Hyperbaric Oxygen or Normobaric Oxygen?
- Dr Kent R. Olson
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The debate over optimal treatment of carbon monoxide continues, despite the publication of two randomised, double-blind controlled trials. What is the clinician to do?
Buckley and colleagueshave expertly summarised the studies by Scheinkestel et al.and Weaver et al.,and their analysis highlights the importance of careful study design, maintenance of blinding throughout the data gathering and analysis process, thorough follow-up of patients, and strict adherence to a priori study objectives and statistical analysis.
The study by Weaver et al.provides the best evidence to date of a possible benefit from hyperbaric oxygen (HBO). However, as described by Buckley et al.,there are several flaws that render its conclusions less convincing. Moreover, it has to be admitted that the neuropsychological testing data are clinically underwhelming. The raw scores show a statistically significant difference between treatment groups in only one of the six subtests (Trail Making Part A), an
- Buckley NA, Isbister GK, Stokes B, et al. Hyperbaric oxygen for carbon monoxide poisoning: a systematic review and critical analysis of the evidence. Toxicol Rev 2005; 24: 75–92 CrossRef
- Scheinkestel CD, Bailey M, Myles PS, et al. Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial. Med J Aust 1999; 170: 203–10
- Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med 2002; 347(14): 1057–67 CrossRef
- Hyperbaric Oxygen or Normobaric Oxygen?
Volume 24, Issue 3 , p 151
- Cover Date
- Print ISSN
- Springer International Publishing
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- Dr Kent R. Olson (1)
- Author Affiliations
- 1. California Poison Control System, University of California, UCSF Box 1369, San Francisco, California, 94143-1369, USA