SPMC pioneers in using hyperbaric for Covid-19

THE Southern Philippines Medical Center (SPMC) has started using hyperbaric oxygen therapy (HBOT) for Covid-19 patients in critical condition, becoming the only hospital in the country using this technology.

“We started on patients with Covid, September 25, we had five severe Covid patients with breathing up to 45 cycles per minute. Normal is 16-20. They were all discharged,” said Dr. Jeffrey M. Ramos, unit head of the Diving Hyperbaric Medicine and Difficult Wound Unit of the SPMC Department of Emergency Medicine (SPMC-EMed).

Ramos said the patients experienced immediate relief from breathlessness after desired treatment pressure was achieved.

They first studied the protocol for six months starting April 2020 and collaborated with their overseas colleagues in New York University Langone Health, who shared what they were doing for severe cases of Covid there.

“There are also hyperbaric facilities in Louisiana, Texas who shared their experience and that made us quite confident that this will work,” Dr. Ramos said. “The first treatment (using hyperbaric technology) was actually done in Wuhan early this year also.”

It was not that easy though as SPMC now only has a single-man hyperbaric chamber after its two-man chamber was sent to the Zamboanga City Medical Center in preparation for the 10-man chamber that recently arrived but will still be installed.

It is also not for every critical patient as one procedure would take 90 minutes during which the patient will be locked inside the pressurized capsule. Add to that the time needed for terminal cleaning to ensure that no trace of the virus is left behind, it makes the process tedious and time-consuming.

“With Covid, we limit our usage because we also cater to non-Covid patients,” he said.

HBOT is used for diabetic foot ulcer, late effects of radiation therapy that includes both bone and soft tissue radiation injuries, difficult plastic surgery cases, severe burn cases, trauma cases with crushed injuries where blood supply to extremities are cut off, sports and commercial scuba diving decompression accidents, flesh-eating bacterial infection and gas gangrene, and sudden blindness of central retinal artery occlusion, among may applications.

With the 10-man unit, SPMC is looking into treating patients with severe case of smoke inhalation of carbon monoxide poisoning and other severe infections, Ramos said.

The 10-man unit that recently arrived will be made operational between January or February 2021 as there are other equipment for the chamber to be operational that are still being shipped.

“The hyperbaric chamber and its ancillary equipment is donated to SPMC by Manila Economic and Cultural Office. They paid everything until unloading,” Dr. Ramos said, but SPMC is shelling out between P200,000 to P400,000 for the installation. “The Taiwanese technicians will piece everything and test before proper operation.”

Once the 10-chamber unit is operational, SPMC will become the only government facility with such capacity.

With this development, SPMC-EMed racks in another first: the first and only medical facility in the country that has used hyperbaric treatment for compassionate use, SPMC-DEMed chief Dr. Benedict Edward Valdez said.

Earlier, SPMC-EMed became the only one in the country that has a fellowship for HBOT.

Dr. Valdez said former SPMC chief now Undersecretary Leopoldo J. Vega and Chief Implementer of the National Task Force against Covid-19 Secretary Carlito Galvez were already briefed about the hyperbaric clinical trials in SPMC and “they were amazed by our presentation.”

“EMed developed its team for flight evacuation and transporting Covid patients for compassionate use of the hyperbaric facility,” Dr. Valdez said.