Fukami - Revision history

M.bennett at 07:41, 17 August 2022

2022-08-17T07:41:29Z

M.bennett at 07:21, 18 August 2021

2021-08-18T07:21:13Z

M.bennett at 06:02, 22 July 2019

2019-07-22T06:02:33Z

M.bennett at 05:39, 22 July 2019

2019-07-22T05:39:07Z

Show changes

M.bennett: Created page with " Hyperbaric oxygen did not improve the outcome from postopertive adhesive small bowel obstruction '''
2019-07-22T05:30:08Z

Created page with " Hyperbaric oxygen did not improve the outcome from postopertive adhesive small bowel obstruction '''Hyperbaric oxygen did not improve the outcome from postopertive adhesive small bowel obstruction

'''Clinical Bottom Line:'''

1.Hyperbaric oxygen made no difference to the outcome

'''Citation/s: '''1. Fukami Y, Kobayashi S, Sekoguchi E, Kurumiya Y. Randomized controlled trial of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction. Langenbeck's archives of surgery. 2018 Aug 1;403(5):555-9.

'''Lead author's name and fax:'''Y Fukami yasuyuki490225@yahoo.co.jp

'''Three-part Clinical Question:'''For patients with postoperative small bowel obstruction, does the addition of a course of hyperbaric oxygen to the usual care, result in a reduction in the time to recovery or need for operation?

'''Search Terms:'''Small bowel obstruction., postoperative compliations

'''The Study: '''Non-blinded concealed randomised controlled trial with intention-to-treat.

'''The Study Patients:'''Adult patients with a history of abdominal surgery more than four weeks previously and clinical signs and symptoms of mechanical obstruction, with dilated loops of small intestine of CT scan.

'''Control group'''(N = 40; 40 analysed): No oral intake, IV fluids and insertion of nasograstric tube.

'''Experimental group'''(N = 33; 33 analysed): As above plus 100% osygen breathing at 2 ATA for 90 minutes daily up to seven times or until improvement in symptoms.

 

'''The Evidence:'''

{| class="Table" style="border:undefined"
|-
| '''Outcome'''
| '''Time to Outcome'''
| '''Standard group'''
| '''HBOT group'''
| style="width:67.85pt" width="92" | '''Relative risk reduction'''
| style="width:69.35pt" width="94" | '''Absolute risk reduction'''
| style="width:80.1pt" width="110" | '''NNT'''
|-
| rowspan="2" | '''Need for operation'''
| no defined period
| 0.10
| 0.18
| style="width:67.85pt" width="92" | -82%
| style="width:69.35pt" width="94" | -0.08
| style="width:80.1pt" width="110" | 12
|-
| colspan="3" | 95% CIs:
| style="width:67.85pt" width="92" | -243% to 79%
| style="width:69.35pt" width="94" | -0.24 to 0.08
| style="width:80.1pt" width="110" | NNT = 4 to INF; NNH = 13 to INF
|-
| rowspan="2" | '''Successful medical treatment'''
| No defined period
| 0.73
| 0.79
| style="width:67.85pt" width="92" | -9%
| style="width:69.35pt" width="94" | -0.06
| style="width:80.1pt" width="110" | 16
|-
| colspan="3" | 95% CIs:
| style="width:67.85pt" width="92" | -36% to 18%
| style="width:69.35pt" width="94" | -0.259 to 0.133
| style="width:80.1pt" width="110" | NNT = 4 to INF; NNH = 7 to INF
|}

 

{| class="Table" style="border:undefined"
|-
| rowspan="2" | '''Measure'''
| colspan="2" | '''Standard Group'''
| colspan="2" | '''HBOT Group'''
| rowspan="2" | '''Difference'''
| rowspan="2" | '''95% CI'''
|-
| '''Mean'''
| '''SD'''
| '''Mean'''
| '''SD'''
|-
|
'''Time to oral intake (days)'''

| 4.2
| 3.7
| 4.2
| 3.3
| 0.0
| -5.8 to 5.8
|-
|
'''Length of hospital stay (days)'''

| 11.5
| 7.0
| 14.2
| 10.0
| -2.7
| -36.4 to 31.0
|}

 

'''Comments:'''

1. Small trial, somewhat underpowered (original target 100 individuals randomised), but no indication of likely benefit.

2. Bias remains possible due to unbiased nature of trial, but this seems unlikely to be large given the nature of the endpoints.

 

'''Appraised by:'''Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019

'''Kill or Update By''': July 2025

@@ Line 2: / Line 2: @@
 &nbsp;
-'''<span style="font-size:16.0pt">Hyperbaric oxygen did not improve the outcome from postoperative adhesive small bowel obstruction</span>'''
+<span style="font-size:x-large;">'''Hyperbaric oxygen did not improve the outcome from postoperative adhesive small bowel obstruction'''</span>
-<span style="font-size:larger;">'''Clinical Bottom Line:'''</span>
+<span style="font-size:larger;">'''Clinical Bottom Line:&nbsp;'''</span><span style="font-size:medium;">1.Hyperbaric oxygen made no difference to the outcome</span>
 <span style="font-size:medium;">'''Citation/s:&nbsp;'''1. Fukami Y, Kobayashi S, Sekoguchi E, Kurumiya Y. Randomized controlled trial of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction. Langenbeck's archives of surgery. 2018 Aug 1;403(5):555-9.</span>
-<span style="font-size:medium;">'''Lead author's name and fax:'''Y Fukami yasuyuki490225@yahoo.co.jp</span>
+----
-&nbsp;
+<span style="font-size:medium;">'''Lead author's name and fax:&nbsp;'''Y Fukami yasuyuki490225@yahoo.co.jp</span>
 <span style="font-size:medium;">'''Three-part Clinical Question:'''For patients with postoperative small bowel obstruction, does the addition of a course of hyperbaric oxygen to the usual care, result in a reduction in the time to recovery or need for operation?</span>
@@ Line 26: / Line 22: @@
 <span style="font-size:medium;">'''The Study Patients:'''Adult patients with a history of abdominal surgery more than four weeks previously and clinical signs and symptoms of mechanical obstruction, with dilated loops of small intestine of CT scan.</span>
-<span style="font-size:medium;">'''Control group'''(N = 40; 40 analysed): No oral intake, IV fluids and insertion of nasograstric tube.</span>
+<span style="font-size:medium;">'''Control group:&nbsp;'''(N = 40; 40 analysed): No oral intake, IV fluids and insertion of nasograstric tube.</span>
-<span style="font-size:medium;">'''Experimental group'''(N = 33; 33 analysed): As above plus 100% osygen breathing at 2 ATA for 90 minutes daily up to seven times or until improvement in symptoms.</span>
+<span style="font-size:medium;">'''Experimental group:&nbsp;'''(N = 33; 33 analysed): As above plus 100% osygen breathing at 2 ATA for 90 minutes daily up to seven times or until improvement in symptoms.</span>
 &nbsp;
@@ Line 117: / Line 113: @@
 &nbsp;
-<span style="font-size:medium;">'''Appraised by:'''Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019</span>
+<span style="font-size:medium;">'''Appraised by:&nbsp;'''Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019</span>
 <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;">[[Flaps_and_grafts|<span style="font-size:x-large;">'''BACK'''</span>]]</p>

@@ Line 6: / Line 6: @@
 <span style="font-size:larger;">'''Clinical Bottom Line:'''</span>
-<span style="font-size:11.0pt">1.Hyperbaric oxygen made no difference to the outcome</span>
+<span style="font-size:medium;">1.Hyperbaric oxygen made no difference to the outcome</span>
 &nbsp;
-'''<span style="font-size:11.0pt">Citation/s:&nbsp;</span>'''<span style="font-size:11.0pt">1. Fukami Y, Kobayashi S, Sekoguchi E, Kurumiya Y. Randomized controlled trial of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction. Langenbeck's archives of surgery. 2018 Aug 1;403(5):555-9.</span>
+<span style="font-size:medium;">'''Citation/s:&nbsp;'''1. Fukami Y, Kobayashi S, Sekoguchi E, Kurumiya Y. Randomized controlled trial of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction. Langenbeck's archives of surgery. 2018 Aug 1;403(5):555-9.</span>
-'''<span style="font-size:11.0pt">Lead author's name and fax:</span>'''<span style="font-size:11.0pt">Y Fukami yasuyuki490225@yahoo.co.jp</span>
+<span style="font-size:medium;">'''Lead author's name and fax:'''Y Fukami yasuyuki490225@yahoo.co.jp</span>
 &nbsp;
-'''<span style="font-size:11.0pt">Three-part Clinical Question:</span>'''<span style="font-size:11.0pt">For patients with postoperative small bowel obstruction, does the addition of a course of hyperbaric oxygen to the usual care, result in a reduction in the time to recovery or need for operation?</span>
+<span style="font-size:medium;">'''Three-part Clinical Question:'''For patients with postoperative small bowel obstruction, does the addition of a course of hyperbaric oxygen to the usual care, result in a reduction in the time to recovery or need for operation?</span>
-'''<span style="font-size:11.0pt">Search Terms:</span>'''<span style="font-size:11.0pt">Small bowel obstruction., postoperative compliations</span>
+<span style="font-size:medium;">'''Search Terms:'''Small bowel obstruction., postoperative compliations</span>
 &nbsp;
-'''<span style="font-size:11.0pt">The Study:&nbsp;</span>'''<span style="font-size:11.0pt">Non-blinded concealed randomised controlled trial with intention-to-treat.</span>
+<span style="font-size:medium;">'''The Study:&nbsp;'''Non-blinded concealed randomised controlled trial with intention-to-treat.</span>
-'''<span style="font-size:11.0pt">The Study Patients:</span>'''<span style="font-size:11.0pt">Adult patients with a history of abdominal surgery more than four weeks previously and clinical signs and symptoms of mechanical obstruction, with dilated loops of small intestine of CT scan.</span>
+<span style="font-size:medium;">'''The Study Patients:'''Adult patients with a history of abdominal surgery more than four weeks previously and clinical signs and symptoms of mechanical obstruction, with dilated loops of small intestine of CT scan.</span>
-'''<span style="font-size:11.0pt">Control group</span>'''<span style="font-size:11.0pt">(N = 40; 40 analysed): No oral intake, IV fluids and insertion of nasograstric tube.</span>
+<span style="font-size:medium;">'''Control group'''(N = 40; 40 analysed): No oral intake, IV fluids and insertion of nasograstric tube.</span>
-'''<span style="font-size:11.0pt">Experimental group</span>'''<span style="font-size:11.0pt">(N = 33; 33 analysed): As above plus 100% osygen breathing at 2 ATA for 90 minutes daily up to seven times or until improvement in symptoms.</span>
+<span style="font-size:medium;">'''Experimental group'''(N = 33; 33 analysed): As above plus 100% osygen breathing at 2 ATA for 90 minutes daily up to seven times or until improvement in symptoms.</span>
 &nbsp;
-'''<span style="font-size:11.0pt">The Evidence:</span>'''
+<span style="font-size:medium;">'''The Evidence:'''</span>
 {| class="Table" style="border-top:outset; border-left:outset; border-bottom:inset; border-right:inset; border-width:1.0pt; border:solid windowtext 1.0pt"
@@ Line 109: / Line 109: @@
 &nbsp;
-'''<span style="font-size:11.0pt">Comments:</span>'''
+<span style="font-size:medium;">'''Comments:'''</span>
-<span style="font-size:11.0pt">1. Small trial, somewhat underpowered (original target 100 individuals randomised), but no indication of likely benefit.</span>
+<span style="font-size:medium;">1. Small trial, somewhat underpowered (original target 100 individuals randomised), but no indication of likely benefit.</span>
-<span style="font-size:11.0pt">2. Bias remains possible due to unbiased nature of trial, but this seems unlikely to be large given the nature of the endpoints.</span>
+<span style="font-size:medium;">2. Bias remains possible due to unbiased nature of trial, but this seems unlikely to be large given the nature of the endpoints.</span>
 &nbsp;
-'''<span style="font-size:11.0pt">Appraised by:</span>'''<span style="font-size:11.0pt">Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019</span>
+<span style="font-size:medium;">'''Appraised by:'''Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019</span>
-<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:x-large;">'''[[Acute_ischaemia|BACK]]'''</span></p>
+<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;">[[Flaps_and_grafts|<span style="font-size:x-large;">'''BACK'''</span>]]</p>

← Older revision		Revision as of 06:02, 22 July 2019
Line 118:		Line 118:

	'''<span style="font-size:11.0pt">Appraised by:</span>'''<span style="font-size:11.0pt">Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019</span>		'''<span style="font-size:11.0pt">Appraised by:</span>'''<span style="font-size:11.0pt">Michael Bennett, POWH m.bennett@unsw.edu.au; Monday, 22 July 2019</span>
		+	<p style="text-align: center;"> </p> <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif\|center\|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:x-large;">'''[[Acute_ischaemia\|BACK]]'''</span></p>