A Cochrane review [Abstract] 1 included 6 studies with a total of 665 subjects. There was a significant decrease in the risk of death with hyperbaric oxygen therapy (HBOT) (RR 0.58, 95% CI 0.36 to 0.92; 5 studies, n = 614). The extent of heart muscle damage was lower following HBOT, as shown by a lesser rise in muscle enzyme in the blood (MD 493 IU, P = 0.005) and a better LVEF (MD 5.5%, P = 0.001). There was evidence from individual trials of reductions in the risk of major adverse coronary events (MACE)(RR 0.12, 95% CI 0.02 to 0.85, 1 study, n = 61; NNT 4, 95% CI 3 to 10), re-infarction (RR 0.28, 95% CI 0.08 to 0.95; 1 study, n = 129) and dysrhythmias following HBOT (RR 0.59, 95% CI 0.39 to 0.89, 1 study, n = 208; NNT 6, 95% CI 3 to 24), and that the time to relief of pain was reduced with HBOT (MD 353 minutes shorter, 95% CI 219 to 488, 1 study, n = 81). One trial (n = 208) suggested a significant incidence of claustrophobia in single occupancy chambers of 15% (RR of claustrophobia with HBOT 31.6, 95%CI 1.92 to 521, P = 0.02). The authors state that the routine adjunctive use of HBOT in these patients cannot be justified by this review.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding) and by imprecise results (limited study size for each comparison).
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