Gordoben: Imported from Wikispaces

2012-01-07T05:13:04Z

Imported from Wikispaces

New page

'''Simulated descent breathing hyperbaric air is as effective as oxygen admininstration in the treatment of mild acute mountain sickness.''' 

'''Clinical Bottom Line:''' 
1. Hyperbaric air was as effective as oxygen in resolving symptoms of acute mountain sickness. 
2. Arterial oxygen saturations were higher in the oxygen treated group. 
'''Appraised by:''' Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital 
Sydney; Tuesday, 16 February, 1999 

'''Clinical Scenario:''' A 35-year-old man suffering with acute mountain sickness. We wondered if simulated descent in a hyperbaric chamber would be an effective treatment. 
'''Three-part Question:''' In patients suffering acute mountain sickness, does the application of pressure in a hyperbaric chamber, compared to the administration of oxygen given by facemask, result in any comparable relief of symptoms? 
'''Search Terms:''' hyperbaric oxygenation, mountain sickness 

'''The Study:''' 
Non-blinded randomised controlled trial with intention-to-treat. 
Patients presenting with acute mountain sickness (headache and/or nausea) or early high altitude pulmonary oedema (X-Ray changes and/or clinical exam). 
Control group (N = 14; 11 analysed): Oxygen administration through a rebreather facemask at 4l/min for two hours. 
Experimental group (N = 15; 13 analysed): Hyperbaric air at 120mmHg above ambient in a portable fabric chamber for two hours. 

'''The Evidence:''' 

{|
| '''Outcome''' || '''Time to Outcome''' || '''Oxygen group''' || '''Hyperbaric group''' || '''Relative risk reduction''' || '''Absolute risk reduction''' || '''NNT''' 
|-
| '''Did not respond''' || 2hrs || 0.09 || 0.08 || 15% || 0.014 || 71 
|-
| '''95% CI:''' || || || || -100% to 100% || -0.21 to 0.24 || NNT'''4 to INF NNH=5 to INF 
|-
|}

'''Non-Event Outcomes Time to outcome Oxygen group Hyperbaric group P-value''' 

Oxygen saturation 1hr 96% 91% <0.05 

Symptom resolution score 3hrs 0.9 0.8 >0.05 

'''Comments:''' 
1. Less than 80% of data set available for analysis in oxygen group. 
2. No longer-term follow-up. 
3. More severe presentations were excluded from the study 

'''Expiry date:'''April 2003
'''References:''' 1. Kasic J, Yaron M, Nicholas R, Lickteig J, Roach R. Treatment of acute mountain sickness: hyperbaric versus oxygen therapy. Annals of Emergency Medicine 1991; 20:1109-1112.

[[File:http://www.hboevidence.com/_themes/copy-of-sumi-painting/sumhorsa.gif|external]]

[[Miscellaneous | BACK]]

Kasic - Revision history

Gordoben: Imported from Wikispaces