Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Summary
The collected evidence examines only a small number of clinical outcomes. In these endpoints,
the effectiveness of exposure to HBO is conflicting. There is evidence of small
improvements in functional status, but these are seen a year after therapy is initiated.
Whether these changes are scale-independent is questionable. Of potential concern is the
evidence that exposure to HBO may be no better than placebo or sham therapy. The
review concluded that no firm and generalisable evidence is available to support the use
of HBOT for cerebrovascular disease at this time.
Peripheral obstructive arterial disease
The study by Verrazzo et al 84 was the only one that met inclusion and exclusion criteria
for this indication. Published in 1995, the study was a randomised controlled trial
conducted in Italy and enrolled 30 patients suffering from stages II to IV of peripheral
obstructive arterial disease. The mean age of participants was 60 years.
The study methodology was inadequately described. Both the methods of randomisation
and masking were unclear. The authors reported no losses to follow-up.
The study compared HBOT to oxygen-ozone therapy on such hemorrheologic
parameters as haematocrit, erythrocyte filterability, blood viscocity, plasma fibronogen
levels, and thrombin time. The comparison therapy consisted of the slow reinfusion of
100 ml of autologous venous blood exposed to an oxygen-ozone mixture. Five
treatments were given every other day. Exposure to HBO was in a monoplace chamber
with oxygen at 2 ATA for 1 hour, five times a day, every other day.
Treatment with HBO did not show changes in the parameters tested after a comparison
with baseline values was performed.
Summary
This small trial provides little evidence of benefit. Methodologically, the use of surrogate
endpoints of uncertain relationship to clinical outcome and the uncertain biological
activity of the comparison treatment provide cause for concern. The study provided no
evidence of the efficacy of HBOT for peripheral obstructive arterial disease.
Soft tissue injuries
The only studies identified as meeting the inclusion and exclusion criteria for this
indication were on soft tissue injuries (ankle strain and crush injuries). A brief description
of both studies follows.
Acute ankle sprains
The study by Borromeo et al85 compared HBOT with placebo exposure on 32 volunteers
with lateral ankle sprains, who were not taking prescription medication, and had not
received treatment beyond ice, elevation, compression with an elastic bandage, and
crutches. They excluded people with fractures on radiograph, upper respiratory tract
infection, active allergies, severe asthma, pulmonary disease, epilepsy, claustrophobia, or
Hyperbaric oxygen therapy 49