Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

HBOT used in conjunction with thrombolytic therapy may be beneficial in pain relief
although more studies are needed to arrive at a firm and generalisable conclusion.
Cerebrovascular disease
Two studies of carotid artery stroke were retrieved and assessed (Table 41). Both studies
were randomised controlled trials and were published four years apart. The study
populations were similar in size, enrolling about 35 to 40 people. One group of
participants was older by a mean difference of about 10 years.
Table 41 Descriptive characteristics of included studies focusing on the use of HBOT in
cerebrovascular disease.*
First Author and Year
of Publication
NHMRC
Level
Study
Design
Location
Nighoghossian 1995 79 II RCT France
Dates of
Enrolment Size
Dec 1988 to
Mar 1992
Anderson 1991 80 II RCT USA ?‡ 39
Characteristics of Study Population †
Age
Mean (SD)
Sex Ratio
(M:F)
46 Hyperbaric oxygen therapy
34
I=53 (3)
C=54 (3)
I=63.7
C=69.1
I=9:8
C=12:5
* Abbreviations: C = comparison group, F = female, I = intervention group, M = male, RCT = randomised controlled trial, SD = standard
deviation.
† Information is given for total study population values, and treatment and control groups.
‡ Unstated, unclear, or unknown.
Study quality
The randomisation procedures used by both studies are uncertain; no information was
provided to properly assess the methods used (Table 42). Anderson et al80 report the use
of double-masked procedures, while Nighoghossian et al79 is unclear. There were a total
of 12 losses to follow-up in the study by Anderson et al80 In the comparison group, the
five losses were distributed as follows: deaths (n = 2), migration (n = 2), and refusals (n
= 1); in the intervention group, there were two deaths, one migration, three refusals, and
one stroke. No comparisons of baseline characteristics between those lost to follow-up
and those remaining in the study were made.
Table 42 Methodological quality of included studies focusing on the use of HBOT in cerebrovascular
disease.*
First Author and Year
of Publication
Study Design Randomisation Masking Losses to Follow-up
Nighoghossian 1995 79 RCT Unclear Unclear 1
Anderson 1991 80 RCT Unclear Double masked T=7, C=5
* Abbreviations: C = control or comparison group, RCT = randomised controlled trial, T = treatment group
Patient criteria
The two studies used similar patient inclusion criteria (Table 43). Nighoghossian et al79 enrolled patients between 20 and 75 years of age with neurological deficit highly
suggestive of middle cerebral artery occlusion while excluding patients with a history of
stroke; those who exhibited substantial improvement or resolution of the deficit within 1
hour; were pregnant; experienced seizures at stroke onset; had metabolic encephalopathy,
significant pulmonary disease, congestive heart failure, or uncontrolled hypertension.
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