Undersea Hyperb Med 2001 Fall;28(3):117-22
Bennett M, Heard R.
Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, University of New South Wales, Sydney, Australia.
Despite considerable research effort there is little controlled evidence that a course of hyperbaric oxygen therapy (HBO2T) results in any benefit for patients with multiple sclerosis (MS).
The great majority of randomized trials involved investigating a course of 20 treatments at pressures between 1.75 and 2.5 atm abs daily for 60-120 min over 4 wk against a placebo regimen.
None has tested the efficacy of HBO2T against alternative current best practice.
A systematic review of this randomized evidence suggests there is no significant benefit from the administration of HBO2T (Improved EDSS after HBO2T: OR = 2.02, 95% CI 0.63-6.43.
Improved sphincter function: OR = 1.3, 95% CI 0.8-2.11).
On average, 42 patients would need to be treated before we could expect one individual to benefit with an improved disability status score; however, we cannot be confident that the number we would need to treat is less than infinite (NNT = 42, 95% CI 15 to infinity).
There is some case for further investigation of possible therapeutic effects in selected sub-groups of patients and for the response to prolonged courses of HBO2T at more modest pressures; however, the case is not strong.
At this time, we cannot recommend the routine treatment of MS with HBO2T.