Conclusion

In using this EBM methodology, we expect every physician reading the jury conclusions to be able to assess the strength of evidence supporting each statement and how this applies to his clinical practice.

It is good to note that using the same EBM methodology, the UHMS expert committee and the ECHM consensus conference juries have drawn up lists of indications which are very similar with only two exceptions : the use of HBO in treating sudden deafness is not accepted in the USA and the treatment of acute blood loss anaemia is not accepted in Europe. Further randomised clinical study is needed to clear up these differences.

Table 2.1-1. List of potential and proposed indications for HBO (Lille, December 2004)_

CONDITION ACCEPTED NON ACCEPTED

Level of Evidence Level of Evidence

Type I

CO poisoning Crush syndromes

Prevention of osteoradionecrosis after dental extraction

Osteoradionecrosis (mandible)

Soft tissue radionecrosis (cystitis)

Decompression accidents

Gas embolism

Anaerobic or mixed bacterial anaerobic infections Type II

Diabetic foot lesions

Compromised skin graft and musculocutaneous flap Osteoradionecrosis (other bones) Radio-induced proctitis / enteritis Radio-induced lesions of soft tissues

Surgery and implant in irradiated tissue (preventative action) Sudden deafness Ischemic ulcers

Refractory chronic Osteomyelitis Stage IV neuroblastoma Type III

Post anoxic encephalopathy

Larynx radionecrosis

Radio-induced CNS lesion

Post-vascular procedure reperfusion syndrome

Limb replantation

Burns >20 % of surface area and 2nd degree

Acute ischemic ophthalmological disorders

Selected non healing wounds secondary to inflammatory processes

Pneumatosis cystoides intestinalis

CONDITION

Others indications

Post sternotomy mediastinitis Stroke

Sickle cell disease Malignant otitis externa Acute myocardial infarction Femoral head necrosis Retinitis pigmentosa Tinnitus

Interstitial cystitis Facial (Bell's) palsy Cerebral palsy Multiple sclerosis Foetoplacental insufficiency

ACCEPTED

NON ACCEPTED

Level of Evidence ABC

Level of Evidence D E F

2.2 Recommended Indications

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