AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home Journal of Neurorestoratology Article
PDF (690.9 KB)
Cite
EndNote(RIS) BibTeX
Collect
Submit Manuscript AI Chat Paper
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Review Article | Open Access

A meta-analysis on the efficiency of the time window of hyperbaric oxygen treatment on disorders of consciousness in China

Yi Yang1,§, Long Xu1,2,§, Rong Xie3, Yuanyuan Dang4, Xiaoyu Xia4, Jianghong He1( ), Jizong Zhao1,2( )
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
China National Clinical Research Center for Neurological Diseases (NCRC-ND), Beijing 100050, China
Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu, China
Department of Neurosurgery, PLA General Hospital, Beijing 100700, China

§ These authors contributed equally to this work.

Show Author Information

Abstract

Objective

To investigate the clinical effects of time window on hyperbaric oxygen treatment (HBOT) in patients with disorders of consciousness (DOC).

Methods

All the clinical research literature regarding HBOT for DOC published between January 2000 and November 2020 were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Standards Database (WFSD) and VIP Database using Chinese key words disorders of consciousness, the vegetable state, minimally conscious state, or hyperbaric oxygen followed by a comprehensive meta-analysis.

Results

The query gave rise to 348 results, in which 21 articles were eventually selected for meta-analysis. Among the selected 21 articles, 18 articles involved a time window comparison. All the patients were classified into < 60- (718 patients) and ≥ 60- (374 patients) day groups depending on the number of days from HBOT initiation. The Jadad scores for the included datasets were relatively low in general with 2 points as the highest score. Comparable baseline data were demonstrated in all of the articles. Datasets from different sources were pooled and analyzed, and the results suggested that the clinical curative effect rate in the treatment group was significantly higher compared with that in the control group (curative effect rate: 69.86% versus 42.30%; Z = 11.28, P = 0.000, odds ratio = 3.80, 95% CI = 3.02-4.80). Additionally, the adverse reaction rate of the < 60-day group was found to be significantly lower compared with that of the ≥ 60-day group (Z = 10.01, P = 0.000, odds ratio = 4.82, 95% CI = 3.54-6.56). The funnel diagram in articles related to curative effect analysis and time window evaluation is inverted and symmetrical, indicating that publication bias was not significant.

Conclusions

The clinical curative effect of the HBOT group is higher compared with that of the control group. However, the conclusions based on meta-analysis are limited because of the methodological problems of some studies. Therefore, the clinical efficacy needs to be further tested using carefully designed large sample trials (multicenter, randomized, controlled, and double-blind).

Keywords

disorders of consciousnesshyperbaric oxygen treatmenttime windowcurative effectmeta-analysis

References

[1]
CA Bareham, J Allanson, N Roberts, et al. Longitudinal assessments highlight long-term behavioural recovery in disorders of consciousness. Brain Commun. 2019, 1(1): fcz017.
Crossref Google Scholar
[2]
S Wannez, O Gosseries, D Azzolini, et al. Prevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state. Neuropsychol Rehabil. 2018, 28(8): 1350-1359.
Crossref Google Scholar
[3]
J Giacino, JJ Fins, A Machado, et al. Central thalamic deep brain stimulation to promote recovery from chronic posttraumatic minimally conscious state: challenges and opportunities. Neuromodulation. 2012, 15(4): 339-349.
Crossref Google Scholar
[4]
HJ Wang, QB Weng, QP Wu, et al. Analysis of hyperbaric oxygen synthetic treatment on disorders of consciousness in 84 patients (in Chinese). Chin J Naut Med & Hyperbar Med. 2001, 8(2): 108-110.
Google Scholar
[5]
CH Gao, L Hou, SR Yao, et al. Efficacy of hyperbaric oxygen treatment on disorders of consciousness (in Chinese). J Ningxia Med Coll. 2002, 24(3): 208-209 .
Google Scholar
[6]
CH Li. Analysis of hyperbaric oxygen treatment on disorders of consciousness in 36 patients (in Chinese). Clin Med. 2002, 22(6): 29-30.
Google Scholar
[7]
XR Pan. Hyperbaric oxygen synthetic treatment on disorders of consciousness following severe cerebral trauma in 18 cases (in Chinese). Guangxi Med J. 2003, 25(7): 1280-1281.
Google Scholar
[8]
QS Wang. Effect of hyperbaric oxygen treatment on disorders of consciousness in 52 cases (in Chinese). Chin J Neurosurg Dis Res. 2003, 2(2): 175-176.
Google Scholar
[9]
GY Shen, X Lu. Promotion effect of hyperbaric oxygen with rehabilitation on the consciousness recovery of disorders of consciousness patients (in Chinese). Chin J Clin Rehab. 2003, 7(25): 3534.
Google Scholar
[10]
Z Li, KH Guo. Efficacy of hyperbaric oxygen treatment on disorders of consciousness (in Chinese). Chin J Rehab. 2003, 18(1): 33-34.
Google Scholar
[11]
YD Xu, MX Wang, ZS Zhang, et al. Effect and EEG analysis of hyperbaric oxygen synthetic treatment on disorders of consciousness (in Chinese). J Clin Neurol. 2004, 11(3): 180.
Google Scholar
[12]
LZ Chen, GF Mu, QB Weng, et al. The computerized tomography manifestation of the patients with brain trauma in persistent vegetative state after treated by hyperbaric oxygen (in Chinese). Chongqing Med J. 2004, 33(6): 866-868,870.
Google Scholar
[13]
SM Geng, BH Jiao, SK Lu, et al. Effiicacy and influence factors of hyperbaric oxygenation combining treatment on patients with persistent state (in Chinese). J Brain Nerv Dis. 2005, 13(1): 37-38,49.
Google Scholar
[14]
D Chen, DJ Yang, FY Xu, et al. Evaluation of the recovery effect of hyperbaric oxygen treatment on disorders of consciousness (in Chinese). Chin J Clin Rehab. 2005, 9(1): 170.
Google Scholar
[15]
L Sun, X Sun. Hyperbaric oxygen synthetic treatment for 52 cases of disorders of consciousness (in Chinese). Modern Hospital. 2005, 5(8): 55-57.
Google Scholar
[16]
H Chen, MS Chen, CF Sun, et al. Hyperbaric oxygen synthetic treatment on disorders of consciousness following cerebral trauma (in Chinese). Zhejiang Clin Med J. 2005, 7(12): 1271.
Google Scholar
[17]
Y Gao, CJ Gao, Huan Ge. Effect of hyperbaric oxygen combined treatment on disorders of consciousness in 30 patients (in Chinese). Chin J Naut Med & Hyperbar Med. 2007, 14(1): 23-25.
Google Scholar
[18]
RH Yu, QY Xie, H Huang, et al. Effect of hyperbaric oxygen combined treatment on persistent vegetative state following cerebral trauma in 102 patients (in Chinese). Mil Med J South China. 2008, 22(6): 13-15.
Google Scholar
[19]
YH Chen, DK Feng, FJ Shang, et al. Efficacy of auxiliary use of hyperbaric oxygen treatment on persistent vegetative state in 28 patients (in Chinese). Chongqing Med. 2010, 39(20): 2841-2842.
Google Scholar
[20]
JW Li. Study on the therapeutic effect of hyperbaric oxygen on severe craniocerebral injury (in Chinese). ZH J J Traumatic. 2010, 15(6): 725-727.
Google Scholar
[21]
AP Li. Hyperbaric oxygen treatment on disorders of consciousness following cerebral trauma (in Chinese). Chin Manipulat & Rehab Med. 2012, 3(3): 214-215.
Google Scholar
[22]
JX Chen, LP Li, YM Liang, et al. Effect of hyperbaric oxygen on persistent vegetative state after brain injury and its influencing factors (in Chinese). J Shanxi Med Univ. 2016, 47(1): 93-96.
Google Scholar
[23]
ZY Peng, MQ Li, PY Ye, et al. Clinical study of hyperbaric oxygen combined with cerebral circulation in the treatment of persistent vegetative state (in Chinese). Chin J Conval Med. 2019, 28(7): 673-675.
Google Scholar
[24]
B Chao, N Ta, B Sun, et al. Effect of early hyperbaric oxygen treatment in treating patients with severe craniocerebral trauma (in Chinese). J Trauma Surg. 2020, 22(5): 336-339,344.
Google Scholar
[25]
SQ Tang, DR Xia. The clinical efficacy of hyperbolic oxygenation combining treatment on persistent vegetative state (in Chinese). Chin Med Fact Mine. 2002, 15(1): 7-8.
Google Scholar
[26]
PQ Wang, YW Luo, WH Luo, et al. Effect of hyperbaric oxygen combined treatment and its influence factor on persistent vegetative state (in Chinese). Chin J Phys Med Rehab. 2003, 25(3): 167-168.
Google Scholar
[27]
H Zhi, P Pang, XW Qian, et al. Observation on therapeutic effect of hyperbaric oxygen on 28 cases of persistent vegetative state after brain injury (in Chinese). Shandong Med. 2006, 46(21): 79 .
Google Scholar
[28]
Q Wang, XY Liu, YC Qiu. Evaluation of consciousness-promoted effect on persistent vegetative state treated with hyperbaric oxygen and blood magnetic treatment (in Chinese). J Taishan Med Coll. 2007, 28(3): 212-214.
Google Scholar
[29]
M Wang, CF Ran, JQ Li, et al. Effect of hyperbaric oxygen combined treatment on persistent vegetative state in 46 patients (in Chinese). J Prac Med. 2008, 24(8): 1370-1372.
Google Scholar
[30]
RH Yu, QY Xie, H Huang, et al. Study of hyperbaric oxygen combining treatment on traumatic vegetative state (in Chinese). Mod J Integr Tradit Chin West Med. 2008, 17(26): 4054-4055, 4211.
Google Scholar
[31]
ZR Zhao, LF Pan, AP Wu, et al. Clinical study of hyperbaric oxygen combining conventional treatment on traumatic brain injury with disorders of consciousness (in Chinese). Clin Med China. 2012, 28(6): 639-641.
Google Scholar
[32]
YF Wang, JL Wang, F Liu, et al. Effect of hyperbaric oxygen on 102 patients with persistent vegetative state after traumatic brain injury (in Chinese). Chin J Naut Med & Hyperbar Med. 2013, 20(5): 343-344.
Google Scholar
[33]
LL Zhang, SQ Hu, X Hong, et al. Application of hyperbaric oxygen treatment in coma patients after severe craniocerebral trauma (in Chinese). J Prac Med Tech. 2015, 22(7): 762-765.
Google Scholar
[34]
Y Zhang, LL Ma, Z Li, et al. Analysis of influential factors on the prognosis of cerebral hemorrhage patients in vegetative state after comprehensive hyperbaric oxygen treatment (in Chinese). Chin J Naut Med & Hyperbar Med. 2018, 25(6): 354-358.
Google Scholar
[35]
M Wang, CF Ran, JQ Li, et al. Effect of hyperbaric oxygen combined treatment on persistent vegetative state in 46 patients (in Chinese). J Prac Med. 2008. 24(8): 1370-1372.
Google Scholar
[36]
J Meng, XW Pan, Y Zhang, et al. Hyperbaric oxygen treatment for 280 cases of persistent vegetative state (in Chinese). Chin J Clin Rehab. 2004, 8(25): 5371．
Google Scholar
[37]
XE Meng, Y Zhang, N Li, et al. Hyperbaric oxygen alleviates secondary brain injury after trauma through inhibition of TLR4/NF-κB signaling pathway. Med Sci Monit. 2016, 22: 284-288.
Crossref Google Scholar
[38]
AL Gill, CN Bell. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM. 2004, 97(7): 385-395.
Crossref Google Scholar
[39]
M Gamdzyk, M Małek, E Bratek, et al. Hyperbaric oxygen and hyperbaric air preconditioning induces ischemic tolerance to transient forebrain ischemia in the gerbil. Brain Res. 2016, 1648(Pt A): 257-265.
Crossref Google Scholar
[40]
LM Yang, J Tang, QW Chen, et al. Hyperbaric oxygen preconditioning attenuates neuroinflammation after intracerebral hemorrhage in rats by regulating microglia characteristics. Brain Res. 2015, 1627: 21-30.
Crossref Google Scholar
[41]
D André-Lévigne, A Modarressi, R Pignel, et al. Hyperbaric oxygen therapy promotes wound repair in ischemic and hyperglycemic conditions, increasing tissue perfusion and collagen deposition. Wound Repair Regen. 2016, 24(6): 954-965.
Crossref Google Scholar
[42]
JE Dougherty. The role of hyperbaric oxygen therapy in crush injuries. Crit Care Nurs Q. 2013, 36(3): 299-309.
Crossref Google Scholar
[43]
S Bhutani, G Vishwanath. Hyperbaric oxygen and wound healing. Indian J Plast Surg. 2012, 45(2): 316-324.
Crossref Google Scholar
[44]
RM Stoekenbroek, TB Santema, DA Legemate, et al. Hyperbaric oxygen for the treatment of diabetic foot ulcers: a systematic review. Eur J Vasc Endovasc Surg. 2014, 47(6): 647-655.
Crossref Google Scholar
[45]
A Marroni, D Mathieu, F Wattel. First European Consensus Conference on Hyperbaric Medicine, Lille 2004. A Marroni, D Mathieu, F Wattel, Eds. The ECHM collection. Flagstaff, AZ: Best Publishing Company, 2005.
[46]
WW Zhai, L Sun, ZQ Yu, et al. Hyperbaric oxygen therapy in experimental and clinical stroke. Med Gas Res. 2016, 6(2): 111-118.
Crossref Google Scholar
Journal of Neurorestoratology
Volume 8 Issue 4,
December 2020
Pages 270-280
DOI: 10.26599/JNR.2020.9040025
Cite this article:
Yang Y, Xu L, Xie R, et al. A meta-analysis on the efficiency of the time window of hyperbaric oxygen treatment on disorders of consciousness in China. Journal of Neurorestoratology, 2020, 8(4): 270-280. https://doi.org/10.26599/JNR.2020.9040025

882

Views

63

Downloads

6

Crossref

6

Web of Science

0

Scopus

Altmetrics
Received: 19 November 2020
Revised: 22 December 2020
Accepted: 29 December 2020
Published: 07 February 2021
© The authors 2020

This article is published with open access at http://jnr.tsinghuajournals.com
Return