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Hyperbaric oxygen therapy for acute ischaemic stroke

Overview of attention for article published in Cochrane database of systematic reviews, July 2005
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Title
Hyperbaric oxygen therapy for acute ischaemic stroke
Published in
Cochrane database of systematic reviews, July 2005
DOI 10.1002/14651858.cd004954.pub2
Pubmed ID
Authors

Bennett, Michael H, Wasiak, Jason, Schnabel, Alexander, Kranke, Peter, French, Christopher, Bennett, M H, Wasiak, J, Schnabel, A, Kranke, P, French, C

Abstract

Most cases of stroke are caused by impairment of blood flow to the brain (ischaemia) which results in a reduction in oxygen available and subsequent cell death. It has been postulated that hyperbaric oxygen therapy (HBOT) may reduce the volume of brain that will die by greatly increasing the oxygen available, and it may further improve outcome by reducing brain swelling. Some centres are using HBOT routinely to treat stroke. To assess the effectiveness and safety of adjunctive HBOT in the treatment of acute ischaemic stroke. We searched the Cochrane Stroke Group Trials Register (last searched 9 January 2004), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 3, 2004), MEDLINE (1966 to July 2004), EMBASE (1980 to July 2004), CINAHL (1982 to July 2004), and DORCTHIM (Database of Randomised Controlled Trials in Hyperbaric Medicine) (from inception to 2004). We handsearched journals and conference proceedings, searched reference lists of articles, and contacted researchers in an effort to identify additional published and unpublished studies. We included all randomised controlled trials that compared the effect of adjunctive HBOT with no HBOT (no treatment or sham). Two authors used standardised forms to extract the data independently. Each trial was assessed for internal validity with differences resolved by discussion. Data were extracted and entered into RevMan 4.2. Three randomised controlled trials (106 participants) satisfied the inclusion criteria. The methodological quality of the trials varied but was generally high. Data could be pooled for a limited number of clinically important outcomes. There were no significant differences in mortality rate at six months in those receiving HBOT compared to the control group (relative risk 0.61, 95% confidence interval (CI) 0.17 to 2.2, P value 0.45). Two of 15 scale measures of disability and functional indicated an improvement following HBOT, both at one year follow up: the mean Trouillas Disability Scale was lower with HBOT (mean difference (MD) 2.2 points reduction with HBOT, 95% CI 0.15 to 4.3, P value 0.04) and the mean Orgogozo Scale was higher (MD 27.9 points, 95% CI 4.0 to 51.8, P value 0.02). These improvements were not reflected in other trials or functional scales. This systematic review has not found evidence to show that HBOT improves clinical outcomes when applied during the acute presentation of ischaemic stroke. While evidence from the three randomised controlled trials is insufficient to provide clear guidelines for practice, clinical benefit does not seem likely. Further research is required to better define the role of HBOT in this condition.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 45 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 2%
United Kingdom 1 2%
Canada 1 2%
Egypt 1 2%
Unknown 41 91%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 18%
Researcher 6 13%
Student > Ph. D. Student 4 9%
Student > Bachelor 4 9%
Professor > Associate Professor 3 7%
Other 11 24%
Unknown 9 20%
Readers by discipline Count As %
Medicine and Dentistry 17 38%
Agricultural and Biological Sciences 5 11%
Business, Management and Accounting 1 2%
Nursing and Health Professions 1 2%
Biochemistry, Genetics and Molecular Biology 1 2%
Other 4 9%
Unknown 16 36%