In neuromodulation therapies, hardware-related infections are a major challenge often leading to hardware removal. To investigate the role of adjuvant hyperbaric oxygen therapy (HBOT) in hardware-related infections. Fourteen hardware-related infection events in 12 consecutive patients between 2002 and 2015 were treated with antibiotics and adjuvant HBOT at the Karolinska University Hospital (Stockholm, Sweden). Two time-independent infection events related to hardware replacements occurred in 2 patients. Infection resolution and the need for hardware removal were assessed. Twelve out of 14 events of hardware-related infection were successfully treated without hardware removal (86%). The 2 patients treated twice with HBOT on 2 time-independent occasions could retain their hardware in both cases. Hardware was removed following HBOT failure in 2 infection events, with long-term infection control achieved in all patients. Further, an intrathecal pump malfunction caused by HBOT at 2.8 bars was observed, leading to a change in the manufacturer’s guidelines.

Bartek, Skyrman, Nekludov, Mathiesen, Lind, Schechtmann (2018). Hyperbaric Oxygen Therapy as Adjuvant Treatment for Hardware-Related Infections in Neuromodulation. Stereotactic and functional neurosurgery, 2018 ;96(2):100-107. https://www.ncbi.nlm.nih.gov/pubmed/29614489