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(Stroke. 2006;37:1953.)
© 2006 American Heart Association, Inc.

Cochrane Corner

Hyperbaric Oxygen Therapy for Acute Ischemic Stroke

Graeme J. Hankey, MD, FRCP, Section Editor:; Michael H. Bennett, FANZCA; Jason Wasiak, RN; Christopher French, FRACP; Peter Kranke, MBA Alexander Schnabel

From the Department of Diving and Hyperbaric Medicine (M.H.B.), Prince of Wales Hospital, Randwick, NSW, Australia; Burns, The Alfred Hospital Melbourne (J.W.), Australia; Department of Neurology (C.F.), Prince of Wales Hospital, Randwick, NSW, Australia; Department of Anesthesiology (P.K.), University Hospital Würzburg, Germany; and University of Würzburg (A.S.), Germany.

Correspondence to Michael H. Bennett, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia. E-mail m.bennett@unsw.edu.au

Key Words: brain infarction • hyperbaric oxygenation • meta-analysis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
During a stroke event, hypoxic changes can occur slowly enough in some patients to suggest that the close management of factors designed to maintain oxygenation might be beneficial. Intensive stroke management protocols and antiplatelet therapy have been established on this basis with some success. Hyperbaric oxygen therapy (HBOT) was first proposed as an adjunct in the treatment of ischemic stroke 40 years ago because of the ability of this therapy to deliver a greatly increased partial pressure of oxygen to the tissues.¹

HBOT is the therapeutic administration of 100% oxygen at pressures >1 atmosphere (101.3 kPa). Typically, treatments involve pressurization to between 152 and 304 kPa for periods between 60 and 120 minutes daily. The potential benefits of HBOT include a reduction of cerebral edema, decreased lipid peroxidation, inhibition of leukocyte activation, and restoration of the functional blood–brain barrier.^2,3 Conversely, oxygen in high doses may increase oxidative stress through the production of oxygen free-radical species, and the brain is particularly at risk.⁴

	Objective

 
The objective was to evaluate the effectiveness and safety of HBOT as an adjunctive therapy for the treatment of acute ischemic stroke.

	Methods

 
We performed a sensitive electronic search of multiple reference databases in late 2004, including Medline (Ovid), Cochrane Stroke Group Trials Registry, the Database of Randomized Controlled Trials in Diving and Hyperbaric Medicine,⁵ and EMBASE. The reference lists of retrieved articles were also searched for further clinical trials. No language restrictions applied. We included all randomized controlled trials that compared the effect of adjunctive HBOT with either . . . [Full Text of this Article]

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