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Rambam: 16-year-old Girl Requires Hyperbaric Oxygen Therapy after Smoking Hookah Pipe

Publication Date: 10/9/2018

Last week a 16-year-old girl was rushed to Rambam Health Care Campus for blood poisoning—the result of a “fun” evening with friends smoking a hookah. Thankfully she was successfully treated in a barometric pressure chamber.

Photo credit: Wesley BaltenPhoto credit: Wesley Balten

Many young people enjoy spending time together with friends smoking hookah pipes. However, this activity, which is often thought to be safe, actually poses several health risks – even more than cigarettes. Last week, a 16-year-old girl was brought to the emergency room at Rambam Health Care Campus. She was suffering from exceptionally high blood levels of a poison known as carboxyhemoglobin (a complex of carbon monoxide and hemoglobin – the oxygen carrier in the red blood cells), the result of having smoked a hookah pipe.

“The teenager smoked a hookah pipe with her friends at home and lost consciousness,” explains Professor Ram Weiss, Director of the Department of Pediatrics A and B at Ruth Rappaport Children’s Hospital at Rambam. “She was brought to Rambam by ambulance, and following her arrival, she received treatment in the pressure chamber. One day later, her condition improved and she was sent home.”

“The hookah pipe looks innocent, but is extremely harmful,” notes Professor Lea Bentur, Director of the D. Dan & Betty Kahn Foundation Pediatric Pulmonary Institute at Ruth Rappaport Children’s Hospital at Rambam. “In past studies conducted at Rambam, we proved the dangers of hookah pipe smoking and the damage it causes. After smoking a hookah pipe for 30 minutes, it’s possible to measure serious damage to lung function, an increase in blood pressure and heartrate, and a decrease in blood oxidation. It’s difficult to comprehend, but smoking once from a hookah pipe contains the amount of nicotine equal to that of 10 cigarettes and the amount of toxins found in 100 cigarettes.”

According to Professor Bentur, the widespread use of hookah pipes among young people is very dangerous. “We encounter a number of cases like these each year that require pressure chamber treatment,” she says, adding, “Only a month ago we treated a similar case, and there have been even worse cases. Parents need to be knowledgeable about the issue and understand its severity.”

Hookah pipe smoking – far more than cigarette smoking – causes an increase in carboxyhemoglobin levels, whereby carbon monoxide bonds to the hemoglobin in the red blood cells and affects the ability to carry oxygen in the blood. “When the concentration of this substance increases, it can cause a number of different, dangerous symptoms,” explains Professor Yedidia Bentur, Director of the Department of Clinical Pharmacology and Toxicology and the Israel Poison Information Center at Rambam. “Loss of consciousness, convulsions, neurological injuries, myocardial infarctions, and more. The longer the smoking time, the higher the number of smokers, the smaller the smoking space, and the deeper the inhalation – the higher the concentration of carbon monoxide in the blood and the greater the risks of damage. It’s important to remember that the amount of nicotine found in hookah smoking is also larger, which only increases the risks. The social environment where a number of people sit together in a small space for hours, smoking and absorbing the toxic substances in the smoke is definitely dangerous. In the past few months we’ve treated three people in the pressure chamber who were either unconscious or had experienced convulsions after smoking a hookah pipe.”

According to specialists, pressure chamber treatment includes breathing clean oxygen at a pressure level equivalent to diving at a depth of 18 meters. This causes a high oxygen concentration in the blood, allowing for quick removal of carbon monoxide from the body. By removing it from the body, the immediate cause is removed and any future damage has effectively been prevented. The teenage girl treated at Rambam will be fine,” summarizes Professor Yedidia Bentur, “on the condition that she doesn’t smoke a hookah pipe again.”