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发布于:2018-2-10 07:44:40  访问:23 次 回复:0 篇
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essential to note that all {five
vital to note that all 5 relapses in our study occurred in individuals provided hyperbaric oxygen (P = 0.03).C D Scheinkestel deputy director cdsch@ozemail.com.au D V Tuxen director Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Australia M Bailey statistical NQDI-1 dose consultant Department of Epidemiology and Preventive Medicine, Monash University, Melbourne P S Myles head of analysis Division of Anaesthesia and Pain Management, Alfred Hospital, Melbourne K Jones psychologist College of Psychology, La Trobe University, Melbourne, Australia D J Cooper head of trauma intensive care unit Alfred Hospital, Melbourne I L Millar head of hyperbaric medicine Alfred Hospital, Melbourne1 Weaver LK. Weaver also criticises Scheinkestel et al for not applying hyperbaric oxygen earlier in their study. This criticism comes in spite of the lack of evidence from controlled potential comparative research that earlier treatment is any far more useful and in spite of the truth that subgroup evaluation of therapy within 4 hours showed no benefit from hyperbaric oxygen. Scheinkestel et al‘s study is representative of most clinical practice because of late presentation plus the need to have for stabilisation and transport to a remote hyperbaric facility. Scheinkestel et al‘s study has shown that hyperbaric oxygen leads to a worse outcome than does normobaric remedy. Even when it is actually wrong, the degree of any advantage is unlikely to become clinically critical compared with all the risk of such treatment. Hyperbaric oxygen as well as the linked transportation are related with appreciable hazards to each the attendant as well as the patient, that are normally understated. I thus recommend that the multicentre study that Weaver proposes would now be unethical. In carbon monoxide poisoning one hundred oxygen need to be provided right away and continued for several days. Resources needs to be concentrated on promulgating this message together with preventing carbon monoxide poisoning and detecting it early in lieu of on giving much more hyperbaric oxygen facilities. The NHS and healthcare agencies in the United states of america should really assessment their Anle138b web funding strategy for the use of hyperbaric oxygen in acute carbon monoxide poisoning, because the only benefit would appear to become towards the profitability of independent hyperbaric facilities.S Q M Tighe consultant anaesthetist Countess of Chester Hospital NHS Trust, Chester CH2 1UL Sean_Tighe@msn.com1 Weaver LK.important to note that all five relapses in our study occurred in sufferers given hyperbaric oxygen (P = 0.03).C D Scheinkestel deputy director cdsch@ozemail.com.au D V Tuxen director Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Australia M Bailey statistical consultant Division of Epidemiology and Preventive Medicine, Monash University, Melbourne P S Myles head of research Division of Anaesthesia and Discomfort Management, Alfred Hospital, Melbourne K Jones psychologist College of Psychology, La Trobe University, Melbourne, Australia D J Cooper head of trauma intensive care unit Alfred Hospital, Melbourne I L Millar head of hyperbaric medicine Alfred Hospital, Melbourne1 Weaver LK. Hyperbaric oxygen in carbon monoxide poisoning. BMJ 1999;319:1083-4. (23 October.) two Scheinkestel CD, Bailey M, Myles PS, Jones K, Cooper DJ, Millar IL, et al. Hyperbaric or normobaric oxygen for acute carbon monoxide poisoning: a randomised controlled clinical trial. Med J Aust 1999;170:203-10.
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