Intervention Review

Hyperbaric oxygen therapy for thermal burns

  1. Elmer Villanueva2,
  2. Michael H Bennett3,
  3. Jason Wasiak1,*,
  4. Jan P Lehm4

Editorial Group: Cochrane Injuries Group

Published Online: 7 OCT 2009

Assessed as up-to-date: 31 MAY 2009

DOI: 10.1002/14651858.CD004727.pub2

Database Title

Additional Information

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.

Author Information

  1. 1

    The Alfred Hospital, Victorian Adult Burns Service, Melbourne, Victoria, Australia

  2. 2

    Monash University, Gippsland Medical School, Churchill, Victoria, Australia

  3. 3

    Prince of Wales Hospital, Department of Anaesthesia, Randwick, NSW, Australia

  4. 4

    Prince of Wales Hospital, Department of Diving and Hyperbaric Medicine, Randwick, NSW, Australia

*Jason Wasiak, Victorian Adult Burns Service, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria, 3181, Australia. J.Wasiak@alfred.org.au. jwasiak1971@gmail.com.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 7 OCT 2009

SEARCH

ARTICLE TOOLS

View Full Article (HTML) Summary (58K)Standard (169K)Full (200K)
 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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 therapy (HBOT) for the treatment of thermal burns.

Search methods

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Medicine: from inception to 2009); reference lists of relevant articles and Internet sources for published and unpublished trials.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.

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 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.

Main results

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.

Authors' 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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

對於熱燙傷之高壓氧治療

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。

目標

這篇回顧的目的為評估高壓氧治療(HBOT)對於熱燙傷效益的證據。

搜尋策略

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。

選擇標準

我們納入比較有HBOT與無HBOT(無治療或模擬)效果的隨機對照試驗。

資料收集與分析

兩名作者分別獨立地使用標準格式來摘錄資料。經由討論以解決每篇試驗被評估之不同的內在效度。資料摘錄並輸入到RevMan 4.2.3。

主要結論

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)。

作者結論

這篇系統性回顧沒有發現足夠的證據可以支持或反對HBOT對於管理熱燙傷的效果。兩篇隨機對照試驗並未充分提供明確的處置指引。需要進一步的研究以更好的定義HBOT在治療熱燙傷的角色。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有證據指出高壓氧對於燙傷患者的效益是很常見的，有時是致命的，以及對於那些患者的心理有高度影響。通常因為感染及結痂的原因造成康復緩慢且複雜。高壓氧是一種治療被設計用來增加燒傷區域氧氣的提供並促進痊癒。HBOT包含患者在一個特殊設計的氣艙裡吸入純氧(如那些用於深海潛水者在重回海面時承受的壓力問題)。回顧只有發現兩篇隨機研究，有限的病患數量。沒有發現HBOT具有一致性的效益，但一篇試驗認為其可以改善痊癒的時間。整體上來說，沒有證據可以支持或反對對於燒傷病患使用HBOT。需要更多的研究。

View Full Article (HTML) Summary (58K)Standard (169K)Full (200K)