期刊報告-101.5

Hyperbaric oxygen therapy as an adjunctive treatment for sternal infection and osteomyelitis after sternotomy and cardiothoracic surgery

Wen-Kuang Yu¹, Yen-Wen Chen^1,2, Huei-Guan Shie¹, Te-Cheng Lien^1,2, Hsin-Kuo Kao^1,2 and Jia-Horng Wang^1*

Abstract

Purpose

A retrospective study to evaluate the effect of hyperbaric oxygen (HBO2) therapy on sternal infection and osteomyelitis following median sternotomy.

Materials and methods

A retrospective analysis of patients who received sternotomy and cardiothoracic surgery which developed sternal infection and osteomyelitis between 2002 and 2009. Twelve patients who received debridement and antibiotic treatment were selected, and six of them received additional HBO2 therapy. Demographic, clinical characteristics and outcome were compared between patients with and without HBO2 therapy.

Results

HBO2 therapy did not cause any treatment-related complication in patients receiving this additional treatment. Comparisons of the data between two study groups revealed that the length of stay in ICU (8.7 ± 2.7 days vs. 48.8 ± 10.5 days, p < 0.05), duration of invasive (4 ± 1.5 days vs. 34.8 ± 8.3 days, p < 0.05) and non-invasive (4 ± 1.9 days vs. 22.3 ± 6.2 days, p < 0.05) positive pressure ventilation were all significantly lower in patients with additional HBO2 therapy, as compared to patients without HBO2 therapy. Hospital mortality was also significantly lower in patients who received HBO2 therapy (0 case vs. 3 cases, p < 0.05), as compared to patients without the HBO2 therapy.

Conclusions

In addition to primary treatment with debridement and antibiotic use, HBO2 therapy may be used as an adjunctive and safe treatment to improve clinical outcomes in patients with sternal infection and osteomyelitis after sternotomy and cardiothoracic surgery.

Keywords: 

hyperbaric oxygen; sternal infection; osteomyelitis; sternotomy; Cardiothoracic surgery

http://www.cardiothoracicsurgery.org/content/pdf/1749-8090-6-141.pdf 

Note：

1. 此研究非 RCT，由於sampling for population in control group 未清楚描述，因此擔心可能因立意收案而造成 biases of outcomes。

2.此paper應該歸為clinical investigation and analysis，非為clinical study，其調查結果可為下次研究的基石與相互驗證。