408 www.thelancet.com Vol 379 February 4, 2012 a full 14 days. Sequential therapy was less eff ective than has been reported in other trials, but a careful appraisal of the data shows that TT-14 was not remarkably better than ST: the number need to treat in favour of TT14 was 18, with a wide 95% CI (9–175) suggesting uncertainty in the true estimate of eff ect. In conclusion, caution should be exercised in the interpretation of these interesting but heterogeneous data. Carefully designed trials with document ation of resistance in individual patients and with a suffi ciently large sample size from each country are necessary before any regimen can be determined as optimal in an individual Latin American country.

Diving and hyperbaric medicine4区 · 医学

Audit of practice in Australasian hyperbaric units on the incidence of central nervous system oxygen toxicity

4区 · 医学

Article

作者: Tabah, Alexis ; Sherlock, Susannah ; Way, Mandy

INTRODUCTION:

Central nervous system oxygen toxicity (CNS-OT) is an uncommon complication of hyperbaric oxygen treatment (HBOT). Different facilities have developed local protocols in an attempt to reduce the risk of CNS-OT. This audit was performed to elucidate which protocols might be of benefit in mitigating CNS-OT and to open discussion on adopting a common protocol for Treatment Table 14 (TT14) to enable future multicentre clinical trials.

METHODS:

Audit of CNS-OT events between units using different compression profiles for TT14, performed at 243 kPa with variable durations of oxygen breathing and 'air breaks', to assess whether there is a statistical diference between protocols. Data were collected retrospectively from public and private hyperbaric facilities in Australia and New Zealand between 01 January 2010 and 31 December 2014.

RESULTS:

Eight of 15 units approached participated. During the five-year period 5,193 patients received 96,670 treatments. There were a total of 38 seizures in 33 patients when all treatment pressures were examined. In the group of patients treated at 243 kPa there were a total of 26 seizures in 23 patients. The incidence of seizure per treatment was 0.024% (2.4 per 10,000 treatments) at 243 kPa and the risk per patient was 0.45% (4.5 in 1,000 patients). There were no statistically significant differences between the incidences of CNS-OT using different TT14 protocols in this analysis.

CONCLUSION:

HBOT is safe and CNS-OT is uncommon. The risk of CNS-OT per patient at 243 kPa was 1 in 222 (0.45%; range 0-1%) and the overall risk irrespective of treatment table was 0.6% (range 0.31-1.8%). These figures are higher than previously reported as they represent individual patient risk as opposed to risk per treatment. The wide disparity of facility protocols for a 243 kPa table without discernible influence on the incidence of CNS-OT rates should facilitate a national approach to consensus.

100 项与 TT-14 相关的药物交易

登录后查看更多信息