Oxigenoterapia hiperbárica para el síndrome coronario agudo
Información
- DOI:
- https://doi.org/10.1002/14651858.CD004818.pub4Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 23 julio 2015see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Corazón
- Copyright:
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- Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Dr. Michael Bennett: Conception, principal author, search strategy, identification of trials, critical appraisal and data extraction. Content expert on hyperbaric medicine and clinical epidemiology. Guarantor of this review.
Dr. Nigel Jepson: Co‐author, critical appraisal and data extraction. Content expert on acute coronary syndrome.
Dr. Jan Lehm: Co‐author, data extraction. Content expert on hyperbaric medicine.
Sources of support
Internal sources
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No internal source of support, Australia
External sources
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No external source of support, Australia
Declarations of interest
None known.
Acknowledgements
The authors wish to acknowledge the help of the Cochrane Heart Group, and in particular Margaret Burke for her assistance with the development of the search strategy, and both Theresa Moore and Katherine Wornell for their patient comments and suggestions.
Version history
| Published | Title | Stage | Authors | Version |
| 2015 Jul 23 | Hyperbaric oxygen therapy for acute coronary syndrome | Review | Michael H Bennett, Jan P Lehm, Nigel Jepson | |
| 2011 Aug 10 | Hyperbaric oxygen therapy for acute coronary syndrome | Review | Michael H Bennett, Jan P Lehm, Nigel Jepson | |
| 2005 Apr 20 | Hyperbaric oxygen therapy for acute coronary syndrome | Review | Michael H Bennett, Jan P Lehm, Nigel Jepson | |
| 2004 Jul 19 | Hyperbaric oxygen therapy for acute coronary syndrome | Protocol | Mike Bennett, Nigel Jepson | |
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Humans;
PICO
Study flow diagram
Forest plot of comparison: 1 Death, outcome: 1.1 Death at any time.
Comparison 1: Death, Outcome 1: Death at any time
Comparison 1: Death, Outcome 2: Death ‐ best case scenario
Comparison 1: Death, Outcome 3: Death ‐ worst case scenario
Comparison 2: Major Adverse Cardiac Events, Outcome 1: Major Adverse Cardiac Events
Comparison 2: Major Adverse Cardiac Events, Outcome 2: MACE ‐ Best case scenario
Comparison 2: Major Adverse Cardiac Events, Outcome 3: MACE ‐ worst case scenario
Comparison 2: Major Adverse Cardiac Events, Outcome 4: Recurrent acute myocardial infarction (AMI)
Comparison 2: Major Adverse Cardiac Events, Outcome 5: Recurrent AMI ‐ best case scenario
Comparison 2: Major Adverse Cardiac Events, Outcome 6: Recurrent AMI ‐ Worst case scenario
Comparison 3: Significant dysrhythmias (complete heart block, ventricular fibrillation, asystole), Outcome 1: Overall (CHB, VF and asystole combined)
Comparison 3: Significant dysrhythmias (complete heart block, ventricular fibrillation, asystole), Outcome 2: Significant dysrrythmias (complete heart block, ventricular fibrillation or asystole)
Comparison 3: Significant dysrhythmias (complete heart block, ventricular fibrillation, asystole), Outcome 3: Overall best case
Comparison 3: Significant dysrhythmias (complete heart block, ventricular fibrillation, asystole), Outcome 4: Overall worst case
Comparison 4: Time to pain relief, Outcome 1: Time to relief of pain
Comparison 5: Magnitude of cardiac enzyme changes, Outcome 1: 12 hour Plasma Creatine Phosphokinase
Comparison 5: Magnitude of cardiac enzyme changes, Outcome 2: 24 hour Plasma Creatine Phosphate
Comparison 5: Magnitude of cardiac enzyme changes, Outcome 3: Maximum Plasma Creatine Phosphate
Comparison 6: Improvement in left ventricular function, Outcome 1: Improved contraction in at least one segment (post‐HBOT echo)
Comparison 6: Improvement in left ventricular function, Outcome 2: Left Ventricular Ejection Fraction‐ % (final estimate)
Comparison 7: Length of Stay, Outcome 1: Overall length of stay (days)
Comparison 8: Adverse events of therapy, Outcome 1: Total adverse events
| hyperbaric oxygen therapy for acute coronary syndrome | ||||||
| Patient or population: patients with acute coronary syndrome | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Assumed risk | Corresponding risk | |||||
| Control | hyperbaric oxygen therapy | |||||
| Death at any time | Study population | RR 0.58 | 614 | ⊕⊕⊝⊝ | ||
| 116 per 1000 | 67 per 1000 | |||||
| Medium risk population | ||||||
| 102 per 1000 | 59 per 1000 | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Critical outcome | ||||||
| hyperbaric oxygen therapy for acute coronary syndrome | ||||||
| Patient or population: patients with acute coronary syndrome | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | No of Participants | Quality of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Assumed risk | Corresponding risk | |||||
| Control | hyperbaric oxygen therapy | |||||
| 12 hour Plasma Creatine Phosphokinase | The mean 12 hour Plasma Creatine Phosphokinase in the intervention groups was | 84 | ⊕⊕⊕⊝ | |||
| 24 hour Plasma Creatine Phosphate | The mean 24 hour Plasma Creatine Phosphate in the intervention groups was | 72 | ⊕⊕⊕⊝ | |||
| Maximum Plasma Creatine Phosphate | The mean Maximum Plasma Creatine Phosphate in the intervention groups was | 184 | ⊕⊕⊕⊕ | |||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Single trial only | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 Death at any time Show forest plot | 5 | 614 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.36, 0.92] |
| 1.1.1 Subjects presenting in cardiogenic shock | 1 | 12 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.61 [0.32, 1.18] |
| 1.1.2 Subjects presenting without cardiogenic shock | 5 | 602 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.57 [0.33, 0.98] |
| 1.2 Death ‐ best case scenario Show forest plot | 5 | 617 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.37 [0.23, 0.58] |
| 1.3 Death ‐ worst case scenario Show forest plot | 5 | 617 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.34 [0.91, 1.96] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 2.1 Major Adverse Cardiac Events Show forest plot | 1 | 61 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.12 [0.02, 0.85] |
| 2.2 MACE ‐ Best case scenario Show forest plot | 1 | 69 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.09 [0.01, 0.61] |
| 2.3 MACE ‐ worst case scenario Show forest plot | 1 | 69 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.56 [0.23, 1.40] |
| 2.4 Recurrent acute myocardial infarction (AMI) Show forest plot | 1 | 129 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.28 [0.08, 0.95] |
| 2.5 Recurrent AMI ‐ best case scenario Show forest plot | 1 | 129 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.17 [0.05, 0.55] |
| 2.6 Recurrent AMI ‐ Worst case scenario Show forest plot | 1 | 129 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.92 [0.42, 2.02] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 3.1 Overall (CHB, VF and asystole combined) Show forest plot | 1 | 208 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.59 [0.39, 0.89] |
| 3.2 Significant dysrrythmias (complete heart block, ventricular fibrillation or asystole) Show forest plot | 1 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
| 3.2.1 Complete heart block | 1 | 208 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.32 [0.12, 0.84] |
| 3.2.2 Ventricular fibrillation | 1 | 208 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.36, 1.71] |
| 3.2.3 Asystole | 1 | 208 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.34, 1.56] |
| 3.3 Overall best case Show forest plot | 1 | 221 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.51 [0.34, 0.77] |
| 3.4 Overall worst case Show forest plot | 1 | 221 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.50, 1.06] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 4.1 Time to relief of pain Show forest plot | 1 | 81 | Mean Difference (IV, Fixed, 95% CI) | ‐353.00 [‐487.55, ‐218.45] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 5.1 12 hour Plasma Creatine Phosphokinase Show forest plot | 1 | 84 | Mean Difference (IV, Fixed, 95% CI) | ‐138.00 [‐843.83, 567.83] |
| 5.2 24 hour Plasma Creatine Phosphate Show forest plot | 1 | 72 | Mean Difference (IV, Fixed, 95% CI) | ‐65.00 [‐530.96, 400.96] |
| 5.3 Maximum Plasma Creatine Phosphate Show forest plot | 2 | 184 | Mean Difference (IV, Fixed, 95% CI) | ‐493.16 [‐838.74, ‐147.58] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 6.1 Improved contraction in at least one segment (post‐HBOT echo) Show forest plot | 1 | 34 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.09 [0.01, 1.40] |
| 6.2 Left Ventricular Ejection Fraction‐ % (final estimate) Show forest plot | 2 | 190 | Mean Difference (IV, Random, 95% CI) | 5.47 [2.19, 8.75] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 7.1 Overall length of stay (days) Show forest plot | 1 | 64 | Mean Difference (IV, Fixed, 95% CI) | ‐1.80 [‐3.70, 0.10] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 8.1 Total adverse events Show forest plot | 3 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
| 8.1.1 Tympanic membrane rupture | 2 | 269 | Risk Ratio (M‐H, Fixed, 95% CI) | 4.56 [0.19, 107.54] |
| 8.1.2 Acute neurological oxygen toxicity | 2 | 274 | Risk Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| 8.1.3 Claustrophobia | 1 | 208 | Risk Ratio (M‐H, Fixed, 95% CI) | 31.60 [1.92, 521.22] |
