Hyperbaric Oxygen Therapy for Diabetic Ulcers: Systematic Review and Meta-Analysis

O’Reilly, Daria; Pasricha, Anjori; Campbell, Kaitryn; Burke, Natasha; Assasi, Nazila; Bowen, James M.; Tarride, Jean‐Éric; Goeree, Ron

doi:10.1017/s0266462313000263

Cited by 39 publications

(41 citation statements)

References 24 publications

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“…The benefit of hyperbaric oxygen therapy is even less clear. In a recent meta‐analysis of six randomized controlled trials and six observational studies, the observational studies showed a benefit, but the randomized trials did not, and none of the studies focused on older adults. A retrospective study also failed to show efficacy or effectiveness .…”

Section: Clinical Research On Chronic Woundsmentioning

confidence: 99%

Chronic wound repair and healing in older adults: Current status and future research

Gould

Abadir

Brem

et al. 2015

Wound Repair Regeneration

244

204

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The incidence of chronic wounds is increased among older adults, and the impact of chronic wounds on quality of life is particularly profound in this population. It is well established that wound healing slows with age. However, the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The impact of age and accompanying multi-morbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables, lack of standardization in data collection, and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this paper, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify key research questions to guide future study of age-associated changes in chronic wound healing.

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Section: Clinical Research On Chronic Woundsmentioning

confidence: 99%

Chronic wound repair and healing in older adults: Current status and future research

Gould

Abadir

Brem

et al. 2015

Wound Repair Regeneration

244

204

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Section: Hyperbaric Oxygenmentioning

confidence: 99%

“…In addition, HBO is widely used as an adjunctive therapy for many conditions, such as diabetic ulcer healing, traumatic brain injury, and ischemic stroke. However, a recent meta-analysis of clinical trials for the latter three conditions found no conclusive evidence for benefit to the patient after HBO therapy (13,81,82).HBO treatment is relatively safe (83,84), and some studies have shown it has anti-inflammatory activity (85-87). These features support further research into HBO treatment as an adjunctive therapy candidate for a wide range of diseases (88).…”

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confidence: 99%

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Pathophysiological Mechanisms in Gaseous Therapies for Severe Malaria

et al. 2016

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cOver 200 million people worldwide suffer from malaria every year, a disease that causes 584,000 deaths annually. In recent years, significant improvements have been achieved on the treatment of severe malaria, with intravenous artesunate proving superior to quinine. However, mortality remains high, at 8% in children and 15% in adults in clinical trials, and even worse in the case of cerebral malaria (18% and 30%, respectively). Moreover, some individuals who do not succumb to severe malaria present longterm cognitive deficits. These observations indicate that strategies focused only on parasite killing fail to prevent neurological complications and deaths associated with severe malaria, possibly because clinical complications are associated in part with a cerebrovascular dysfunction. Consequently, different adjunctive therapies aimed at modulating malaria pathophysiological processes are currently being tested. However, none of these therapies has shown unequivocal evidence in improving patient clinical status. Recently, key studies have shown that gaseous therapies based mainly on nitric oxide (NO), carbon monoxide (CO), and hyperbaric (pressurized) oxygen (HBO) alter vascular endothelium dysfunction and modulate the host immune response to infection. Considering gaseous administration as a promising adjunctive treatment against severe malaria cases, we review here the pathophysiological mechanisms and the immunological aspects of such therapies. Malaria exerts a heavy burden over human populations, with an estimated 124 to 283 million cases and 584,000 deaths in 2013 (1). Currently, intravenous (i.v.) artesunate is the treatment of choice in severe malaria cases in children and adults (2, 3). However, despite the efficacy of intravenous artesunate, mortality from severe malaria in general and from cerebral malaria (CM) in particular remains high, at 18% for African children and 30% for adults in Southeast Asia (2, 3). In addition, 11% of children who survive CM show severe neurological deficits, and up to 25% can maintain long-term cognitive deficits (4-8). Therefore, strategies focusing only on parasite killing may not be sufficient to prevent neurological complications and deaths related to severe malaria. Accordingly, adjunctive therapies-defined as therapies administered in combination with antiparasitic drugs that modify pathophysiological processes caused by malaria-are being sought in order to mitigate complications caused by severe malaria (9). Considering the fact that currently administered antimalarial drugs often take 12 to 18 h to kill parasites, adjunctive therapies could reduce the risk of neurocognitive sequelae and mortality, particularly in patients with CM (10).Different adjunctive therapies have been or are being tested, including treatments aimed at modulation of the immune response to infection (dexamethasone, intravenous immunoglobulin), reduction of iron burden, reduction of oxidative stress, modulation of the prothrombotic state, and reduction of parasitemia (blood transfusion), amon...

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“…Ein Technology Assessment Report aus Kanada (O'Reilly et al 2013) analysierte 157 Arbeiten. Ein Technology Assessment Report aus Kanada (O'Reilly et al 2013) analysierte 157 Arbeiten.…”

Section: Hyperbare Sauerstofftherapieunclassified

Evidenzbasierte Gefäßchirurgie

Debus¹,

Grundmann²

2015

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Hyperbaric Oxygen Therapy for Diabetic Ulcers: Systematic Review and Meta-Analysis

Abstract: Due to the limited RCT evidence, it is not possible to conclusively establish the benefits and harms of treating diabetic lower limb ulcers with HBOT. No significant effects on amputation rates were found in the RCT evidence and in the high quality studies, no difference was found.

Cited by 39 publications

References 24 publications

Chronic wound repair and healing in older adults: Current status and future research

Chronic wound repair and healing in older adults: Current status and future research

Pathophysiological Mechanisms in Gaseous Therapies for Severe Malaria

Evidenzbasierte Gefäßchirurgie

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