Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis
Abstract Objective This study aims to evaluate the efficacy and safety of adjunctive hyperbaric oxygen therapy (HBOT) in acute ischaemic stroke (AIS) based on existing evidence. Methods We conducted a comprehensive search through April 15, 2023, of seven major databases for randomized controlled tri...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-024-03555-w |
| _version_ | 1797274262494511104 |
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| author | Xuezheng Li Lijun Lu Yu Min Xuefeng Fu Kaifeng Guo Wen Yang Hao Li Haoming Xu Hua Guo Zhen Huang |
| author_facet | Xuezheng Li Lijun Lu Yu Min Xuefeng Fu Kaifeng Guo Wen Yang Hao Li Haoming Xu Hua Guo Zhen Huang |
| author_sort | Xuezheng Li |
| collection | DOAJ |
| description | Abstract Objective This study aims to evaluate the efficacy and safety of adjunctive hyperbaric oxygen therapy (HBOT) in acute ischaemic stroke (AIS) based on existing evidence. Methods We conducted a comprehensive search through April 15, 2023, of seven major databases for randomized controlled trials (RCTs) comparing adjunctive hyperbaric HBOT with non-HBOT (no HBOT or sham HBOT) treatments for AIS. Data extraction and assessment were independently performed by two researchers. The quality of included studies was evaluated using the tool provided by the Cochrane Collaboration. Meta-analysis was conducted using Rev Man 5.3. Results A total of 8 studies involving 493 patients were included. The meta-analysis showed no statistically significant differences between HBOT and the control group in terms of NIHSS score (MD = -1.41, 95%CI = -7.41 to 4.58), Barthel index (MD = 8.85, 95%CI = -5.84 to 23.54), TNF-α (MD = -5.78, 95%CI = -19.93 to 8.36), sICAM (MD = -308.47, 95%CI = -844.13 to 13227.19), sVCAM (MD = -122.84, 95%CI = -728.26 to 482.58), sE-selectin (MD = 0.11, 95%CI = -21.86 to 22.08), CRP (MD = -5.76, 95%CI = -15.02 to 3.51), adverse event incidence within ≤ 6 months of follow-up (OR = 0.98, 95%CI = 0.25 to 3.79). However, HBOT showed significant improvement in modified Rankin score (MD = 0.10, 95%CI = 0.03 to 0.17), and adverse event incidence at the end of treatment (OR = 0.42, 95%CI = 0.19 to 0.94) compared to the control group. Conclusion While our findings do not support the routine use of HBOT for improving clinical outcomes in AIS, further research is needed to explore its potential efficacy within specific therapeutic windows and for different cerebral occlusion scenarios. Therefore, the possibility of HBOT offering clinical benefits for AIS cannot be entirely ruled out. |
| first_indexed | 2024-03-07T14:55:52Z |
| format | Article |
| id | doaj.art-d578c3cd356c46cb873d42b7f865ba40 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-03-07T14:55:52Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-d578c3cd356c46cb873d42b7f865ba402024-03-05T19:28:07ZengBMCBMC Neurology1471-23772024-02-0124111110.1186/s12883-024-03555-wEfficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysisXuezheng Li0Lijun Lu1Yu Min2Xuefeng Fu3Kaifeng Guo4Wen Yang5Hao Li6Haoming Xu7Hua Guo8Zhen Huang9Postgraduate cultivation base of Guangzhou University of Chinese Medicine, Panyu Central HospitalPostgraduate cultivation base of Guangzhou University of Chinese Medicine, Panyu Central HospitalPostgraduate cultivation base of Guangzhou University of Chinese Medicine, Panyu Central HospitalPostgraduate cultivation base of Guangzhou University of Chinese Medicine, Panyu Central HospitalDepartment of Rehabilitation Medicine, Guangzhou Panyu Central HospitalPostgraduate cultivation base of Guangzhou University of Chinese Medicine, Panyu Central HospitalPostgraduate cultivation base of Guangzhou University of Chinese Medicine, Panyu Central HospitalSouth China Normal UniversityDepartment of Rehabilitation Medicine, Guangzhou Panyu Central HospitalDepartment of Rehabilitation Medicine, Guangzhou Panyu Central HospitalAbstract Objective This study aims to evaluate the efficacy and safety of adjunctive hyperbaric oxygen therapy (HBOT) in acute ischaemic stroke (AIS) based on existing evidence. Methods We conducted a comprehensive search through April 15, 2023, of seven major databases for randomized controlled trials (RCTs) comparing adjunctive hyperbaric HBOT with non-HBOT (no HBOT or sham HBOT) treatments for AIS. Data extraction and assessment were independently performed by two researchers. The quality of included studies was evaluated using the tool provided by the Cochrane Collaboration. Meta-analysis was conducted using Rev Man 5.3. Results A total of 8 studies involving 493 patients were included. The meta-analysis showed no statistically significant differences between HBOT and the control group in terms of NIHSS score (MD = -1.41, 95%CI = -7.41 to 4.58), Barthel index (MD = 8.85, 95%CI = -5.84 to 23.54), TNF-α (MD = -5.78, 95%CI = -19.93 to 8.36), sICAM (MD = -308.47, 95%CI = -844.13 to 13227.19), sVCAM (MD = -122.84, 95%CI = -728.26 to 482.58), sE-selectin (MD = 0.11, 95%CI = -21.86 to 22.08), CRP (MD = -5.76, 95%CI = -15.02 to 3.51), adverse event incidence within ≤ 6 months of follow-up (OR = 0.98, 95%CI = 0.25 to 3.79). However, HBOT showed significant improvement in modified Rankin score (MD = 0.10, 95%CI = 0.03 to 0.17), and adverse event incidence at the end of treatment (OR = 0.42, 95%CI = 0.19 to 0.94) compared to the control group. Conclusion While our findings do not support the routine use of HBOT for improving clinical outcomes in AIS, further research is needed to explore its potential efficacy within specific therapeutic windows and for different cerebral occlusion scenarios. Therefore, the possibility of HBOT offering clinical benefits for AIS cannot be entirely ruled out.https://doi.org/10.1186/s12883-024-03555-wAcute ischaemic strokeHyperbaric oxygenMeta-analysisSystematic reviewRandomized controlled trialsRehabilitation |
| spellingShingle | Xuezheng Li Lijun Lu Yu Min Xuefeng Fu Kaifeng Guo Wen Yang Hao Li Haoming Xu Hua Guo Zhen Huang Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis BMC Neurology Acute ischaemic stroke Hyperbaric oxygen Meta-analysis Systematic review Randomized controlled trials Rehabilitation |
| title | Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis |
| title_full | Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis |
| title_short | Efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke: a systematic review and meta-analysis |
| title_sort | efficacy and safety of hyperbaric oxygen therapy in acute ischaemic stroke a systematic review and meta analysis |
| topic | Acute ischaemic stroke Hyperbaric oxygen Meta-analysis Systematic review Randomized controlled trials Rehabilitation |
| url | https://doi.org/10.1186/s12883-024-03555-w |
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