Difference between revisions of "HartB"
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<span style="line-height:normal">'''<span style="font-size:14.0pt">Some justification for further clinical trials of hyperbaric oxygen for post-concussive symptoms</span>'''</span> | <span style="line-height:normal">'''<span style="font-size:14.0pt">Some justification for further clinical trials of hyperbaric oxygen for post-concussive symptoms</span>'''</span> | ||
| − | | + | <span style="font-size:medium;">'''Citation:''' Hart BB, Weaver LK, Gupta A, Wilson SH, Vijayarangan A, Deru K, Hebert D. Hyperbaric oxygen for mTBI-associated PCS and PTSD: Pooled analysis of results from Department of Defense and other published studies. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2019;46(3):353.</span> |
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<span style="font-size:medium;"><span style="line-height:normal">'''Background: '''Some clinical trials report improvement in persistent post-concussive symptoms (PCS) with hyperbaric oxygen (HBO2) following mild traumatic brain injury (mTBI), but questions remain regarding the utility of HBO2 for PCS, the effects of HBO2 on post-traumatic stress disorder (PTSD), and the influences of sham control exposures.</span></span> | <span style="font-size:medium;"><span style="line-height:normal">'''Background: '''Some clinical trials report improvement in persistent post-concussive symptoms (PCS) with hyperbaric oxygen (HBO2) following mild traumatic brain injury (mTBI), but questions remain regarding the utility of HBO2 for PCS, the effects of HBO2 on post-traumatic stress disorder (PTSD), and the influences of sham control exposures.</span></span> | ||
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<span style="font-size:medium;"><span style="line-height:normal">'''Results: '''Pooled DoD data analyses indicated trends toward improvement favoring HBO2 for PCS (Rivermead Total Score: -2.3, 95% CI [-5.6, 1.0], p=0.18); PTSD (PTSD Checklist Total Score: -2.7, 95% CI [-5.8, 0.4], p=0.09); and significant improvement in verbal memory (CVLT-II Trial 1-5 Free Recall: 3.8; 95% CI [1.0, 6.7], p=0.01). A dose-response trend to increasing oxygen partial pressure was also found, with a greater HBO2 effect in mTBI-associated PTSD suggested. The direction of results was consistent with other published studies.</span></span> | <span style="font-size:medium;"><span style="line-height:normal">'''Results: '''Pooled DoD data analyses indicated trends toward improvement favoring HBO2 for PCS (Rivermead Total Score: -2.3, 95% CI [-5.6, 1.0], p=0.18); PTSD (PTSD Checklist Total Score: -2.7, 95% CI [-5.8, 0.4], p=0.09); and significant improvement in verbal memory (CVLT-II Trial 1-5 Free Recall: 3.8; 95% CI [1.0, 6.7], p=0.01). A dose-response trend to increasing oxygen partial pressure was also found, with a greater HBO2 effect in mTBI-associated PTSD suggested. The direction of results was consistent with other published studies.</span></span> | ||
| − | + | <p style="text-align: center;"><span style="font-size:medium;"><span style="line-height:normal">'''Conclusions: '''A definitive clinical trial, with an appropriate control group, should be considered to identify the optimal HBO2 dosing regimen for individuals with mTBI-associated PTSD ± PCS.</span></span></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;">[[Head_Injury|BACK]]</span></p> | |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''Conclusions: '''A definitive clinical trial, with an appropriate control group, should be considered to identify the optimal HBO2 dosing regimen for individuals with mTBI-associated PTSD ± PCS.</span></span> | ||
Latest revision as of 01:55, 7 April 2020
Some justification for further clinical trials of hyperbaric oxygen for post-concussive symptoms
Citation: Hart BB, Weaver LK, Gupta A, Wilson SH, Vijayarangan A, Deru K, Hebert D. Hyperbaric oxygen for mTBI-associated PCS and PTSD: Pooled analysis of results from Department of Defense and other published studies. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2019;46(3):353.
Background: Some clinical trials report improvement in persistent post-concussive symptoms (PCS) with hyperbaric oxygen (HBO2) following mild traumatic brain injury (mTBI), but questions remain regarding the utility of HBO2 for PCS, the effects of HBO2 on post-traumatic stress disorder (PTSD), and the influences of sham control exposures.
Methods: A systematic review and pooled analysis was conducted to summarize available evidence for HBO2 in mTBI-associated PCS ± PTSD. Data aggregated from four Department of Defense (DoD) studies with participant level data (n=254) were grouped into pooled HBO2 and sham intervention groups. Changes from baseline to post-intervention on PCS, PTSD, and neuropsychological measures were assessed using linear mixed models to evaluate main intervention and intervention-by-baseline PTSD effects. Potential dose-response relationships to oxygen partial pressures were investigated. Intervention effects from three other published studies with summary level participant data (n=135) were also summarized.
Results: Pooled DoD data analyses indicated trends toward improvement favoring HBO2 for PCS (Rivermead Total Score: -2.3, 95% CI [-5.6, 1.0], p=0.18); PTSD (PTSD Checklist Total Score: -2.7, 95% CI [-5.8, 0.4], p=0.09); and significant improvement in verbal memory (CVLT-II Trial 1-5 Free Recall: 3.8; 95% CI [1.0, 6.7], p=0.01). A dose-response trend to increasing oxygen partial pressure was also found, with a greater HBO2 effect in mTBI-associated PTSD suggested. The direction of results was consistent with other published studies.
Conclusions: A definitive clinical trial, with an appropriate control group, should be considered to identify the optimal HBO2 dosing regimen for individuals with mTBI-associated PTSD ± PCS.
