Hyperbaric oxygen therapy for comatose patients:a meta-analysis of randomized controlled trials

XIE Yangdan; WANG Zitong; MA Xiao; SUN Zhongqing; ZHAO Jingjing; JIANG Wen

doi:10.13276/j.issn.2097-1656.2026.05.014

Abstract：Objective To systematically evaluate the clinical efficacy of hyperbaric oxygen therapy(HBOT)in comatose patients and provide evidence-based medical support for its clinical application.Methods A systematic literature search was conducted in PubMed,Cochrane Library,Embase,CNKI,VIP,WanFang Data,and SinoMed databases from their inception to December 21,2025.Search terms included"coma","hyperbaric oxygen","hyperbaric oxygen therapy",and"randomized controlled trials".Randomized controlled trials(RCTs)involving comatose patients with a Glasgow Coma Scale(GCS)score≤8 were included.The literature screening and data extraction were performed independently,and the RoB 1.0 tool was used to assess the risk of bias in included studies.Meta-analysis was conducted to analyze the efficacy of HBOT,with the main outcome measure being GCS score.Results A total of 2 176 articles were retrieved,and 50 RCTs involving 4 411 comatose patients were finally included,among which 49 were Chinese articles and 1 was English article.All included studies were conducted in China,with 49 focusing on traumatic brain injury and 1 on severe stroke.Meta-analysis results showed that HBOT combined with standard treatment significantly improved GCS scores of comatose patients,and this effect was verified in subgroup analyses of different courses and etiologies.Regarding prognostic outcomes,significant differences were observed in Glasgow Outcome Scale(GOS)score,GOS grade,and mortality rate between the HBOT group and the control group.Conclusion HBOT can significantly improve GCS scores and prognosis of comatose patients,and may alleviate immune responses.However,the included studies have limitations such as low overall quality,geographical concentration,and non-standardized HBOT regimens.