Hyperbare Zuurstoftherapie: Rapid Assessment - KCE

KCE Reports 74 Hyperbaric Oxygenation Therapy 90
Table 37. Overview of indications for HBOT, the evidence on effectiveness, acceptance by scientific bodies, current Belgian practice and
propose maximum number of sessions
Indication Evidence ECHM accepted
indication* 9
CO Intoxication No evidence on short term outcomes and low quality evidence for
non-efficacy on neurologic sequels
UHMS accepted
indication 8
Current Belgian
practice**
Yes Yes Sessions: 724 (5%)
Patients: 710 (40.5%)
Decompression Accidents Empirical evidence (evidence level high), but no RCTs Yes Yes Sessions: 228 (1.6%)
Patients: 60 (3.4%)
Gas Embolism Empirical evidence (evidence level low), but no RCTs Yes Yes Sessions: 6 (0.04%)
Patients: 4 (0.2%)
Anaerobic or mixed Anaerobic-Aerobic
Bacterial Infections
Very low quality or no evidence Yes Yes Sessions: 545 (3.8%)
Patients: 62 (3.5%)
Acute Soft Tissue Ischemia Very low quality or no evidence Yes Yes Sessions: 626 (4.4%)
Patients: 39 (2.2%)
Post-radiotherapy tissue damage Low quality evidence from small RCTs on the clinical efficacy of HBOT
in selected cases of post-radiotherapy tissue damage
Low quality evidence from small RCTs on the clinical efficacy of
Delayed Wound Healing
adjuvant HBOT in patients with diabetic ulcers with effect on major
amputations in the medium term
Very low quality or no evidence for the efficacy of adjuvant HBOT for
delayed wound healing other than that associated with diabetes
Osteomyelitis Very low quality or no evidence for the efficacy of adjuvant HBOT for
chronic refractory osteomyelitis
Post-anoxic Encephalopathy Very low quality or no evidence for the efficacy of adjuvant HBOT Yes No
Yes Yes Sessions: 4357 (30.3%)
Patients: 181 (10.3%)
Yes Yes Delayed wound healing
Sessions: 772 (5.4%)
Patients: 58 (3.3%)
Diabetic ischemic injuries
Sessions: 1122 (7.8%)
Patients: 85 (4.8%)
Yes Yes Sessions: 823 (5.7%)
Patients: 41 (2.3%)
Thermal Burns Very low quality or no evidence for the efficacy of adjuvant HBOT Yes Yes Sessions: 30 (0.2%)
Patients: 3 (0.2%)
Hearing Disorders Low quality evidence from small RCTs on the clinical efficacy of HBOT
in acute deafness presenting early. A slightly better recovery was
observed with adjuvant HBOT but the clinical relevance is uncertain
Ophtalmological Disorders Very low quality or no evidence for the efficacy of adjuvant HBOT for
acute ophtalmological ischemia
Yes No Sessions: 4736 (32.9%)
Patients: 463 (26.4%)
Yes No
Neuroblastoma Stage IV Very low quality or no evidence for the efficacy of adjuvant HBOT Yes No
Pneumatosis Cystoides Intestinalis Very low quality or no evidence for the efficacy of adjuvant HBOT Yes No
Exceptional Anaemia Very low quality or no evidence for the efficacy of adjuvant HBOT No Yes
* For levels of evidence, see appendix
** Data from Belgian questionnaire see chapter 5.7
*** Proposal approved in 2004 by the Technische Geneeskundige Raad/Conseil Technique Medical; see chapter 5.5
Proposed maximum
number of sessions***
3
7
7
7
10
40
40 in two years
30 in two years
15 in five years