Hyperbaric oxygen therapy for thermal burns
Editorial Group: Cochrane Injuries Group
Published Online: 19 APR 2004
Assessed as up-to-date: 31 MAY 2009
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Villanueva E, Bennett MH, Wasiak J, Lehm JP. Hyperbaric oxygen therapy for thermal burns. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD004727. DOI: 10.1002/14651858.CD004727.pub2.
- Publication Status: New search for studies and content updated (no change to conclusions)
- Published Online: 19 APR 2004
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.
The aim of this review was to assess the evidence for the benefit of hyperbaric oxygen therapy (HBOT) for the treatment of thermal burns.
We searched the Cochrane Injuries Group Specialised Register; CENTRAL (The Cochrane Library 2009, Issue 2); MEDLINE; PubMed; EMBASE; ISI Web of Science and Conference Proceedings Citation Index-Science (CPCI-S); DORCTHIM (Database of Randomised Controlled Trials in Hyperbaric Medicine: from inception to 2009); reference lists of relevant articles and Internet sources for published and unpublished trials. The latest search was carried out in June 2009.
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 independently extracted data using standardised forms. Each trial was assessed for internal validity with differences resolved by discussion. Data were extracted and entered into RevMan 4.2.3.
Five 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 was not appropriate to pool the data.
One trial reported no difference in mortality, number of surgeries or length of stay between the control and HBOT groups once these variables were adjusted for the patients' condition. The second trial reported mean healing times that were shorter in patients exposed to HBOT (mean: 19.7 days versus 43.8 days). No further eligible trials were found when the search was updated in June 2009.
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.
Plain language summary
Little evidence that burns patients benefit from hyperbaric oxygen therapy
Burns are very common, sometimes fatal, and have a high impact on the wellbeing of those affected. Recovery is often slow and complicated by infection and scarring. Hyperbaric oxygen therapy (HBOT) is a treatment designed to increase the supply of oxygen to the burnt area and improve healing. HBOT involves people breathing pure oxygen in a specially designed chamber (such as those used for deep sea divers suffering pressure problems after resurfacing). The review found only two randomised trials, with only a limited number of patients. There was no consistent benefit from HBOT, but one trial did suggest an improvement in healing time. Overall, there is little evidence to support or refute the use of HBOT for burns patients. More research is needed.
高壓氧治療(Hyperbaric oxygen therapy (HBOT))包括在大於一大氣壓的壓力艙裡間歇性地施予100%的氧氣。這種技術已被用來治療各種的疾病狀況且已被描述用來幫助燒傷患者。
我們檢索the CENTRAL (考科藍圖書館，2006年，第4期)，MEDLINE (Ovid 1966至2007年1月)，CINAHL (Ovid 1982至2007年1月)，EMBASE (Ovid 1980至2007年1月)，2006年第4期的National Research Register，ISI Web of Knowledge(2003至2007年)，及成立於2003年的DORCTHIM (Database of Randomised Controlled Trials in Hyperbaric Medicine)，以及相關文章的參考文獻。
確定了五篇隨機對照試驗，其中兩篇符合納入標準。試驗的方法學品質不佳。因此，很難信任各項結果且不適合加總資料。一篇試驗報告在這些變項調整病患的狀況後，對照與HBOT組其死亡率，手術量或住院天數沒有差異。第二篇試驗指出暴露於HBOT的病患其平均痊癒天數較短(平均值：19.7天 對照 43.8天)。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。