A systematic review of the use of hyperbaric oxygen therapy in the treatment of acute traumatic brain injury. The Cochrane Database of Systematic Reviews 2004

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A systematic review of the use of hyperbaric oxygen therapy in the treatment of acute traumatic brain injury. The Cochrane Database of Systematic Reviews 2004

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Title: A systematic review of the use of hyperbaric oxygen therapy in the treatment of acute traumatic brain injury. The Cochrane Database of Systematic Reviews 2004
Author: Bennett, MH; Trytko, BE; Jonker, B
Abstract: Introduction: We aimed to assess the randomised clinical evidence for the benefits and harms of adjunctive hyperbaric oxygen therapy (HBOT) for acutely brain-injured patients. HBOT can improve oxygen supply to the injured brain and reduce both cerebral oedema and cerebrospinal fluid pressure and might therefore result in a reduction in patient death and disability. Methods: We performed a systematic search of the literature for randomised controlled trials and made pooled analyses of pre-determined clinical outcomes where possible using Cochrane Collaboration methodology. We included adults with serious closed head injury requiring admission to an intensive care environment and included trials must have compared a standard therapy with adjunctive HBOT to standard therapy alone following randomised allocation. We pre-determined important clinical outcomes and assessed them when reported in the primary studies. Results: Four trials contributed to this review (382 participants, 199 receiving HBOT and 183 control). Pooled analysis suggested a significant reduction in the risk of dying when HBOT was added (RR 0.69, 95% CI 0.54 to 0.88, NNT = 7, P = 0.003), but no statistically significant increase in the chance of a favourable clinical outcome (RR 1.94, 95% CI 0.92 to 4.08, P = 0.08). Conclusions: HBOT reduced the risk of death but did not clearly increase the chance of favourable clinical outcome. Routine application of HBOT to these patients should not be justified from this review. More research of high methodological rigour is needed in order to confirm or refute the findings of this review.
Description: The Journal of the South Pacific Underwater Medicine Society (Incorporated in Victoria) A0020660B and the European Underwater and Baromedical Society
URI: http://archive.rubicon-foundation.org/10182
Date: 2006

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