Difference between revisions of "Svalestad2"

(Created page with " <span style="line-height:normal">'''<span style="font-size:16.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Hyperbaric oxygen ind...")
 
 
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<span style="line-height:normal">'''<span style="font-size:16.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Hyperbaric oxygen induced a greater percentage increase in doppler flowmetry in cheek and gingiva on heat provocation and may improve transcutaneous oxygenation when oxygen breathing.</span></span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:16.0pt"><span style="font-family:"><span style="color:black">Hyperbaric oxygen induced a greater percentage increase in doppler flowmetry in cheek and gingiva on heat provocation and may improve transcutaneous oxygenation when oxygen breathing.</span></span></span>'''</span>
  
 
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<span style="line-height:normal"><span style="height:92.8pt">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Clinical Bottom Line:</span></span></span>'''</span></span>
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<span style="line-height:normal"><span style="height:92.8pt">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical Bottom Line:</span></span></span>'''</span></span>
  
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'''<span style="line-height:normal"><span style="height:92.8pt"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. The percentage change from baseline in transcutaneous oxygen on the administration of 100% oxygen (1ATA) was greater after HBOT than control. The absolute difference was not statistically significant between groups.<br/> 2. No clinical outcomes reported.</span></span></span></span>'''
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'''<span style="line-height:normal"><span style="height:92.8pt"><span style="font-size:12.0pt"><span style="font-family:">1. The percentage change from baseline in transcutaneous oxygen on the administration of 100% oxygen (1ATA) was greater after HBOT than control. The absolute difference was not statistically significant between groups.<br/> 2. No clinical outcomes reported.</span></span></span></span>'''
  
 
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Citation/s:</span></span>'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. Svalestad J, Thorsen E, Vaagbø G, Hellem S. Effect of hyperbaric oxygen treatment on oxygen tension and vascular capacity in irradiated skin and mucosa. International journal of oral and maxillofacial surgery. 2014 Jan 31;43(1):107-12.<br/> '''Lead author's name and fax: '''Jarle Svalestad: : Jarle.Svalestad@iko.uib.no</span></span></span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Citation/s:</span></span>'''<span style="font-family:"><span style="color:black">1. Svalestad J, Thorsen E, Vaagbø G, Hellem S. Effect of hyperbaric oxygen treatment on oxygen tension and vascular capacity in irradiated skin and mucosa. International journal of oral and maxillofacial surgery. 2014 Jan 31;43(1):107-12.<br/> '''Lead author's name and fax: '''Jarle Svalestad:&nbsp;: Jarle.Svalestad@iko.uib.no</span></span></span></span>
  
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Three-part Clinical Question:</span></span>'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">For adult patients with a history of irradiation on the face, does a course of hyperbaric oxygen therapy versus no treatment, improve vascular function and transcutaneous oximetry?<br/> '''Search Terms:''' Transcutaneous, vascular function, perfusion</span></span></span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span>'''<span style="font-family:"><span style="color:black">For adult patients with a history of irradiation on the face, does a course of hyperbaric oxygen therapy versus no treatment, improve vascular function and transcutaneous oximetry?<br/> '''Search Terms:''' Transcutaneous, vascular function, perfusion</span></span></span></span>
  
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">The Study:</span></span>'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Non-blinded concealed randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Patients with irradiation > 50Gy for the treatment of head and neck cancer.<br/> '''Control group''' (N = 8; 8 analysed): No specific therapy aimed at improving perfusion.<br/> '''Experimental group''' (N = 14; 14 analysed): 100% oxygen breathing at 2.4 ATA for 90 minutes daily, five days per week to a total of 28 treatments.</span></span></span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">The Study:</span></span>'''<span style="font-family:"><span style="color:black">Non-blinded concealed randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Patients with irradiation > 50Gy for the treatment of head and neck cancer.<br/> '''Control group''' (N = 8; 8 analysed): No specific therapy aimed at improving perfusion.<br/> '''Experimental group''' (N = 14; 14 analysed): 100% oxygen breathing at 2.4 ATA for 90 minutes daily, five days per week to a total of 28 treatments.</span></span></span></span>
  
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">The Evidence:</span></span>'''</span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">The Evidence:</span></span>'''</span></span>
  
 
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| rowspan="2" style="width:160.5pt; border:solid windowtext 1.0pt" width="214" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Measure</span></span>'''</span></p>  
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| rowspan="2" style="width:160.5pt; border:solid windowtext 1.0pt" width="214" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Measure</span></span>'''</span></p>  
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| colspan="2" style="width:76.5pt; border:solid windowtext 1.0pt" width="102" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control Group</span></span>'''</span></p>  
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| colspan="2" style="width:76.5pt; border:solid windowtext 1.0pt" width="102" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Control Group</span></span>'''</span></p>  
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| colspan="2" style="width:69.35pt; border:solid windowtext 1.0pt" width="92" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">HBOT Group</span></span>'''</span></p>  
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| colspan="2" style="width:69.35pt; border:solid windowtext 1.0pt" width="92" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">HBOT Group</span></span>'''</span></p>  
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| rowspan="2" style="width:55.2pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Difference</span></span>'''</span></p>  
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| rowspan="2" style="width:55.2pt; 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:10.0pt"><span style="font-family:">Difference</span></span>'''</span></p>  
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| rowspan="2" style="width:80.25pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CI</span></span>'''</span></p>  
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| rowspan="2" style="width:80.25pt; 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:10.0pt"><span style="font-family:">95% CI</span></span>'''</span></p>  
 
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p>  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Mean</span></span>'''</span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">SD</span></span>'''</span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">SD</span></span>'''</span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mean</span></span>'''</span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Mean</span></span>'''</span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">SD</span></span>'''</span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">SD</span></span>'''</span></p>  
 
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<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Transcutaneous oximetry on 100% oxygen (kPa) 6 months</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Transcutaneous oximetry on 100% oxygen (kPa) 6 months</span></span>'''</span>
  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">12.7</span></span></span></p>  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">12.7</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">4.6</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">4.6</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">19.8</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">19.8</span></span></span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">6.5</span></span></span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">6.5</span></span></span></p>  
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| style="width:55.2pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">7.1</span></span></span></p>  
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| style="width:55.2pt; 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:10.0pt"><span style="font-family:">7.1</span></span></span></p>  
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| style="width:80.25pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">-25.1 to 39.3</span></span></span></p>  
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| style="width:80.25pt; 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:10.0pt"><span style="font-family:">-25.1 to 39.3</span></span></span></p>  
 
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<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Doppler flowmetry in gingiva in arbitrary units at 6 months</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Doppler flowmetry in gingiva in arbitrary units at 6 months</span></span>'''</span>
  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">146</span></span></span></p>  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">146</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">104</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">104</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">265</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">265</span></span></span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">137</span></span></span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">137</span></span></span></p>  
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| style="width:55.2pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">119</span></span></span></p>  
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| style="width:55.2pt; 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:10.0pt"><span style="font-family:">119</span></span></span></p>  
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| style="width:80.25pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">-14,660 to 14,898</span></span></span></p>  
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| style="width:80.25pt; 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:10.0pt"><span style="font-family:">-14,660 to 14,898</span></span></span></p>  
 
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<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Doppler flowmetry in cheek in arbitrary units at 6 months</span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Doppler flowmetry in cheek in arbitrary units at 6 months</span></span>'''</span>
  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">143</span></span></span></p>  
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="55" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">143</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">79</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">79</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">306</span></span></span></p>  
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">306</span></span></span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">237</span></span></span></p>  
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="45" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">237</span></span></span></p>  
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Comments:</span></span>'''<br/> <span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. Small study with low power to demonstrate between group differences. A number of within-group statistically significant increases from baseline in the HBO group.<br/> 2. Laser flowmetry measures perfusion of the tissue concerned.<br/> 3. All changes were in the direction of improvement with HBOT.<br/> 4. Authors also reported a small but significant improvement in cheek blood flow over time in the control group.</span></span></span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Comments:</span></span>'''<br/> <span style="font-family:"><span style="color:black">1. Small study with low power to demonstrate between group differences. A number of within-group statistically significant increases from baseline in the HBO group.<br/> 2. Laser flowmetry measures perfusion of the tissue concerned.<br/> 3. All changes were in the direction of improvement with HBOT.<br/> 4. Authors also reported a small but significant improvement in cheek blood flow over time in the control group.</span></span></span></span>
  
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Appraised by:</span></span>'''<span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Mike Bennett: m.bennett@unsw.edu.au; Saturday, 17 December 2022<br/> '''Kill or Update By:''' December 2025</span></span></span></span>
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<span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Appraised by:</span></span>'''<span style="font-family:"><span style="color:black">Mike Bennett: m.bennett@unsw.edu.au; Saturday, 17 December 2022<br/> '''Kill or Update By:''' December 2025</span></span></span></span>
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<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Radiation_tissue_injury|'''BACK''']]</span></p>
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Latest revision as of 01:24, 19 December 2022

Hyperbaric oxygen induced a greater percentage increase in doppler flowmetry in cheek and gingiva on heat provocation and may improve transcutaneous oxygenation when oxygen breathing.

Clinical Bottom Line:

1. The percentage change from baseline in transcutaneous oxygen on the administration of 100% oxygen (1ATA) was greater after HBOT than control. The absolute difference was not statistically significant between groups.
2. No clinical outcomes reported.

Citation/s:1. Svalestad J, Thorsen E, Vaagbø G, Hellem S. Effect of hyperbaric oxygen treatment on oxygen tension and vascular capacity in irradiated skin and mucosa. International journal of oral and maxillofacial surgery. 2014 Jan 31;43(1):107-12.
Lead author's name and fax: Jarle Svalestad: : Jarle.Svalestad@iko.uib.no

Three-part Clinical Question:For adult patients with a history of irradiation on the face, does a course of hyperbaric oxygen therapy versus no treatment, improve vascular function and transcutaneous oximetry?
Search Terms: Transcutaneous, vascular function, perfusion

The Study:Non-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Patients with irradiation > 50Gy for the treatment of head and neck cancer.
Control group (N = 8; 8 analysed): No specific therapy aimed at improving perfusion.
Experimental group (N = 14; 14 analysed): 100% oxygen breathing at 2.4 ATA for 90 minutes daily, five days per week to a total of 28 treatments.

The Evidence:

Measure

Control Group

HBOT Group

Difference

95% CI

Mean

SD

Mean

SD

Transcutaneous oximetry on 100% oxygen (kPa) 6 months

12.7

4.6

19.8

6.5

7.1

-25.1 to 39.3

Doppler flowmetry in gingiva in arbitrary units at 6 months

146

104

265

137

119

-14,660 to 14,898

Doppler flowmetry in cheek in arbitrary units at 6 months

143

79

306

237

163

-35,610 to 35.936

 

Comments:
1. Small study with low power to demonstrate between group differences. A number of within-group statistically significant increases from baseline in the HBO group.
2. Laser flowmetry measures perfusion of the tissue concerned.
3. All changes were in the direction of improvement with HBOT.
4. Authors also reported a small but significant improvement in cheek blood flow over time in the control group.

Appraised by:Mike Bennett: m.bennett@unsw.edu.au; Saturday, 17 December 2022
Kill or Update By: December 2025

 

Sumhorsa.gif

 

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