Efficacy And Safety Of Oxygen Therapy In Acute Stroke

Objective:To evaluate the efficacy and safety of oxygen therapy in acute stroke.Methods:The PubMed,OVID,Embase,Cochrane Library,Clinical trials.gov,China Biology Medicine disc(CBMdisc),Wanfang Data,CJFD and VIP Information System were retrieved with computer.Randomized controlled trials and Cohort studies(up to September 2018)about oxygen therapy in acute stroke were included.Two authors independently screened trials based on the inclusion and exclusion criteria and extracted data from the included studies.The quality of the included studies were assessment by using the modified Jadad quality scale score or NewcastleOttawa Scale score.Modified Jadad quality scale score of 4 to 7 or Newcastle-Ottawa Scale score of 6 to 9 were considered high quality studies.RevMan 5.3 software was used to conduct Meta-analysis for studies with high quality.Results:Nine RCTs and 1 observational study involving 6717 patients with acute stroke were finally enrolled.There were five studies on Hyperbaric Oxygen(190 participants).And 5 studies on Normobaric Oxygen(6547 participants).Pooled analysis demonstrated that compared with controls,hyperbaric oxygen therapy did not reduce the risk of death(RR 0.97,95% CI: 0.31~3.01,P=0.96)and disability in patient with acute ischemic(OR 1.46,95% CI 0.06~36.56,P=0.82).No significant adverse effects were founded between the experimental group and the control group(OR 5.46,95% CI 0.61~48.69,P=0.13).Compared with the controls,normobaric oxygen therapy in the acute stroke did not reduce the disability of 3 to 6 months(RR 0.99,95% CI 0.94~1.04,P=0.57)and the mortality of short-term(OR 1.12,95% CI 0.76~1.65,P=0.57)and long-term(OR 1.06,95% CI 0.93~1.22,P=0.37),did not improve the neurological deficits of 7 days(OR 1.01,95% CI 0.90~1.12,P=0.90)and the quality of life of 3 to 7 months(MD-1.63,95% CI –5.14~1.88,P=0.36).Only one study reported adverse events,and there was no significant difference between the experimental group and the control group(RR 1.08,95% CI 0.94~1.25,P=0.28).Conclusion:Hyperbaric oxygen therapy does not improve long-term prognosis of patients with acute ischemic stroke.Normobaric oxygen therapy does not reduce disability and mortality in patient with acute ischemic and hemorrhagic stroke.There were no significant adverse effects were founded.