Sylvain Boet1,2,3,4, Cole Etherington2, Nibras Ghanmi5, Paul Ioudovski5, Andrea C Tricco6,7,8, Lindsey Sikora9, Rita Katznelson10. 1. Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada. 2. Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada. 3. Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada. 4. Corresponding author: Dr Sylvain Boet, Department of Anesthesiology and Pain Medicine, Hyperbaric Medicine Unit, The Ottawa Hospital, 501 Smyth Rd, Critical Care Wing 1401, Ottawa, K1H 8L6, Ontario, Canada, sboet@toh.ca. 5. Department of Public Health Sciences, Faculty of Health Sciences, Queens University, Ontario, Canada. 6. Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada. 7. Epidemiology Division and Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 8. Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Ontario, Canada. 9. Sciences Library, University of Ottawa, Ottawa, Canada. 10. Department of Anesthesia and Pain Management, University Health Network, Toronto, Ontario, Canada.
Abstract
INTRODUCTION: As the COVID-19 pandemic evolves, new effective treatment options are essential for reducing morbidity and mortality as well as the strain placed on the healthcare system. Since publication of our initial review on hyperbaric oxygen treatment (HBOT) for hypoxaemic COVID-19 patients, interest in HBOT for COVID-19 has grown and additional studies have been published. METHODS: For this living systematic review update the previously published search strategy (excluding Google Scholar) was adopted with an extension from 01 February 2021 to 01 April 2022. Study inclusion criteria, data extraction, risk of bias estimation and dispute resolution methods were repeated. RESULTS: Two new studies enrolling 127 patients were included in this update, taking the total to eight studies with 224 patients. Both new studies were randomised controlled trials, one at moderate and one at high risk of bias. Across these eight studies, 114 patients were treated with HBOT. All reported improved clinical outcomes without observation of any serious adverse events. Meta-analysis remained unjustified given the high heterogeneity between studies and incomplete reporting. CONCLUSIONS: This updated living systematic review provides further evidence on the safety and effectiveness of HBOT to treat acute hypoxaemic COVID-19 patients. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: As the COVID-19 pandemic evolves, new effective treatment options are essential for reducing morbidity and mortality as well as the strain placed on the healthcare system. Since publication of our initial review on hyperbaric oxygen treatment (HBOT) for hypoxaemic COVID-19 patients, interest in HBOT for COVID-19 has grown and additional studies have been published. METHODS: For this living systematic review update the previously published search strategy (excluding Google Scholar) was adopted with an extension from 01 February 2021 to 01 April 2022. Study inclusion criteria, data extraction, risk of bias estimation and dispute resolution methods were repeated. RESULTS: Two new studies enrolling 127 patients were included in this update, taking the total to eight studies with 224 patients. Both new studies were randomised controlled trials, one at moderate and one at high risk of bias. Across these eight studies, 114 patients were treated with HBOT. All reported improved clinical outcomes without observation of any serious adverse events. Meta-analysis remained unjustified given the high heterogeneity between studies and incomplete reporting. CONCLUSIONS: This updated living systematic review provides further evidence on the safety and effectiveness of HBOT to treat acute hypoxaemic COVID-19 patients. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
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Authors: Patrick R Lawler; Ewan C Goligher; Jeffrey S Berger; Matthew D Neal; Bryan J McVerry; Jose C Nicolau; Michelle N Gong; Marc Carrier; Robert S Rosenson; Harmony R Reynolds; Alexis F Turgeon; Jorge Escobedo; David T Huang; Charlotte A Bradbury; Brett L Houston; Lucy Z Kornblith; Anand Kumar; Susan R Kahn; Mary Cushman; Zoe McQuilten; Arthur S Slutsky; Keri S Kim; Anthony C Gordon; Bridget-Anne Kirwan; Maria M Brooks; Alisa M Higgins; Roger J Lewis; Elizabeth Lorenzi; Scott M Berry; Lindsay R Berry; Aaron W Aday; Farah Al-Beidh; Djillali Annane; Yaseen M Arabi; Diptesh Aryal; Lisa Baumann Kreuziger; Abi Beane; Zahra Bhimani; Shailesh Bihari; Henny H Billett; Lindsay Bond; Marc Bonten; Frank Brunkhorst; Meredith Buxton; Adrian Buzgau; Lana A Castellucci; Sweta Chekuri; Jen-Ting Chen; Allen C Cheng; Tamta Chkhikvadze; Benjamin Coiffard; Todd W Costantini; Sophie de Brouwer; Lennie P G Derde; Michelle A Detry; Abhijit Duggal; Vladimír Džavík; Mark B Effron; Lise J Estcourt; Brendan M Everett; Dean A Fergusson; Mark Fitzgerald; Robert A Fowler; Jean P Galanaud; Benjamin T Galen; Sheetal Gandotra; Sebastian García-Madrona; Timothy D Girard; Lucas C Godoy; Andrew L Goodman; Herman Goossens; Cameron Green; Yonatan Y Greenstein; Peter L Gross; Naomi M Hamburg; Rashan Haniffa; George Hanna; Nicholas Hanna; Sheila M Hegde; Carolyn M Hendrickson; R Duncan Hite; Alexander A Hindenburg; Aluko A Hope; James M Horowitz; Christopher M Horvat; Kristin Hudock; Beverley J Hunt; Mansoor Husain; Robert C Hyzy; Vivek N Iyer; Jeffrey R Jacobson; Devachandran Jayakumar; Norma M Keller; Akram Khan; Yuri Kim; Andrei L Kindzelski; Andrew J King; M Margaret Knudson; Aaron E Kornblith; Vidya Krishnan; Matthew E Kutcher; Michael A Laffan; Francois Lamontagne; Grégoire Le Gal; Christine M Leeper; Eric S Leifer; George Lim; Felipe Gallego Lima; Kelsey Linstrum; Edward Litton; Jose Lopez-Sendon; Jose L Lopez-Sendon Moreno; Sylvain A Lother; Saurabh Malhotra; Miguel Marcos; Andréa Saud Marinez; John C Marshall; Nicole Marten; Michael A Matthay; Daniel F McAuley; Emily G McDonald; Anna McGlothlin; Shay P McGuinness; Saskia Middeldorp; Stephanie K Montgomery; Steven C Moore; Raquel Morillo Guerrero; Paul R Mouncey; Srinivas Murthy; Girish B Nair; Rahul Nair; Alistair D Nichol; Brenda Nunez-Garcia; Ambarish Pandey; Pauline K Park; Rachael L Parke; Jane C Parker; Sam Parnia; Jonathan D Paul; Yessica S Pérez González; Mauricio Pompilio; Matthew E Prekker; John G Quigley; Natalia S Rost; Kathryn Rowan; Fernanda O Santos; Marlene Santos; Mayler Olombrada Santos; Lewis Satterwhite; Christina T Saunders; Roger E G Schutgens; Christopher W Seymour; Deborah M Siegal; Delcio G Silva; Manu Shankar-Hari; John P Sheehan; Aneesh B Singhal; Dayna Solvason; Simon J Stanworth; Tobias Tritschler; Anne M Turner; Wilma van Bentum-Puijk; Frank L van de Veerdonk; Sean van Diepen; Gloria Vazquez-Grande; Lana Wahid; Vanessa Wareham; Bryan J Wells; R Jay Widmer; Jennifer G Wilson; Eugene Yuriditsky; Fernando G Zampieri; Derek C Angus; Colin J McArthur; Steven A Webb; Michael E Farkouh; Judith S Hochman; Ryan Zarychanski Journal: N Engl J Med Date: 2021-08-04 Impact factor: 176.079