Villanueva E, Bennett MH, Wasiak J, Lehm JP, et al.
The Cochrane database of systematic reviews. Date of publication 2004 Jan 1;volume (3):CD004727.
1. Cochrane Database Syst Rev. 2004;(3):CD004727.
Hyperbaric oxygen therapy for thermal burns.
Villanueva E, Bennett MH, Wasiak J, Lehm JP.
BACKGROUND: Hyperbaric oxygen therapy (HBOT) consists of intermittently
administering 100% oxygen at pressures greater than 1 atmosphere in a pressure
vessel. This technology has been used to treat a variety of disease states and
has been described as helping patients who have sustained burns.
OBJECTIVES: The aim of this review was to assess the evidence for the benefit of
hyperbaric oxygen treatment (HBOT) for the treatment of thermal burns.
SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register (The
Cochrane Library, Issue 3, 2002), MEDLINE (Ovid 1966 to November Week 2, 2003),
CINAHL (Ovid 1982 to December Week 2 2003), EMBASE (Ovid 1980 to September 2003),
DORCTHIM (Database of Randomised Controlled Trials in Hyperbaric Medicine) from
inception to 2003, and reference lists of articles.
SELECTION CRITERIA: We included all randomised controlled trials that compared
the effect of HBOT with no HBOT (no treatment or sham).
DATA COLLECTION AND ANALYSIS: Two authors using standardised forms extracted the
data independently. Each trial was assessed for internal validity with
differences resolved by discussion. Data was extracted and entered into RevMan
4.2.3.
MAIN RESULTS: Four randomised controlled trials were identified, of which two
satisfied the inclusion criteria. The trials were of poor methodological quality.
As a result, it was difficult to have confidence in the individual results and it
would not have been appropriate to attempt to pool the data. One trial reported
no difference in length of stay, mortality, or number of surgeries between the
control and HBO-treated groups once these variables were adjusted for the
patient's condition. The second trial reported mean healing times that were
shorter in patients exposed to HBOT (mean: 19.7 days versus 43.8 days).
REVIEWERS' CONCLUSIONS: This systematic review has not found sufficient evidence
to support or refute the effectiveness of HBOT for the management of thermal
burns. Evidence from the two randomised controlled trials is insufficient to
provide clear guidelines for practice. Further research is needed to better
define the role of HBOT in the treatment of thermal burns.
DOI: 10.1002/14651858.CD004727.pub2
PMID: 15266540 [Indexed for MEDLINE]
