http://hboevidence.wikis.unsw.edu.au/index.php?action=history&feed=atom&title=Jay
Jay - Revision history
2026-10-04T11:35:48Z
Revision history for this page on the wiki
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http://hboevidence.wikis.unsw.edu.au/index.php?title=Jay&diff=445&oldid=prev
M.bennett at 05:00, 30 August 2019
2019-08-30T05:00:07Z
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<td colspan="2" style="background-color: #fff; color: #222; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #222; text-align: center;">Revision as of 05:00, 30 August 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l1" >Line 1:</td>
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<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Hyperbaric oxygenation significantly shortens the elimination half-life of carboxyhaemoglobin.''' </span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-<del class="diffchange diffchange-inline">family</del>: <del class="diffchange diffchange-inline">Arial,Helvetica,sans</del>-<del class="diffchange diffchange-inline">serif; font-size: 120%</del>;"><del class="diffchange diffchange-inline">'''Clinical Bottom Line:''' </span></del></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="font-<ins class="diffchange diffchange-inline">size</ins>:<ins class="diffchange diffchange-inline">x</ins>-<ins class="diffchange diffchange-inline">large</ins>;"><span style="font-family: Arial, Helvetica, sans-serif;"><ins class="diffchange diffchange-inline">'''Hyperbaric oxygenation significantly shortens the elimination </ins>half-life of carboxyhaemoglobin.'''</span></span></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif<del class="diffchange diffchange-inline">; font-size: 120%</del>;"><del class="diffchange diffchange-inline">1. Elimination </del>half-life of carboxyhaemoglobin <del class="diffchange diffchange-inline">was significantly decreased by the administration of hyperbaric oxygenation at 1</del>.<del class="diffchange diffchange-inline">58ATA. </span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'</del>''<del class="diffchange diffchange-inline">Appraised by:</del>'<del class="diffchange diffchange-inline">'' Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital </del></span></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Sydney; Thursday, 10 December, 1998 </del></span></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="<del class="diffchange diffchange-inline">font-family: Arial,Helvetica,sans-serif; </del>font-size: <del class="diffchange diffchange-inline">120%</del>;"><del class="diffchange diffchange-inline">'''Clinical Scenario:''' A patient with carbon monoxide poisoning. </span></del></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="font-size:<ins class="diffchange diffchange-inline">large</ins>;"><span style="font-family: Arial, Helvetica, sans-serif;">'''<ins class="diffchange diffchange-inline">Clinical Bottom Line</ins>:'''</span></span></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif<del class="diffchange diffchange-inline">; font-size: 120%</del>;">'''<del class="diffchange diffchange-inline">Three-part Question</del>:''' <del class="diffchange diffchange-inline">For patients with elevated levels of carboxyhaemoglobin, does administration of hyperbaric oxygen, compared to a normobaric regime, result in more rapid reduction in carboxyhaemoglobin? </del></span></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' hyperbaric oxygenation, carbon monoxide. </del></span></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' </span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-size:large;"><span style="font-family: Arial, Helvetica, sans-serif;">1. Elimination half-life of carboxyhaemoglobin was significantly decreased by the administration of hyperbaric oxygenation at 1.58ATA.</span></span></ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Non-blinded randomised controlled crossover trial with intention-to-treat. </span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Healthy volunteer smokers exposed to a standard regime of five cigarettes in an hour to produce elevated COHb levels. </span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Appraised by:''' Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Sydney; Thursday, 10 December, 1998</span></ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Control group (N =12 ;12 analysed): 40 minutes of oxygen via non-rebreathing mask at 15 liters/min. </span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Experimental group (N =12 ;12 analysed): 40 minutes of 100% oxygen at 1.58 ATA in a Gamow bag inflatable chamber. </span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Scenario:''' A patient with carbon monoxide poisoning.</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Question:''' For patients with elevated levels of carboxyhaemoglobin, does administration of hyperbaric oxygen, compared to a normobaric regime, result in more rapid reduction in carboxyhaemoglobin?</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' hyperbaric oxygenation, carbon monoxide.</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Non-blinded randomised controlled crossover trial with intention-to-treat. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Healthy volunteer smokers exposed to a standard regime of five cigarettes in an hour to produce elevated COHb levels. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Control group (N =12<ins class="diffchange diffchange-inline">&nbsp;</ins>;12 analysed): 40 minutes of oxygen via non-rebreathing mask at 15 liters/min. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Experimental group (N =12<ins class="diffchange diffchange-inline">&nbsp;</ins>;12 analysed): 40 minutes of 100% oxygen at 1.58 ATA in a Gamow bag inflatable chamber.</span></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">**</del><span style="font-family: <del class="diffchange diffchange-inline">arial</del>,<del class="diffchange diffchange-inline">helvetica</del>,sans-serif; font-size: 15px;"> <del class="diffchange diffchange-inline">Non</del>-<del class="diffchange diffchange-inline">Event NBO group HBO group P-value </del></span>'''</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: <ins class="diffchange diffchange-inline">Arial</ins>,<ins class="diffchange diffchange-inline">Helvetica</ins>,sans-serif;<ins class="diffchange diffchange-inline">">'''<span style="</ins>font-size: 15px;"><ins class="diffchange diffchange-inline">Half</ins>-<ins class="diffchange diffchange-inline">life</ins></span>'''<ins class="diffchange diffchange-inline"></span> </ins><span style="font-family: Arial,Helvetica,sans-serif;">'''<span style="font-size: 15px;"><ins class="diffchange diffchange-inline">of COHb:</ins></span>'''<ins class="diffchange diffchange-inline"><span style="font-size: 15px;">Oxygen 1ATA:&nbsp;71.3 minutes Oxygen 2 ATA: 28.6 minutes&nbsp;&nbsp;''P''<0.05</span></span></ins></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif;">'''<span style="font-size: 15px;"> <del class="diffchange diffchange-inline">Outcomes </del></span>'''</span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Comments:'''</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. No clinical outcomes, so the significance of these findings is not clear.</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Further statistical evaluation suggests a shift from zero order to first order kinetics on application of hyperbaric oxygen.</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. This study addresses experimental, mild CO poisoning, unlike the clinical situation.</span></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">4. Two reports appear to be using the same data although slightly different t1/2s are published. Conclusions are identical.</ins></span></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif;<del class="diffchange diffchange-inline">">'''<span style="</del>font-size: <del class="diffchange diffchange-inline">15px;"> Half-life </span>'''</span></del></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: <ins class="diffchange diffchange-inline">120%</ins>;">'''<ins class="diffchange diffchange-inline">Expiry date</ins>:'''<ins class="diffchange diffchange-inline">&nbsp</ins>;<ins class="diffchange diffchange-inline">August 2022</ins></span></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif</del>;">'''<del class="diffchange diffchange-inline"><span style="font-size</del>: <del class="diffchange diffchange-inline">15px;"> of COHb</span></del>'''<del class="diffchange diffchange-inline"><span style="font-size: 15px</del>;<del class="diffchange diffchange-inline">"> 71.3 minutes 28.6 minutes ''P''<0.05 </span></del></span></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''<del class="diffchange diffchange-inline">Comments</del>:''' </span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''<ins class="diffchange diffchange-inline">References</ins>:''' </span> <span style="font-family: <ins class="diffchange diffchange-inline">arial</ins>,<ins class="diffchange diffchange-inline">helvetica</ins>,sans-serif; font-size: 120%;">1. <ins class="diffchange diffchange-inline">Jay GD</ins>, <ins class="diffchange diffchange-inline">McKindley DS</ins>. <ins class="diffchange diffchange-inline">Alterations in pharmacokinetics </ins>of <ins class="diffchange diffchange-inline">carboxyhaemoglobin produced by </ins>oxygen <ins class="diffchange diffchange-inline">under pressure</ins>. <ins class="diffchange diffchange-inline">Undersea and Hyperbaric Medicine 1997</ins>; <ins class="diffchange diffchange-inline">24</ins>:<ins class="diffchange diffchange-inline">165</ins>-<ins class="diffchange diffchange-inline">174</ins>.</span></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: <del class="diffchange diffchange-inline">Arial</del>,<del class="diffchange diffchange-inline">Helvetica</del>,sans-serif; font-size: 120%;">1. <del class="diffchange diffchange-inline">No clinical outcomes</del>, <del class="diffchange diffchange-inline">so the significance of these findings is not clear</del>. <del class="diffchange diffchange-inline"></span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Further statistical evaluation suggests a shift from zero order to first order kinetics on application </del>of <del class="diffchange diffchange-inline">hyperbaric </del>oxygen. <del class="diffchange diffchange-inline"></span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif</del>; <del class="diffchange diffchange-inline">font-size</del>: <del class="diffchange diffchange-inline">120%;">3. This study addresses experimental, mild CO poisoning, unlike the clinical situation. </span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline"><span style="font-family: Arial,Helvetica,sans-serif; font</del>-<del class="diffchange diffchange-inline">size: 120%;">4. Two reports appear to be using the same data although slightly different t1/2s are published. Conclusions are identical</del>. </span></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' April 2020</span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:''' </span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"><span style="font-family: arial,helvetica,sans-serif; font-size: 120%;">1. Jay GD, McKindley DS. Alterations in pharmacokinetics of carboxyhaemoglobin produced by oxygen under pressure. Undersea and Hyperbaric Medicine 1997; 24:165-174. </span></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: arial,helvetica,sans-serif; font-size: 120%;">2. Jay GD, Tetz DJ, Hartigan CF, Lane LL, Aghababian RV. Portable hyperbaric oxygen therapy in the emergency department with the modified Gamow bag. Annals of Emergency Medicine 1995; 26:707-711.</span></div></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div><span style="font-family: arial,helvetica,sans-serif; font-size: 120%;">2. Jay GD, Tetz DJ, Hartigan CF, Lane LL, Aghababian RV. Portable hyperbaric oxygen therapy in the emergency department with the modified Gamow bag. Annals of Emergency Medicine 1995; 26:707-711.</span></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>[[File:<del class="diffchange diffchange-inline">sumhorsa</del>.gif|center]]</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>[[File:<ins class="diffchange diffchange-inline">Sumhorsa</ins>.gif|center<ins class="diffchange diffchange-inline">|Sumhorsa.gif</ins>]]</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><span style="display: block; text-align: center;"><span style="color: #7d00ff; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 140%; text-align: center;">[[<del class="diffchange diffchange-inline">Carbon monoxide </del>| BACK]]</span></span></div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><span style="display: block; text-align: center;"><span style="color: #7d00ff; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 140%; text-align: center;">[[<ins class="diffchange diffchange-inline">Carbon_monoxide</ins>|BACK]]</span></span></div></td></tr>
</table>
M.bennett
http://hboevidence.wikis.unsw.edu.au/index.php?title=Jay&diff=133&oldid=prev
Gordoben: Imported from Wikispaces
2018-04-27T07:36:18Z
<p>Imported from Wikispaces</p>
<p><b>New page</b></p><div><span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Hyperbaric oxygenation significantly shortens the elimination half-life of carboxyhaemoglobin.''' </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Bottom Line:''' </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. Elimination half-life of carboxyhaemoglobin was significantly decreased by the administration of hyperbaric oxygenation at 1.58ATA. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Appraised by:''' Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Sydney; Thursday, 10 December, 1998 </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Scenario:''' A patient with carbon monoxide poisoning. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Question:''' For patients with elevated levels of carboxyhaemoglobin, does administration of hyperbaric oxygen, compared to a normobaric regime, result in more rapid reduction in carboxyhaemoglobin? </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' hyperbaric oxygenation, carbon monoxide. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Non-blinded randomised controlled crossover trial with intention-to-treat. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Healthy volunteer smokers exposed to a standard regime of five cigarettes in an hour to produce elevated COHb levels. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Control group (N =12 ;12 analysed): 40 minutes of oxygen via non-rebreathing mask at 15 liters/min. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Experimental group (N =12 ;12 analysed): 40 minutes of 100% oxygen at 1.58 ATA in a Gamow bag inflatable chamber. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span><br />
<br />
**<span style="font-family: arial,helvetica,sans-serif; font-size: 15px;"> Non-Event NBO group HBO group P-value </span>'''<br />
<span style="font-family: Arial,Helvetica,sans-serif;">'''<span style="font-size: 15px;"> Outcomes </span>'''</span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif;">'''<span style="font-size: 15px;"> Half-life </span>'''</span><br />
<span style="font-family: Arial,Helvetica,sans-serif;">'''<span style="font-size: 15px;"> of COHb</span>'''<span style="font-size: 15px;"> 71.3 minutes 28.6 minutes ''P''<0.05 </span></span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Comments:''' </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. No clinical outcomes, so the significance of these findings is not clear. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Further statistical evaluation suggests a shift from zero order to first order kinetics on application of hyperbaric oxygen. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. This study addresses experimental, mild CO poisoning, unlike the clinical situation. </span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">4. Two reports appear to be using the same data although slightly different t1/2s are published. Conclusions are identical. </span><br />
<br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' April 2020</span><br />
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:''' </span><br />
<span style="font-family: arial,helvetica,sans-serif; font-size: 120%;">1. Jay GD, McKindley DS. Alterations in pharmacokinetics of carboxyhaemoglobin produced by oxygen under pressure. Undersea and Hyperbaric Medicine 1997; 24:165-174. </span><br />
<span style="font-family: arial,helvetica,sans-serif; font-size: 120%;">2. Jay GD, Tetz DJ, Hartigan CF, Lane LL, Aghababian RV. Portable hyperbaric oxygen therapy in the emergency department with the modified Gamow bag. Annals of Emergency Medicine 1995; 26:707-711.</span><br />
<br />
[[File:sumhorsa.gif|center]]<br />
<br />
<span style="display: block; text-align: center;"><span style="color: #7d00ff; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 140%; text-align: center;">[[Carbon monoxide | BACK]]</span></span></div>
Gordoben