The effects of hyperbaric oxygen on cultured fibroblasts

The Effects of Hyperbaric Oxygenation on Oxidative Stress, Inflammation and Angiogenesis

Hyperbaric oxygen therapy (HBOT) is commonly used as treatment in several diseases, such as non-healing chronic wounds, late radiation injuries and carbon monoxide poisoning. Ongoing research into HBOT has shown that preconditioning for surgery is a potential new treatment application, which may reduce complication rates and hospital stay. In this review, the effect of HBOT on oxidative stress, inflammation and angiogenesis is investigated to better understand the potential mechanisms underlying preconditioning for surgery using HBOT. A systematic search was conducted to retrieve studies measuring markers of oxidative stress, inflammation, or angiogenesis in humans. Analysis of the included studies showed that HBOT-induced oxidative stress reduces the concentrations of pro-inflammatory acute phase proteins, interleukins and cytokines and increases growth factors and other pro-angiogenesis cytokines. Several articles only noted this surge after the first HBOT session or for a short duration after each session. The anti-inflammatory status following HBOT may be mediated by hyperoxia interfering with NF-κB and IκBα. Further research into the effect of HBOT on inflammation and angiogenesis is needed to determine the implications of these findings for clinical practice.

Hyperbaric oxygen therapy for nonhealing wounds: Treatment results of a single center

The present article evaluates the results of the treatment with adjuvant hyperbaric oxygen therapy (HBOT) of patients with nonhealing, chronic wounds. In the period 2013 to 2016, 248 patients were referred from various hospitals because of chronic wounds that were recalcitrant in healing despite standard wound care as described in national and international guidelines. After inclusion, all patients were treated with HBOT and subjected to a weekly standard wound care treatment. During each HBOT session, 100% O2 was administered for 75 minutes under increased pressure of 2.4 ATA. Wounds and quality of life were assessed before and after the total treatment period. A total of 248 patients have been evaluated. Diabetic foot ulcers were present in 134 patients, the remainder (114 patients) showed a variety of wound locations and etiologies. The number of HBOT treatments amounted to an average of 48 (range 20-68) sessions. Before referral to our clinic, 31% of all wounds had existed for at least 18 months (72 patients). After HBOT, 81% of all wounds were near complete healing or completely healed, in 13% of the cases the wound was stable, and in 2% minor or major amputation had to be carried out. The mean treatment time for wounds pre-existing fewer than 6 weeks ("early referrals") was 67 days, and 119 days for wounds pre-existing more than 18 months ("late referrals"). A majority of the patients in our study referred with nonhealing wounds clinically improved when adjuvant HBOT was added to standard wound care protocols. No differences in success rate were seen between diabetic and nondiabetic wounds. It showed that HBOT is a well-tolerated treatment.

Deconvolution of RNA-Seq Analysis of Hyperbaric Oxygen-Treated Mice Lungs Reveals Mesenchymal Cell Subtype Changes

Hyperbaric oxygen (HBO) is widely applied to treat several hypoxia-related diseases. Previous studies have focused on the immediate effect of HBO-exposure induced oxidative stress on the lungs, but knowledge regarding the chronic effects from repetitive HBO exposure is limited, especially at the gene expression level. We found that repetitive HBO exposure did not alter the morphology of murine lungs. However, by deconvolution of RNA-seq from those mice lungs using CIBERSORTx and the expression profile matrices of 8 mesenchymal cell subtypes obtained from bleomycin-treated mouse lungs, we identify several mesenchymal cell subtype changes. These include increases in Col13a1 matrix fibroblasts, mesenchymal progenitors and mesothelial cell populations and decreases in lipofibroblasts, endothelial and Pdgfrb high cell populations. Our data suggest that repetitive HBO exposure may affect biological processes in the lungs such as response to wounding, extracellular matrix, vasculature development and immune response.

Angiogenesis: is it the key to controlling the healing process?

Much research has been undertaken on the complex processes involved in angiogenesis. This may lead to the development of new treatments that help to improve patients' quality of life

Hyperbaric oxygen therapy: what is the case for its use?

Hyperbaric oxygen therapy can be used for a variety of indications, ranging from decompression sickness to thermal burns. This article explains why it may improve healing in diabetic foot ulcers.

Treatment of diabetic foot ulcers with hyperbaric oxygen

The delivery of oxygen to the wound site is crucial in healing diabetic foot ulcers, and impairment of this process in people with diabetes leads to delayed wound repair. Hyperbaric oxygen therapy works by elevating the plasma oxygen level. Fibroblasts synthesise and modify collagen, and both these activities require relatively high partial pressures of oxygen. Hyperbaric oxygen can promote healing by stimulating fibroblast activity and collagen formation. Increasing oxygen tensions also has a direct and toxic effect on anaerobes, therefore hyperbaric oxygen therapy has a special role in treating diabetic foot infections. Studies on hyperbaric oxygen therapy in general show it to be a beneficial adjunctive therapy for diabetic foot ulcers. However much of the work is anecdotal and more controlled trials are required.

Nursing assessment of patients with non-acute wounds

Accurate and thorough assessment of patients with wounds is essential in order to provide correct treatment. In relation to patients with open, non-acute wounds, the areas that need assessing include general health and specific underlying disease process, care being given and local wound environment. This article outlines specific details of the assessment process. It includes a breakdown of factors affecting healing, a discussion of the importance of diagnosis of cause, an outline of factors within care provision that may have a negative effect on healing, and areas relevant to the wound itself that should be assessed.

Innovations in leg ulcer care

This master class article discusses some of the new techniques that are currently being considered in the management of patients with leg ulcers