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Evidence summaries

Hyperbaric Oxygen Therapy for Acute Ischaemic Stroke

Adjunctive hyperbaric oxygen therapy (HBOT) may not be effective in the treatment of acute ischaemic stroke. Level of evidence: "C"

A Cochrane review [Abstract] 1 11 randomized controlled trials with a total of 705 participants. The patients had had an ischaemic stroke within 24 hours (4 trials), 48 hours (1 trial), 72 h (2 trials), 7 days (1 trial) or 2 weeks (1 trial). On one trial the stroke was described as “acute” without further information and on one the information was unspecified. Hyperbaric oxygen therapy (HBOT) lasted for 40 (1 trials), 60 (6 trials), 80 (2 trials) or 120 minutes (1 trial). On one trial the length of HBOT was unspecified. The follow-up time ranged from 21 days to 1 year. There were no significant differences in mortality rate at 6 months in those receiving HBOT compared to the control group (relative risk 0.97, 95 % CI 0.34 to 2.75). Some indications showed improvement on some functional and clinical scales (including mean Orgogozo scale and mean Trouillas Disability scale) following HBOT between 5 days and 1 year follow up, but these findings were inconsistent. In all of the 15 comparisons made, three studies reported a total of four comparisons with a statistically significant difference in favour of HBOT, but the clinical importance of these differences is unclear.

Comment:The quality of evidence is downgraded by study quality (unclear allocation concealment) and inconsistency (heterogeneity in patients and outcomes).

    References

    • Bennett MH, Weibel S, Wasiak J et al. Hyperbaric oxygen therapy for acute ischaemic stroke. Cochrane Database Syst Rev 2014;11():CD004954. [PubMed].

Primary/Secondary Keywords