Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

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HBOT used in conjunction with thrombolytic therapy may be beneficial in pain relief although more studies are needed to arrive at a firm and generalisable conclusion. Cerebrovascular disease Two studies of carotid artery stroke were retrieved and assessed (Table 41). Both studies were randomised controlled trials and were published four years apart. The study populations were similar in size, enrolling about 35 to 40 people. One group of participants was older by a mean difference of about 10 years. Table 41 Descriptive characteristics of included studies focusing on the use of HBOT in cerebrovascular disease.* First Author and Year of Publication NHMRC Level Study Design Location Nighoghossian 1995 79 II RCT France Dates of Enrolment Size Dec 1988 to Mar 1992 Anderson 1991 80 II RCT USA ?‡ 39 Characteristics of Study Population † Age Mean (SD) Sex Ratio (M:F) 46 <strong>Hyperbaric</strong> oxygen therapy 34 I=53 (3) C=54 (3) I=63.7 C=69.1 I=9:8 C=12:5 * Abbreviations: C = comparison group, F = female, I = intervention group, M = male, RCT = randomised controlled trial, SD = standard deviation. † <strong>Information</strong> is given for total study population values, and treatment and control groups. ‡ Unstated, unclear, or unknown. Study quality The randomisation procedures used by both studies are uncertain; no information was provided to properly assess the methods used (Table 42). Anderson et al80 report the use of double-masked procedures, while Nighoghossian et al79 is unclear. There were a total of 12 losses to follow-up in the study by Anderson et al80 In the comparison group, the five losses were distributed as follows: deaths (n = 2), migration (n = 2), and refusals (n = 1); in the intervention group, there were two deaths, one migration, three refusals, and one stroke. No comparisons of baseline characteristics between those lost to follow-up and those remaining in the study were made. Table 42 Methodological quality of included studies focusing on the use of HBOT in cerebrovascular disease.* First Author and Year of Publication Study Design Randomisation Masking Losses to Follow-up Nighoghossian 1995 79 RCT Unclear Unclear 1 Anderson 1991 80 RCT Unclear Double masked T=7, C=5 * Abbreviations: C = control or comparison group, RCT = randomised controlled trial, T = treatment group Patient criteria The two studies used similar patient inclusion criteria (Table 43). Nighoghossian et al79 enrolled patients between 20 and 75 years of age with neurological deficit highly suggestive of middle cerebral artery occlusion while excluding patients with a history of stroke; those who exhibited substantial improvement or resolution of the deficit within 1 hour; were pregnant; experienced seizures at stroke onset; had metabolic encephalopathy, significant pulmonary disease, congestive heart failure, or uncontrolled hypertension. ?
Anderson et al 80 recruited non-pregnant patients aged 20 to 90 years with onset of neurological deficits due to ischaemic cerebral infarction in the brain region perfused by one carotid artery during the preceding 2 weeks. They excluded patients with minor deficits (
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Hyperbaric Oxygen Therapy November
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Contents Executive summary.........
Page 5 and 6:
Tables Table 1 Measures of disease
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Table 45 Functional neurologic scor
Page 9 and 10:
Figures Figure 1. Outline of search
Page 11 and 12: Effectiveness Published guidelines
Page 13 and 14: evidence that exposure to HBO may b
Page 15 and 16: No available evidence No evidence w
Page 17 and 18: Introduction The Medicare Services
Page 19 and 20: Multiplace chambers can accommodate
Page 21 and 22: Marketing status of the device The
Page 23 and 24: Table 3 1998 - 1999 self-reported d
Page 25 and 26: Table 6 retrieval. Indication-speci
Page 27 and 28: Phase of Search Initial Search Ful
Page 29 and 30: Conduct of meta-analysis When the d
Page 31 and 32: early as 1995. The guidelines - kno
Page 33 and 34: Table 10 Minimum staff qualificatio
Page 35 and 36: Is it effective? The review assesse
Page 37 and 38: Table 14 Patient criteria of includ
Page 39 and 40: offered ample details. The remainin
Page 41 and 42: characteristics compared to the tre
Page 43 and 44: Assessment of heterogeneity All the
Page 45 and 46: Odds ratio 10 1 0.1 0.01 A sensitiv
Page 47 and 48: Wound healing Two of the five ident
Page 49 and 50: Studies of necrotising soft tissue
Page 51 and 52: Summary Table 25 Survival in patien
Page 53 and 54: Table 29 Therapeutic protocols used
Page 55 and 56: Osteomyelitis The study by Esterhai
Page 57 and 58: Summary The HBO group showed a stat
Page 59 and 60: Summary These results are difficult
Page 61: outcomes or that decreased the risk
Page 65 and 66: Summary The collected evidence exam
Page 67 and 68: Table 46 Major outcomes following t
Page 73 and 74: Thirty-seven subjects (comparison g
Page 75 and 76: whose hearing loss was not secondar
Page 77 and 78: tinnitus (6 versus 3 subjects). Non
Page 79 and 80: assume that all participants knew o
Page 83 and 84: Table 65 Descriptive characteristic
Page 87 and 88: These contrasted with the conclusio
Page 91 and 92: Summary There are conflicting resul
Page 93 and 94: Summary separate and previously-stu
Page 95 and 96: need to insulate patients from outs
Page 97 and 98: Reactive effects A reactive effect
Page 99 and 100: Cost of major amputation The hospit
Page 101 and 102: Sensitivity analysis Table 79 shows
Page 103 and 104: Table 80 Estimation of incremental
Page 105 and 106: Sensitivity analysis Table 83 shows
Page 107 and 108: Conclusions Safety Potential risks
Page 109 and 110: Recommendations MSAC recommended th
Page 111 and 112: Appendix B Supporting committee Sup
Page 113 and 114:
Appendix C Studies included in this
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Necrotising soft tissue infections:
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Soft tissue injuries: crush injurie
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Cancer: cervix First Author and Yea
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Appendix D Studies excluded in this
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2. Shandling AH, Ellestad MH, Hart
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5. Woo TCS, Joseph D, Oxer H. Hyper
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22. Kunkler PB, Boulis-Wassif S, Sh
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45. Wiernik G, Perrins D. The radio
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Appendix E Calculation of monoplace
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Hence, the total operating costs of
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Appendix G Reviews received from ot
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Sechrist Industries -- Hyperbaric O
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References 1. Hampson N. Hyperbaric
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31. L'Abbe K, Detsky A, O'Rourke K.
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61. Perrins DJ. Influence of hyperb
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89. DiSabato F, Giacovazzo M, Crist
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117.Plenk HP. Hyperbaric radiation
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