Gong Xiu-Bing, Feng Rui-Hua, Dong Hong-Mei, Liu Wen-Hua, Gu Ya-Nan, Jiang Xiang-Yue, Lou Ye-Hao, Xu Jun, Dou Qing-Li
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Health Economics, Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Pediatr. 2022 Apr 21;10:707136. doi: 10.3389/fped.2022.707136. eCollection 2022.
Preclinical and clinical evidence suggests that hyperbaric oxygen therapy (HBOT) may benefit newborns. The effectiveness of HBOT for neonatal hypoxic-ischemic encephalopathy (HIE) remains controversial. We conducted a meta-analysis to evaluate the efficacy and prognosis of HBOT in neonates with HIE.
A systematic search of eight databases was performed for available articles published between January 1, 2015, and September 30, 2020, to identify randomized controlled clinical trials (RCTs) on HBOT for neonatal HIE. Methodological quality assessment was performed by applying the simple procedure detailed by the Cochrane collaboration. Afterward, quality assessment and data analysis were performed using Revman 5.3 software. STATA 15 software was used to detect publication bias as well as for sensitivity analysis.
A total of 46 clinical RCTs were selected for the study and included 4,199 patients with neonatal HIE. The results indicated that HBOT significantly improved the total efficiency (TEF) of treatment for neonatal HIE patients [odds ratio (OR) = 4.61, 95% confidence interval (CI) (3.70, 5.75), < 0.00001] and reduced the risk of sequelae (OR = 0.23, 95% CI (0.16, 0.33), < 0.00001) and the neonatal behavioral neurological assessment (NBNA) scores [mean difference (MD) = 4.51, 95%CI (3.83,5.19, < 0.00001)].
In light of the effectiveness of HBOT neonatal HIE, this meta-analysis suggested that HBOT can be a potential therapy for the treatment of neonatal HIE. Due to the heterogeneity of studies protocol and patient selection being only from China, more research is needed before this therapy can be widely implemented in the clinic.
PROSPERO (ID: CRD42020210639). Available online at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020210639.
临床前和临床证据表明，高压氧疗法（HBOT）可能对新生儿有益。HBOT治疗新生儿缺氧缺血性脑病（HIE）的有效性仍存在争议。我们进行了一项荟萃分析，以评估HBOT对新生儿HIE的疗效和预后。
对八个数据库进行系统检索，以查找2015年1月1日至2020年9月30日期间发表的可用文章，以确定关于HBOT治疗新生儿HIE的随机对照临床试验（RCT）。采用Cochrane协作组织详细描述的简单程序进行方法学质量评估。之后，使用Revman 5.3软件进行质量评估和数据分析。使用STATA 15软件检测发表偏倚并进行敏感性分析。
共选择46项临床RCT进行研究，纳入4199例新生儿HIE患者。结果表明，HBOT显著提高了新生儿HIE患者的治疗总有效率（TEF）[比值比（OR）=4.61，95%置信区间（CI）（3.70，5.75），P<0.00001]，降低了后遗症风险（OR=0.23，95%CI（0.16，0.33），P<0.00001）和新生儿行为神经评分[平均差（MD）=4.51，95%CI（3.83，5.19），P<0.00001]。
鉴于HBOT对新生儿HIE的有效性，这项荟萃分析表明HBOT可能是治疗新生儿HIE的一种潜在疗法。由于研究方案的异质性以及患者选择仅来自中国，在该疗法能够在临床广泛应用之前，还需要更多的研究。
PROSPERO（ID：CRD42020210639）。可在以下网址在线获取：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020210639 。
