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Not enough evidence on whether hyperventilation therapy improves outcomes for people with traumatic brain injury

Traumatic brain injury is a major cause of premature death and disability. Severe head injury can trigger brain swelling, thereby increasing pressure on the brain (raised intracranial pressure, ICP). Raised ICP increases the likelihood of brain damage or death. Treatment to lower people's ICP commonly involves hyperventilation therapy (increasing blood oxygen levels) following the brain injury. While hyperventilation therapy can reduce ICP after traumatic brain injury, the review of trials found there is no strong evidence about whether this improves outcomes. More trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Breathing exercises for dysfunctional breathing/hyperventilation syndrome

Dysfunctional breathing/hyperventilation syndrome (DB/HVS) is a breathing problem that involves breathing too deeply and/or too rapidly (hyperventilation). There are many possible causes of DB/HVS and if left untreated it can lead to a variety of unpleasant symptoms such as breathlessness, dizziness, pins and needles and chest pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Is breathing retraining useful in the treatment of children with dysfunctional breathing/hyperventilation syndrome?

Dysfunctional breathing/hyperventilation syndrome is a breathing problem that involves breathing using a poor pattern or breathing too deeply or too rapidly (or both) (hyperventilation). There are many possible causes of dysfunctional breathing and if left untreated it can lead to a variety of unpleasant symptoms such as breathlessness, dizziness, pins and needles and chest pain. Little is known about dysfunctional breathing in children. Preliminary data suggest that at least 5.3% of children with asthma have dysfunctional breathing but no accepted recommendations are available for the treatment of these children. Dysfunctional breathing is currently treated using breathing exercises where the overall aim is to teach the patient to breathe gently using the lower part of their chest at a rate that matches their activity level.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Removal of a section of skull bone (decompressive craniectomy) after a severe traumatic brain injury in patients with raised intracranial pressure that has not responded to conventional medical treatments

An injury to the brain may cause it to swell. Pressure within the skull then increases as the brain has no room to expand; this excess pressure, known as intracranial pressure, can cause further brain injury. High intracranial pressure (ICP) is the most frequent cause of death and disability in brain‐injured patients. If high ICP cannot be controlled using general or first‐line therapeutic measures such as adjusting body temperature or carbon dioxide levels in the blood and sedation, second‐line treatments are initiated. One of these is a procedure called decompressive craniectomy (DC). DC involves the removal of a section of skull so that the brain has room to expand and the pressure decrease. There is however clinical uncertainty regarding the use of DC and a lack of consensus on the optimal management of traumatic brain injury.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Ethosuximide, sodium valproate or lamotrigine for absence seizures in children and adolescents

Epilepsy is a disorder where seizures are caused by abnormal electrical discharges from the brain. Absence epilepsy involves seizures that cause a sudden loss of awareness. It often starts in childhood or adolescence. Three antiepileptic drugs are often used for absence epilepsy: valproate; ethosuximide and lamotrigine. Valproate can lead to weight gain, and may cause fetal abnormalities. The review found some evidence that individuals taking lamotrigine are more likely to be seizure free than those using placebos. No difference in effectiveness has been found between valproate and ethosuximide, but more research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Scopolamine for preventing and treating motion sickness

This Cochrane Review summarises evidence from 14 randomised controlled studies evaluating the effectiveness and safety of scopolamine for motion sickness. The results show that scopolamine is more effective than placebo and scopolamine‐like derivatives in the prevention of nausea and vomiting associated with motion sickness. However, scopolamine was not shown to be superior to antihistamines and combinations of scopolamine and ephedrine. Scopolamine was less likely to cause drowsiness, blurred vision or dizziness when compared to these other agents.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Permissive hypercapnia for the prevention of morbidity and mortality in mechanically ventilated newborn infants

Not enough evidence to show the effect of permissive hypercapnia compared to routine ventilation for preterm babies needing mechanical ventilation. Sometimes preterm babies need help from a machine to breathe (mechanical ventilation). Very low carbon dioxide levels, produced by mechanical ventilation of the lungs are thought to cause lung damage and developmental problems. Hypercapnia (increasing the levels of carbon dioxide in the blood) is used for adults in critical care. It may also help newborn babies, especially those with lung damage on mechanical ventilation. The review of trials found there was not enough evidence to show the effect of permissive hypercania compared to routine ventilation for preterm babies. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Surgical decompression for cerebral oedema in acute ischaemic stroke

About four‐fifths of strokes are due to blockage of an artery in the brain. When the artery is blocked, part of the brain is damaged, this is called a cerebral infarct. If a large artery is blocked the area of brain damage can be large. About 24 to 48 hours after a large infarct the brain can swell, causing a dangerous rise of pressure inside the head. Surgery to remove some of the skull bone over the swollen area of brain reduces the pressure. Results from recent clinical trials showed that surgery reduced the risk of death. However, survivors were left with moderate to severe disability requiring help in their daily life activities. These results only apply to people 60 years of age or younger.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Breathing exercises for asthma

Asthma is a lung disease, that comprises underlying inflammation and tightening of the small tubes in the airways (called airway obstruction), which occurs in response to asthma triggers such as animal danders or pollen (also called bronchial hyperresponsiveness). The high prevalence of asthma worldwide is a major public health problem because of the high healthcare costs associated with hospitalisation and medication. Breathing exercises are a non‐pharmacological intervention that has been used routinely in the treatment of patients with asthma. Breathing exercises aim to control the hyperventilation symptoms of asthma and can be performed as the Papworth Method, the Buteyko breathing technique, yoga or any other similar intervention that manipulates the breathing pattern.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Non-drug interventions for asthma

Medication is important in the treatment of asthma, to prevent asthma attacks and keep the condition under control. But many people would like to do more than just take medication. Some of the additional things that can be done have been scientifically proven to help, whereas others have not.A lot of people use special breathing techniques to try to cope better with asthma attacks. If someone reacts to certain asthma triggers, they can try to avoid them as best as possible. Regular exercise and appropriate levels of sport can help you keep fit and prevent asthma symptoms. One of the most important things you can do is stop smoking – or not start smoking in the first place.Many people with asthma also try out “alternative” treatments like herbal medicine or acupuncture. But it is often not clear whether, and how well, these approaches work and what side effects they might have.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

Systematic Reviews in PubMed

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