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Hyperbaric Oxygen Therapy in Tetanus

James S. Milledge, MRCPE
JAMA. 1968;203(10):875-876. doi:10.1001/jama.1968.03140100057012.
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Following the successful use of hyperbaric oxygen in Clostridium welchii infections, occasional cases of tetanus were treated by this method.

The first series published was by Pascale et al1 who reported dramatic improvement in most of their nine patients. Treatment consisted of one to three treatments of two hours' duration. No complications or difficulties were encountered and all except one patient appeared to make a rapid recovery. Other workers had rather less favorable experience. Winkel and Kroon2 treated seven patients and considered the therapy to be moderately successful. Brummelkamp,3 with seven patients, could not see any definite effect on their condition except for some relaxation of trismus.

We report our experience of treating eight patients with tetanus: three neonates, three children, and two adults. These cases were all of severe tetanus, ie grade 4 or 5 of Patel and Joag's4 classification, the spasms of which were


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