A 7-year retrospective analysis of the outcome of hyperbaric oxygen therapy in osteoradionecrosis patients treated at the London Hyperbaric Medicine Unit

ObjectivesThe aim of the study is to evaluate the effect of hyperbaric oxygen therapy (HBOT) in participants suffering from chronic neurological deficits due to traumatic brain injury (TBI) of all severities in the largest cohort evaluated so far with objective cognitive function tests and metabolic brain imaging.MethodsA retrospective analysis was conducted of 154 patients suffering from chronic neurocognitive damage due to TBI, who had undergone computerised cognitive evaluations pre-HBOT and post-HBOT treatment.ResultsThe average age was 42.7±14.6 years, and 58.4% were men. All patients had documented TBI 0.3–33 years (mean 4.6±5.8, median 2.75 years) prior to HBOT. HBOT was associated with significant improvement in all of the cognitive domains, with a mean change in global cognitive scores of 4.6±8.5 (p<0.00001). The most prominent improvements were in memory index and attention, with mean changes of 8.1±16.9 (p<0.00001) and 6.8±16.5 (p<0.0001), respectively. The most striking changes observed in brain single photon emission computed tomography images were in the anterior cingulate and the postcentral cortex, in the prefrontal areas and in the temporal areas.ConclusionsIn the largest published cohort of patients suffering from chronic deficits post-TBI of all severities, HBOT was associated with significant cognitive improvements. The clinical improvements were well correlated with increased activity in the relevant brain areas.

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Double-blind trials in hyperbaric medicine: A narrative review on past experiences and considerations in designing sham hyperbaric treatment

Clinical Trials ◽

10.1177/1740774518776952 ◽

2018 ◽

Vol 15 (5) ◽

pp. 462-476 ◽

Cited By ~ 6

Author(s):

Nina CA Lansdorp ◽

Rob A van Hulst

Keyword(s):

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Lower Pressure ◽

Controlled Trials ◽

Double Blind ◽

Hyperbaric Treatment ◽

Hyperbaric Medicine ◽

Oxygen Group ◽

Blind Trials

Background Hyperbaric oxygen therapy, which consists of breathing 100% oxygen under a higher atmospheric pressure than normal, is utilized worldwide in the treatment of several diseases. With the growing demand for evidence-based research, hyperbaric oxygen therapy has been criticized for delivering too little high-quality research, mainly in the form of randomized controlled trials. While not always indispensable, the addition of a sham-controlled group to such a trial can contribute to the quality of the research. However, the design of a sham (hyperbaric) treatment is associated with several considerations regarding adequate blinding and the use of pressure and oxygen. This narrative review discusses information on the sham profile and the blinding and safety of double-blind trials in hyperbaric medicine, irrespective of the indication for treatment. Methods MEDLINE, Embase and CENTRAL were searched for sham-controlled trials on hyperbaric oxygen therapy. The control treatment was considered sham if patients were blinded to their allocation and treatment took place in a hyperbaric chamber, with no restrictions regarding pressurization, oxygen levels or indication. Studies involving children or only one session of hyperbaric oxygen were excluded. Information on (the choice of) treatment profile, blinding measures, patient’s perception regarding allocation and safety issues was extracted from eligible studies. Results A total of 42 eligible trials were included. The main strategies for sham treatment were (1) use of a lower pressure than that of the hyperbaric oxygen group, while breathing 21% oxygen; (2) use of the same pressure as the hyperbaric oxygen group, while breathing an adjusted percentage of oxygen; and (3) use of the same pressure as the hyperbaric oxygen group, while breathing 21% oxygen. The advantages and disadvantages of each strategy are discussed using the information provided by the trials. Conclusion Based on this review, using a lower pressure than the hyperbaric oxygen group while breathing 21% oxygen best matches the inertness of the placebo. Although studies show that use of a lower pressure does allow adequate blinding, this is associated with more practical issues than with the other strategies. The choice of which sham profile to use requires careful consideration; moreover, to ensure proper performance, a clear and detailed protocol is also required.

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HISTORICAL DEVELOPMENT OF THE HYPERBARIC OXYGENATION

Journal of IMAB - Annual Proceeding (Scientific Papers) ◽

10.5272/jimab.2021272.3772 ◽

2021 ◽

Vol 27 (2) ◽

pp. 3772-3777

Author(s):

Krasimira Tsankova ◽

◽

Mila Dimitrova ◽

Keyword(s):

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Therapy ◽

Historical Development ◽

Oxygen Therapy ◽

Hyperbaric Oxygenation ◽

The Past ◽

History Of ◽

Hyperbaric Medicine ◽

Physical Laws ◽

Based Medicine

Background: Hyperbaric oxygenation (HBO) is a treatment in which a patient breathes near 100% oxygen within a chamber at a pressure greater than one atmosphere absolute (ATA). The development of hyperbaric medicine is continuous and associated with the history of underwater activities, the development of physical laws and physiological mechanisms of breathing. Purpose: The aim of this article is to present the development of hyperbaric oxygenation internationally and nationally. Materials and Methods: We have conducted a literature review of the published works on hyperbaric oxygen therapy (HBOT) during the last 100 years. Our survey includes scientific reports and books in English and Bulgarian. Results: Three main periods of the historical development of HBOT can be defined. In the past, HBO did not have much scientific support but is extensively used in the field of medicine. We observed an increase in scientific interest in HBO during the last two decades both in our country and worldwide. The majority of the reviewed articles contained information about different aspects of HBO as clinical uses, effects, risks. HBOT has been used as a primary and adjuvant treatment for a variety of diseases for nearly 50 years in Bulgaria. The main areas of application and researches of hyperbaric oxygen therapy include diving diseases, intoxications, traumatic injuries, soft tissue infections, diabetic foot, hearing loss, some neurological disorders, etc. Conclusion: Over the past decades, hyperbaric oxygen therapy has grown rapidly worldwide in accordance with evidence-based medicine methods, and future developments to expand the knowledge are perspective.

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