Hyperbaric oxygen therapy in Québec

Hyperbaric oxygen (HBO) therapy has been medically available in Québec since 1982. Until recently, this technology was available only at one hospital. Recognized as the treatment of choice for carbon monoxide poisoning and diving-related decompression sickness, HBO therapy has evolved, given that it is now being used more and more as an adjuvant treatment for a number of chronic, nonemergency medical conditions.

This led the Ministère de la Santé et des Services sociaux to ask the Conseil d’évaluation des technologies de la santé (CETS) to determine if it would be useful to support broader diffusion of this technology in Québec and, if so, to define the guidelines for this diffusion. After describing the technology, this report examine its efficacy in the treatment of various conditions and it’s complications, explains what safety measures are needed to control its risk, and estimates the potential demand for new facilities in Québec.

Although HBO therapy has been tried out on nearly 130 medical conditions, it is CETS’s conclusions that this technology can be recommended for only 13 of them. Its efficacy in the treatment of cerebral palsy, although not demonstrated, is still controversial, given the results of a randomized, comparative trial recently conducted in Québec.

CETS also believes that the potential demand justifies installing hyperbaric chambers in the Greater Québec City Area and gradually installing others in the Greater Montréal Area. These decisions would lead to considerable expenses that would probably be offset by the decrease in the lengths of hospital stay for chronic cases. Studies would be necessary in order to validate the clinical and administrative efficacy. Lastly, steps would need to be taken to ensure the presence of a multidisciplinary team, permanent medical supervision and compliance with safety standards.