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I have read osteoradionecrosis -Mandible should be at 2.5ATA, however DFUs and Chronic Osteo can range from 2.0 to 2.5 ATA. What makes the difference in choosing 2.0 vs 2.5 ATA? Is 2.5ATA preferred if patient tolerates?
Mar 20, 2024 by Lisa Lagerwey,
3 replies
Eugene Worth
MD, M.Ed., FABA, ABPM/UHM

Lisa, this is a great question. However, I'm stumped. Your question really requires a textbook and review the literature answer. So, please help fill me in ... Who is requiring that ORN be treated at 2.5ATA while other indications have a range of possible treatment levels?

If you (or your facility) has a copy of the UHMS Hyperbaric Oxygen Therapy Indications manual, I suggest you read the section on radiation soft tissue injuries and HBOT. I have carefully read that chapter (and just reviewed the pertinent section) on treatment pressures. There remains the treatment range of 2.0 to 2.5ATA for ORN. ( I would note that 2.0 ATA be treated for 120 minutes of oxygen breathing and 2.5 ATA would be 90 minutes of oxygen breathing. That has been my practice.)

Unless something has changed recently, this has been the recommendation for many years.

Now, if you are telling me that your fiscal intermediary requires what you stated, then that would be another story.

Hope that helps.


gene

Mar 20, 2024
Thank you for your insight, I understand this is not a requirement, I read 2.5 ATA under the treatment protocol wound reference provides for ORN-Mandibular. The other dx. mentioned have 2.0-2.5 ATA under treatment protocol wound reference provides.
Mar 20, 2024
Eugene Worth
MD, M.Ed., FABA, ABPM/UHM

Interesting ... I see your point. FYI -- I wrote that section, so I now see that it needs to be modified. Thank you for pointing that out.

gene

Mar 20, 2024
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