chesapeake Bay.  Her interest in the physiology of diving lead her to specialize in Undersea and Hyperbaric Medicine as well as Pulmonary and Critical Care Medicine.  She is interested in human physiology in extreme environments, from space to the intensive care unit.  She joined the faculty at the Geisel School of Medicine last year and she enjoys working in both the Pulmonary Critical Care and Hyperbaric Sections.

Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content for Under Pressure: Should We Give Hyperbaric Oxygen to COVID-19 Patients? 8-21-2020 (Medicine Grand Rounds) have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and is on the Scientific Advisory Board for Allurion. 

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
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