Research Reports - Is hyperbaric oxygen therapy effective for traumatic brain injury?

J Head Trauma Rehabil. 2016 Sep 6. [Epub ahead of print]

Crawford C(1), Teo L, Yang E, Isbister C, Berry K.

OBJECTIVE: This systematic review examines the efficacy of hyperbaric oxygen
(HBO2) for traumatic brain injury (TBI) to make evidence-based recommendations
for its application and future research.
METHODS: A comprehensive search was conducted to identify studies through 2014.
Methodological quality was assessed and synthesis and interpretation of relevant
data was performed.
RESULTS: Twelve randomized trials were included. All mild TBI studies
demonstrated minimal bias and no statistically significant differences between
HBO2 and sham arms. Statistically significant improvement occurred over time
within both groups. Moderate-to-severe TBI studies were of mixed quality, with
majority of results favoring HBO2 compared with "standard care." The placebo
analysis conducted was limited by lack of details.
CONCLUSIONS: For mild TBI, results indicate HBO2 is no better than sham
treatment. Improvements within both HBO2 and sham groups cannot be ignored. For
acute treatment of moderate-to-severe TBI, although methodology appears flawed
across some studies, because of the complexity of brain injury, HBO2 may be
beneficial as a relatively safe adjunctive therapy if feasible. Further research
should be considered to resolve the controversy surrounding this field, but only
if methodological flaws are avoided and bias minimized.This is an open-access
article distributed under the terms of the Creative Commons Attribution-Non
Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to
download and share the work provided it is properly cited. The work cannot be
changed in any way or used commercially. 

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