Hyperbaric oxygenation as an adjunct therapy in strokes due to thrombosis. A review of 122 patients.

Neubauer, Richard A.; End, Edgar

doi:10.1161/01.str.11.3.297

Cited by 70 publications

(24 citation statements)

References 6 publications

(2 reference statements)

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“…Despite this, it is difficult to determine the true benefit or harm from HBO for ischemic stroke due to the heterogeneity of patients, treatments and experimental designs (table 5). Most of the early trials reported a benefit from treatment of ischemic stroke patients with HBO [4,74,75,76,77]. Unfortunately, these trials were for the most part, uncontrolled, and utilized greatly disparate criteria for inclusion as well as for evaluation of improvement.…”

Section: Human Studiesmentioning

confidence: 99%

“…Animal studies suggest that treatment beyond 4–6 h is less beneficial and may be harmful. In humans, Neubauer and End [74] reported 16 patients who were treated with HBO within 4 h of stroke and observed a shorter length of stay and better outcome, as determined by discharge location, than for age- and severity-matched patients at another institution. Similarly Kapp[ 75] administered HBO to 2 patients within 1 h after stroke onset and described complete resolution of symptoms, whereas patients treated later did not have such a dramatic response.…”

Section: Human Studiesmentioning

confidence: 99%

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Hyperbaric Oxygen Therapy of Cerebral Ischemia

Helms

Whelan

Torbey³

2005

Cerebrovasc Dis

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Background: Hyperbaric oxygen (HBO) therapy of cerebral ischemia has been evaluated in a number of human and animal studies; however, there is presently no consensus on its efficacy. Methods: We present a review of animal and human studies on HBO therapy of cerebral ischemia as well as present potential mechanisms of action of HBO. Results: Animal studies of HBO have shown promise by reducing infarct size and improving neurologic outcome. HBO has also been shown to inhibit inflammation and apoptosis after cerebral ischemia. Early reports in humans also suggested benefit in stroke patients treated with HBO. Recent randomized, controlled human studies, however, have not shown benefit, although all were limited by small sample size. Important differences between animal and human studies suggest HBO might be more effective in stroke within the first few hours and at a pressure of 2–3 ATA. Conclusions: The clinical usefulness of HBO in the treatment of cerebral ischemia is not yet certain. Attention to emerging pathophysiologic data should be taken into consideration in design of any future clinical trials of HBO in acute ischemic stroke.

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Section: Human Studiesmentioning

confidence: 99%

Section: Human Studiesmentioning

confidence: 99%

Hyperbaric Oxygen Therapy of Cerebral Ischemia

Helms

Whelan

Torbey³

2005

Cerebrovasc Dis

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“…3,8,10,13,15,20) HBO was reportedly difficult to administer by schedule and to tolerate, but all of our patients except one underwent HBO on schedule, with no patient refusal to continue. 3) As intravenous edaravone administration also had no major adverse reactions, combined treatment could be performed safely in patients with embolic stroke.…”

Section: Discussionmentioning

confidence: 77%

“…3,8,10,13,15,20) The experimental studies suggested considerable potential, 5,12,18,24) but the clinical effectiveness in patients with acute ischemic stroke has been controversial. With the exception of three studies, 3,15,20) the major criticism of most clinical investigations has been the lack of controlled prospective analysis.…”

Section: Introductionmentioning

confidence: 99%

Hyperbaric Oxygen Combined With Intravenous Edaravone for Treatment of Acute Embolic Stroke: a Pilot Clinical Trial

Imai

Mori

Izumoto

et al. 2006

Neurol. Med. Chir.(Tokyo)

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The efficacy of hyperbaric oxygen (HBO) therapy combined with intravenous edaravone (free radical scavenger) administration was prospectively investigated in patients with acute embolic stroke involving the anterior cerebral circulation. Patients with acute embolic stroke in the anterior cerebral circulation admitted within 48 hours of onset from August 2001 to March 2002 with National Institutes of Health Stroke Scale (NIHSS) scores on admission of 5 or more were assigned randomly to HBO and control groups. The HBO group underwent HBO therapy combined with intravenous edaravone administration for 7 days, whereas the control group received only conventional treatment. The primary endpoint was the modified Rankin Scale score at 90 days (favorable outcome, score 0 or 1). The secondary endpoint was the NIHSS score at 7 days. Analysis was carried out by intention to treat. Six of the 19 patients in the HBO group, but only one of the 19 patients in the control group, had favorable outcomes at 90 days (p º 0.05), although NIHSS score at 7 days did not differ significantly between the two groups. HBO therapy combined with intravenous edaravone administration appears to be effective for the treatment of patients with acute embolic stroke in the anterior cerebral circulation.

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“…Most of the early trials reported a benefit from treatment of ischemic stroke patients with HBO. (21,22,23,24,25) These trials, however, were for the most part, uncontrolled, and utilized greatly disparate criteria for inclusion as well as for evaluation of improvement. Of the three small recent randomized trials of HBO in AIS (26,27,28), no significant difference was seen between treatment and sham groups.…”

Section: Hyperbaric Oxygen For Stroke Protocol Backgroundmentioning

confidence: 99%