Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

Table 37 Descriptive characteristics of included studies focusing on the use of HBOT in acute
myocardial infarction.*
First Author and
Year of Publication
Stavitsky 1998 77
Thurston 1973 78
NHMRC
Level
Study
Design
II RCT
II RCT UK
Location
US,
Yugoslavi
a
Dates of
Enrolment Size
Aug 1989 to
Dec 1997
Sep 1968 to
Jan 1972
Characteristics of Study Population †
Age
Mean (SD)
Sex Ratio
(M:F)
44 Hyperbaric oxygen therapy
112
208
I=58 (11.1)
C= 59 (11.7)
I=58.1
C=57.2
* Abbreviations: C = comparison group, F = female, I = intervention group, M = male, RCT = randomised controlled trial.
† Information is given for total study population values, and intervention and comparison groups.
I=49:10
C=48:15
I=88:15
C=87:18
Study quality
Only the study by Stavitsky et al77 was described in enough detail to determine the
adequacy of randomisation. Both studies were unclear about the presence or process of
masking. None of the studies reported patients lost to follow-up. Table 38 summarises
these findings.
Table 38 Methodological quality of included studies focusing on the use of HBOT in acute myocardial
infarction.*
First Author and
Year of Publication
Study Design Randomisation Masking Losses to Follow-up
Stavitsky 1998 77 RCT Adequate Unclear No losses
Thurston 1973 78
RCT Unclear Unclear No losses
* Abbreviation: C = control or comparison group, RCT = randomised controlled trial, T = treatment group
Patient criteria
There is concern about the potential for differences in the criteria on which patient
recruitment was based (Table 39). Stavitsky et al 77 provided explicit and measurable signs
and symptoms. In contrast, Thurston et al 78 recruited on the basis of “strong clinical
probability” of acute myocardial infarction. An effort to confirm and exclude
misdiagnosed participants was done, although these procedures and criteria were not
described in detail and may ostensibly be exposed to similar biases.
Table 39 Patient criteria of included studies focusing on the use of HBOT in acute myocardial
infarction.
First Author and
Year of Publication
Stavitsky 1998 77
Thurston 1973 78
Patient Criteria
Patients aged between 18 and 80 years admitted to the emergency department showing signs
(ST elevation ≥ 1 mm in two adjacent electrocardiograph leads) or symptoms (chest pain ≥ 20
minutes but ≤ 6 hours in duration unrelieved by sublingual nitroglycerin) suggestive of an acute
myocardial infarction.
Patients under 70 years of age with a strong clinical probability of acute myocardial infarction
occurring within 24 hours of enrolment, and without contraindications to HBO.
Interventions examined
Both studies made use of “conventional therapy” (Table 40) for the comparison group,
but this has changed considerably over the 25 year interval between the identified studies.
The use of more effective therapy over time that increased the probability of better