Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Summary
These results are difficult to interpret in the light of the failure of both studies to
adequately describe their patient populations and comparison interventions, and the
limited and poorly described outcomes they measured. Exposure to HBOT may well
demonstrate a beneficial effect on the survival of split skin grafts and myocutaneous
flaps, but these studies possess serious flaws that strictly limit their generalisability.
Multiple sclerosis
The search of the literature revealed several studies focusing on the use of HBOT on
multiple sclerosis. 63-75 Of these, the study by Kleijnen and Knipschild 63 was a systematic
review that used broad search strategies, explicit inclusion and exclusion criteria, and
performed comprehensive methodological assessments of all studies captured by this
report. A search revealed no studies that met the inclusion and exclusion criteria
published subsequent to the release of this systematic review. The following discussion is
consequently limited to an assessment of the Kleijnen and Knipschild review.
Using explicit search criteria, the review assessed 14 reports of double-blind, randomised
or pseudo-randomised clinical trials. After assessing study designs by the use of a 10point
methodological quality score, the authors examined the eight studies with the
highest ratings (≥ 7). 66,68-73,75
In this high-quality subset, patients had chronic progressive or chronic stable multiple
sclerosis. Patients were treated in either mono- or multiplace chambers at 1.75 to 2 ATA.
The principle outcome was based on changes in the (Expanded) Disability Status Score
(EDSS) and the Functional Status Score (FSS) as described by Kurtzke. 76 Both end
points showed conflicting results, although the conclusions of a majority of studies
showed a lack of statistically significant differences between the groups. Direction of
effect was the only means of summarising effect due to the “great differences” in the way
the results of individual studies were presented.
Summary
The studies do not consistently demonstrate any beneficial effect of HBOT on clinical
outcomes of multiple sclerosis. There is little evidence to support the use of HBOT for
this indication at this time.
Cardiovascular disease conditions
The efficacy of HBOT for acute myocardial infarction, cerebrovascular disease, and
peripheral obstructive arterial disease is discussed below.
Acute myocardial infarction
Two studies were retrieved from the published literature (Table 37). A difference of 25
years separated the publication of the studies, although both recruited a large number of
participants with similar mean ages and sex ratios.
Hyperbaric oxygen therapy 43