A meta-analysis on the efficiency of the time window of hyperbaric oxygen treatment on disorders of consciousness in China

ObjectiveTo investigate the clinical effects of time window on hyperbaric oxygen treatment (HBOT) in patients with disorders of consciousness (DOC).MethodsAll the clinical research literature regarding HBOT for DOC published between January 2000 and November 2020 were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Standards Database (WFSD) and VIP Database using Chinese key words disorders of consciousness, the vegetable state, minimally conscious state, or hyperbaric oxygen followed by a comprehensive meta-analysis.ResultsThe query gave rise to 348 results, in which 21 articles were eventually selected for meta-analysis. Among the selected 21 articles, 18 articles involved a time window comparison. All the patients were classified into < 60- (718 patients) and ≥ 60- (374 patients) day groups depending on the number of days from HBOT initiation. The Jadad scores for the included datasets were relatively low in general with 2 points as the highest score. Comparable baseline data were demonstrated in all of the articles. Datasets from different sources were pooled and analyzed, and the results suggested that the clinical curative effect rate in the treatment group was significantly higher compared with that in the control group (curative effect rate: 69.86% versus 42.30%; Z = 11.28, P = 0.000, odds ratio = 3.80, 95% CI = 3.02-4.80). Additionally, the adverse reaction rate of the < 60-day group was found to be significantly lower compared with that of the ≥ 60-day group (Z = 10.01, P = 0.000, odds ratio = 4.82, 95% CI = 3.54-6.56). The funnel diagram in articles related to curative effect analysis and time window evaluation is inverted and symmetrical, indicating that publication bias was not significant.ConclusionsThe clinical curative effect of the HBOT group is higher compared with that of the control group. However, the conclusions based on meta-analysis are limited because of the methodological problems of some studies. Therefore, the clinical efficacy needs to be further tested using carefully designed large sample trials (multicenter, randomized, controlled, and double-blind).

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Advantages and Disadvantages of Hyperbaric Oxygen Treatment in Mice with Obesity Hyperlipidemia and Steatohepatitis

The Scientific World JOURNAL ◽

10.1100/2011/380236 ◽

2011 ◽

Vol 11 ◽

pp. 2124-2135 ◽

Cited By ~ 11

Author(s):

Koichi Tsuneyama ◽

Yen-Chen Chen ◽

Makoto Fujimoto ◽

Yoshiyuki Sasaki ◽

Wataru Suzuki ◽

...

Keyword(s):

Oxidative Stress ◽

Hyperbaric Oxygen ◽

Lipid Level ◽

The Body ◽

Cellular Damage ◽

Control Group ◽

Second Phase ◽

Hyperbaric Oxygen Treatment ◽

Advantages And Disadvantages ◽

Oxygen Treatment

The effect of hyperbaric oxygen treatment (HBOT) was examined using MSG mice, which are an animal model of obesity, hyperlipidemia, diabetes, and nonalcoholic fatty liver disease. Nineteen MSG male mice were divided into HBOT treated and control groups at 12 weeks of ages. The HBOT group was treated with hyperbaric oxygen from 12 to 14 weeks (first phase) and then from 16 to 18 weeks (second phase). Interestingly, the body weight of the HBOT group was significantly lower (P<0.01) than that of the control group. In contrast, the serum lipid level did not show significant changes between the two groups. As for the effects of increasing oxidative stress, the liver histology of the HBOT group showed severer cellular damage and aberrant TNF-α expression. HBOT has the advantage of improving obesity in patients with metabolic syndrome, but the fault of causing organ damage by increasing oxidative stress.

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Preliminary Clinical Study On Ms Treatment With Hyperbaric Oxygenation

Polish Hyperbaric Research ◽

10.1515/phr-2015-0010 ◽

2015 ◽

Vol 51 (2) ◽

pp. 47-51

Author(s):

Kazimierz Ulewicz ◽

Janusz Masłowski ◽

Przemysław Michniewski ◽

Brunon Kierznikowicz ◽

Romuald Olszański

Keyword(s):

Hyperbaric Oxygen ◽

Hyperbaric Oxygenation ◽

Disease Duration ◽

Clinical Investigation ◽

Hyperbaric Oxygen Treatment ◽

Curative Effect ◽

Immunological Parameters ◽

Oxygen Treatment ◽

Disability Status ◽

Laboratory Investigations

Abstract The authors conducted the preliminary clinical investigation on 16 multiple sclerosis (Sclerosis multiplex) patients of median disease duration 9.33 years and symptoms evaluated on Kurtzke’s scale. The patients underwent between 25 and 30 hyperbaric oxygen exposures at a pressure of 2 ata in intervals spread over a few days. The patients were qualified and classified to the treatment symptomatologically according to Fisher but the obtained results were evaluated according to the standardised Disability Status Scale by Kurtzke. During the investigations the authors carried out additional quantitative immunoglobulin and complement activity determination, lymphocyte T and B determinations as well as the usually applied clinical and laboratory investigations. Evident clinical improvement was observed in 14 patients, but in the case of one patient a deterioration was observed after 15 hyperbaric expositions (resulting in the hyperbaric oxygen treatment being stopped), whilst in another case no curative effect could be observed. By utilising the 50% haemolysis method, within the examined immunological parameters the authors observed an increase of complement fractions and its activity, white lymphocytes T and B examined qualitatively did not maintain the characteristic shift. The authors are still discussing the obtained results.

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Adjunctive hyperbaric oxygen treatment for necrotising soft-tissue infections: A systematic review and meta-analysis

Diving and Hyperbaric Medicine Journal ◽

10.28920/dhm51.1.34-43 ◽

2021 ◽

Vol 51 (1) ◽

pp. 34-43

Author(s):

Morten Hedetoft ◽

◽

Michael H Bennett ◽

Ole Hyldegaard ◽

◽

...

Keyword(s):

Soft Tissue ◽

Hospital Mortality ◽

Hyperbaric Oxygen ◽

Meta Analysis ◽

Major Amputation ◽

Adjunctive Treatment ◽

Soft Tissue Infections ◽

Hyperbaric Oxygen Treatment ◽

Oxygen Treatment ◽

Necrotising Soft Tissue Infections

Introduction: Surgical intervention, broad-spectrum antibiotics and intensive care support are the standard of care in the treatment of necrotising soft-tissue infections (NSTI). Hyperbaric oxygen treatment (HBOT) may be a useful adjunctive treatment and has been used for almost 60 years, but its efficacy remains unknown and has not been systematically appraised. The aim was to systematically review and synthesise the highest level of clinical evidence available to support or refute the use of HBOT in the treatment of NSTI. Methods: The review was prospectively registered (PROSPERO; CRD42020148706). MEDLINE, EMBASE, CENTRAL and CINAHL were searched for eligible studies that reported outcomes in both HBOT treated and non-HBOT treated individuals with NSTI. In-hospital mortality was the primary outcome. Odds ratio (ORs) were pooled using random-effects models. Results: The search identified 486 papers of which 31 were included in the qualitative synthesis and 21 in the meta-analyses. Meta-analysis on 48,744 patients with NSTI (1,237 (2.5%) HBOT versus 47,507 (97.5%) non-HBOT) showed in-hospital mortality was 4,770 of 48,744 patients overall (9.8%) and the pooled OR was 0.44 (95% CI 0.33–0.58) in favour of HBOT. For major amputation the pooled OR was 0.60 (95% CI 0.28–1.28) in favour of HBOT. The dose of oxygen in these studies was incompletely reported. Conclusions: Meta-analysis of the non-random comparative data indicates patients with NSTI treated with HBOT have reduced odds of dying during the sentinel event and may be less likely to require a major amputation. The most effective dose of oxygen remains unclear.

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Results of a prospective randomized trial for treatment of severely brain-injured patients with hyperbaric oxygen

Journal of Neurosurgery ◽

10.3171/jns.1992.76.6.0929 ◽

1992 ◽

Vol 76 (6) ◽

pp. 929-934 ◽

Cited By ~ 144

Author(s):

Gaylan L. Rockswold ◽

Sandra E. Ford ◽

David C. Anderson ◽

Thomas A. Bergman ◽

Robert E. Sherman

Keyword(s):

Mortality Rate ◽

Hyperbaric Oxygen ◽

Control Group ◽

Hyperbaric Oxygen Treatment ◽

Content Type ◽

Oxygen Treatment ◽

Number Of Patients ◽

Chi Squared ◽

Gcs Score ◽

Fine Print

✓ The authors enrolled 168 patients with closed-head trauma into a prospective trial to evaluate the effect of hyperbaric oxygen in the treatment of brain injury. Patients were included if they had a total Glasgow Coma Scale (GCS) score of 9 or less for at least 6 hours. After the GCS score was established and consent obtained, the patient was randomly assigned, stratified by GCS score and age, to either a treatment or a control group. Hyperbaric oxygen was administered to the treatment group in a monoplace chamber every 8 hours for 1 hour at 1.5 atm absolute; this treatment course continued for 2 weeks or until the patient was either brain dead or awake. An average of 21 treatments per patient was given. Outcome was assessed by blinded independent examiners. The entire group of 168 patients was followed for 12 months, with two patients lost to follow-up study. The mortality rate was 17% for the 84 hyperbaric oxygen-treated patients and 32% for the 82 control patients (chi-squared test, 1 df, p = 0.037). Among the 80 patients with an initial GCS score of 4, 5, or 6, the mortality rate was 17% for the hyperbaric oxygen-treated group and 42% for the controls (chi-squared test, 1 df, p = 0.04). Analysis of the 87 patients with peak intracranial pressures (ICP) greater than 20 mm Hg revealed a 21 % mortality rate for the hyperbaric oxygen-treated patients, as opposed to 48% for the control group (chi-squared test, 1 df, p = 0.02). Myringotomy to reduce pain during hyperbaric oxygen treatment helped to reduce ICP. Analysis of the outcome of survivors reveals that hyperbaric oxygen treatment did not increase the number of patients in the favorable outcome categories (good recovery and moderate disability). The possibility that a different hyperbaric oxygen treatment paradigm or the addition of other agents, such as a 21-aminosteroid, may improve quality of survival is being explored.

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Postoperative Hyperbaric Oxygen Treatment of Peripheral Nerve Damage,

10.21236/ada255842 ◽

1992 ◽

Author(s):

Zhao Dewei ◽

Cui Zhenjiang

Keyword(s):

Peripheral Nerve ◽

Hyperbaric Oxygen ◽

Nerve Damage ◽

Hyperbaric Oxygen Treatment ◽

Peripheral Nerve Damage ◽

Oxygen Treatment

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Method for Estimating the Remaining Capacity of the Carbon Dioxide Scrubber in the Hyperbaric Oxygen Treatment Pack

10.21236/ada442777 ◽

2002 ◽

Author(s):

Dan E. Warkender ◽

John R. Clarke

Keyword(s):

Carbon Dioxide ◽

Hyperbaric Oxygen ◽

Hyperbaric Oxygen Treatment ◽

Oxygen Treatment ◽

Remaining Capacity

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Hyperoxic myopia: a case series of four divers

Undersea and Hyperbaric Medicine ◽

10.22462/04.06.2020.12 ◽

2020 ◽

pp. 261-265

Author(s):

Jonathan W. Brügger ◽

Glenn A. Rauscher ◽

John P. Florian ◽

Keyword(s):

Hyperbaric Oxygen ◽

Prolonged Exposure ◽

Case Series ◽

Oxygen Toxicity ◽

Hyperbaric Oxygen Treatment ◽

Subjective Data ◽

Residual Symptoms ◽

Oxygen Treatment ◽

Blurry Vision ◽

Record Review

Hyperoxic myopia is a phenomenon reported in individuals who have prolonged exposure to an increased partial pressure of oxygen (PO2) and subsequently have a myopic (nearsighted) change in their vision. To date, there are numerous accounts of hyperoxic myopia in dry hyperbaric oxygen treatment patients; however, there have been only three confirmed cases reported in wet divers. This case series adds four confirmed cases of hyperoxic myopia in wet divers using 1.35 atmospheres (ATM) PO2 at the Navy Experimental Diving Unit (NEDU). The four divers involved were the first author’s patients at NEDU. Conditions for two divers were confirmed via record review, whereas the other two divers were diagnosed by the first author. All subjects were interviewed to correlate subjective data with objective findings. Each subject completed five consecutive six-hour hyperoxic (PO2 of 1.35 ATM) dives with 18-hour surface intervals. Each individual was within the U. S. Navy Dive Manual’s standards for general health. Visual acuity was measured prior to diving. Within three to four days after diving, the individuals reported blurry vision with an associated myopic refraction shift. Each diver had spontaneous resolution of his myopia over the next two to three weeks, with no significant residual symptoms. The divers in this case series were exposed to an increased PO2 (1.35 ATM for 30 hours over five days), a lesser exposure than that in other reports of hyperoxic myopia in wet divers diagnosed with hyperoxic myopia (1.3-1.6 ATM for 45-85 hours in 12-18 days). Furthermore, this pulse of exposure was more concentrated than typically seen with traditional hyperbaric oxygen therapy. Hyperoxic myopia continues to be a risk for those conducting intensive diving with a PO2 between 1.3-1.6 ATM. Additional investigation is warranted to better define risk factors and PO2 limits regarding ocular oxygen toxicity.

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