, Volume 24, Issue 3, p 151
Date: 23 Aug 2012

Hyperbaric Oxygen or Normobaric Oxygen?

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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 colleagues[1]have expertly summarised the studies by Scheinkestel et al.[2]and Weaver et al.,[3]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.[3]provides the best evidence to date of a possible benefit from hyperbaric oxygen (HBO). However, as described by Buckley et al.,[1]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