Naval Special Warfare Command, Coronado, California.
Naval Special Warfare Group FOUR, Virginia Beach, Virginia.
J Appl Physiol (1985). 2021 May 1;130(5):1594-1603. doi: 10.1152/japplphysiol.01084.2020. Epub 2021 Apr 1.
Hyperbaric oxygen therapy has been proposed as a method to treat traumatic brain injuries. The combination of pressure and increased oxygen concentration produces a higher content of dissolved oxygen in the bloodstream, which could generate a therapeutic benefit for brain injuries. This dissolved oxygen penetrates deeper into damaged brain tissue than otherwise possible and promotes healing. The result includes improved cognitive functioning and an alleviation of symptoms. However, randomized controlled trials have failed to produce consistent conclusions across multiple studies. There are numerous explanations that might account for the mixed evidence, although one possibility is that prior evidence focuses primarily on statistical significance. The current analyses explored existing evidence by calculating an effect size from each active treatment group and each control group among previous studies. An effect size measure offers several advantages when comparing across studies, as it can be used to directly contrast evidence from different scales, and it provides a proximal measure of clinical significance. When exploring the therapeutic benefit through effect sizes, there was a robust and consistent benefit to individuals who underwent hyperbaric oxygen therapy. Placebo effects from the control condition could account for approximately one-third of the observed benefits, but there appeared to be a clinically significant benefit to using hyperbaric oxygen therapy as a treatment intervention for traumatic brain injuries. This evidence highlights the need for design improvements when exploring interventions for traumatic brain injury and the importance of focusing on clinical significance in addition to statistical significance.
高压氧治疗被提议作为治疗创伤性脑损伤的一种方法。压力和增加的氧气浓度的结合在血流中产生更高的溶解氧含量，这可能为脑损伤产生治疗益处。这种溶解氧比其他方式更深入地渗透到受损的脑组织中，并促进愈合。结果包括改善认知功能和减轻症状。然而，随机对照试验未能在多项研究中得出一致的结论。有许多解释可以解释混合证据，尽管有一种可能性是，先前的证据主要集中在统计学意义上。目前的分析通过计算每个活性治疗组和每个对照组在先前研究中的效应大小来探索现有证据。当在研究之间进行比较时，效应大小衡量标准具有几个优势，因为它可以用于直接对比来自不同尺度的证据，并且它提供了临床意义的接近测量。当通过效应大小探索治疗益处时，接受高压氧治疗的个体有明显的益处。对照条件下的安慰剂效应可以解释大约三分之一的观察到的益处，但似乎使用高压氧治疗作为创伤性脑损伤的治疗干预有明显的临床益处。这一证据强调了在探索创伤性脑损伤干预措施时需要改进设计，并强调了除了统计学意义之外，还需要关注临床意义。
