Difference between revisions of "Mutzbauer3"
(Created page with " <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Some weak evidence th...") |
|||
| Line 1: | Line 1: | ||
| − | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">Some weak evidence that vitamin C and E ingestion before hyperbaric oxygen may reduce the drop in erythropoietin plasma concentrations in divers.</span></span></span>'''</span> |
| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical Bottom Line:</span></span></span>'''</span> |
{| class="Table" style="width: 901px; border: 1pt solid windowtext;" width="595" | {| class="Table" style="width: 901px; border: 1pt solid windowtext;" width="595" | ||
|- | |- | ||
| style="width: 887px; border: 1pt solid windowtext;" width="591" | | | style="width: 887px; border: 1pt solid windowtext;" width="591" | | ||
| − | <span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family:">1. No important difference between groups demonstrated, but there was a greater in-group fall in EPO in the placebo divers.</span></span></span> |
|} | |} | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. Mutzbauer TS, Schneider M, Neubauer B, Weiss M, Tetzlaff K. Antioxidants may Attenuate Plasma Erythropoietin Decline after Hyperbaric Oxygen Diving. International journal of sports medicine. 2015 Nov;36(13):1035-40.<br/> '''Lead author's name and fax: '''Till Mutzbauer mutzbauer@gmail.com</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">For those exposed to hyperbaric oxygen during in-water diving, does the administration of antioxidants during exposure result in maintenance of plasma erythropoietin?<br/> '''Search Terms:''' Erythropoietin; antioxidants; adverse effects</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Double-blinded concealed randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Healthy volunteer divers.<br/> '''Control group''' (N = 8 ; 8 analysed): Placebo medication three hours prior to three dives to 4 msw (1.4 ATA) breathing 100% oxygen on successive days.<br/> '''Experimental group''' (N = 8 ; 8 analysed): As above but active antioxidants: 1g of ascorbic acid combined with 600 IU d- a -tocopherol three hours before each exposure.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> |
| | ||
| Line 23: | Line 23: | ||
{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
|- | |- | ||
| − | | rowspan="2" style="width:150.85pt; border:solid windowtext 1.0pt" width="201" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:150.85pt; border:solid windowtext 1.0pt" width="201" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Measure</span></span>'''</span></p> |
| − | | colspan="2" style="width:89.85pt; border:solid windowtext 1.0pt" width="120" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | colspan="2" style="width:89.85pt; border:solid windowtext 1.0pt" width="120" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Placebo Group</span></span>'''</span></p> |
| − | | colspan="2" style="width:80.6pt; border:solid windowtext 1.0pt" width="107" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | colspan="2" style="width:80.6pt; border:solid windowtext 1.0pt" width="107" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBO Group</span></span>'''</span></p> |
| − | | rowspan="2" style="width:55.8pt; border:solid windowtext 1.0pt" width="74" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:55.8pt; border:solid windowtext 1.0pt" width="74" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Difference</span></span>'''</span></p> |
| − | | rowspan="2" style="width:64.7pt; border:solid windowtext 1.0pt" width="86" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:64.7pt; border:solid windowtext 1.0pt" width="86" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">95% CI</span></span>'''</span></p> |
|- | |- | ||
| − | | style="width:43.6pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:43.6pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p> |
| − | | style="width:44.75pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:44.75pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p> |
| − | | style="width:37.3pt; border:solid windowtext 1.0pt" width="50" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:37.3pt; border:solid windowtext 1.0pt" width="50" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p> |
| − | | style="width:41.8pt; border:solid windowtext 1.0pt" width="56" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.8pt; border:solid windowtext 1.0pt" width="56" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p> |
|- | |- | ||
| style="width:150.85pt; border:solid windowtext 1.0pt" width="201" | | | style="width:150.85pt; border:solid windowtext 1.0pt" width="201" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Plasma erythropoietin after third dive (mIU/ml)</span></span>'''</span> |
| − | | style="width:43.6pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:43.6pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">5.1</span></span></span></p> |
| − | | style="width:44.75pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:44.75pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.4</span></span></span></p> |
| − | | style="width:37.3pt; border:solid windowtext 1.0pt" width="50" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:37.3pt; border:solid windowtext 1.0pt" width="50" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">5.5</span></span></span></p> |
| − | | style="width:41.8pt; border:solid windowtext 1.0pt" width="56" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.8pt; border:solid windowtext 1.0pt" width="56" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.4</span></span></span></p> |
| − | | style="width:55.8pt; border:solid windowtext 1.0pt" width="74" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.8pt; border:solid windowtext 1.0pt" width="74" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-0.40</span></span></span></p> |
| − | | style="width:64.7pt; border:solid windowtext 1.0pt" width="86" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:64.7pt; border:solid windowtext 1.0pt" width="86" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-2.5 to 1.7</span></span></span></p> |
|- | |- | ||
| style="width:150.85pt; border:solid windowtext 1.0pt" width="201" | | | style="width:150.85pt; border:solid windowtext 1.0pt" width="201" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Plasma EPO as proportion of starting value day 1 (%)</span></span>'''</span> |
| − | | style="width:43.6pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:43.6pt; border:solid windowtext 1.0pt" width="58" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">72.3</span></span></span></p> |
| − | | style="width:44.75pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:44.75pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">28.1</span></span></span></p> |
| − | | style="width:37.3pt; border:solid windowtext 1.0pt" width="50" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:37.3pt; border:solid windowtext 1.0pt" width="50" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">81.5</span></span></span></p> |
| − | | style="width:41.8pt; border:solid windowtext 1.0pt" width="56" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:41.8pt; border:solid windowtext 1.0pt" width="56" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">28.1</span></span></span></p> |
| − | | style="width:55.8pt; border:solid windowtext 1.0pt" width="74" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:55.8pt; border:solid windowtext 1.0pt" width="74" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-9.2</span></span></span></p> |
| − | | style="width:64.7pt; border:solid windowtext 1.0pt" width="86" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:64.7pt; border:solid windowtext 1.0pt" width="86" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-856 to 837</span></span></span></p> |
|} | |} | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. Small study underpowered to detect a potentially important difference between groups. Main results in the paper compared within group differences. No sample size calculation reported.<br/> 2. Results suggest a trend decline in EPO plasma levels over a period of 3 days HBO exposure but no statistically important differences between groups. Reduced EPO may mean a reduction in endogenous antioxidant mechanisms.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Saturday, 18 September 2021<br/> '''Kill or Update By:''' September 2026</span></span></span></span> |
| + | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> | ||
| + | = [[Diving_Medicine|BACK]] = | ||
Latest revision as of 21:28, 17 September 2021
Some weak evidence that vitamin C and E ingestion before hyperbaric oxygen may reduce the drop in erythropoietin plasma concentrations in divers.
Clinical Bottom Line:
|
1. No important difference between groups demonstrated, but there was a greater in-group fall in EPO in the placebo divers. |
Citation/s:1. Mutzbauer TS, Schneider M, Neubauer B, Weiss M, Tetzlaff K. Antioxidants may Attenuate Plasma Erythropoietin Decline after Hyperbaric Oxygen Diving. International journal of sports medicine. 2015 Nov;36(13):1035-40.
Lead author's name and fax: Till Mutzbauer mutzbauer@gmail.com
Three-part Clinical Question:For those exposed to hyperbaric oxygen during in-water diving, does the administration of antioxidants during exposure result in maintenance of plasma erythropoietin?
Search Terms: Erythropoietin; antioxidants; adverse effects
The Study:
Double-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Healthy volunteer divers.
Control group (N = 8 ; 8 analysed): Placebo medication three hours prior to three dives to 4 msw (1.4 ATA) breathing 100% oxygen on successive days.
Experimental group (N = 8 ; 8 analysed): As above but active antioxidants: 1g of ascorbic acid combined with 600 IU d- a -tocopherol three hours before each exposure.
The Evidence:
Measure |
Placebo Group |
HBO Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
|
Plasma erythropoietin after third dive (mIU/ml) |
5.1 |
1.4 |
5.5 |
1.4 |
-0.40 |
-2.5 to 1.7 |
|
Plasma EPO as proportion of starting value day 1 (%) |
72.3 |
28.1 |
81.5 |
28.1 |
-9.2 |
-856 to 837 |
Comments:
1. Small study underpowered to detect a potentially important difference between groups. Main results in the paper compared within group differences. No sample size calculation reported.
2. Results suggest a trend decline in EPO plasma levels over a period of 3 days HBO exposure but no statistically important differences between groups. Reduced EPO may mean a reduction in endogenous antioxidant mechanisms.
Appraised by:Mike Bennett m.bennett@unsw.edu.au; Saturday, 18 September 2021
Kill or Update By: September 2026
