Hyperbaric oxygen breathing improved reflex vasoconstriction on dependency in diabetic patients with neuropathy.

Clinical Bottom Line:
1. Blood flow on dependency was decreased significantly more while hyperbaric oxygen breathing.
2. No clinical outcomes were measured.

Appraised by: Mike Bennett
Dept of Diving and Hyperbaric Medicine
Prince of Wales Hospital
Sydney ; Thursday, 21 September 2000

Clinical Scenario: A patient with diabetic neuropathy.
Three-part Question: In patients with diabetic neuropathy, does the administration of hyperbaric oxygen, compared to normal air breathing, improve sympathetic reflex vasoconstriction on making the legs dependent?

Search Terms: diabetic neuropathies, diabetic angiopathies, diabetic foot

The Study:
Non-blinded randomised controlled trial, intention-to-treat unknown.
Patients with diabetic neuropathy.
Control group (N = 4; 4 analysed): 15 sessions of air breathing at 2.4ATA for 90 minutes daily.
Experimental group (N = 4; 4 analysed): As above, but breathing 100% oxygen at 2.4ATA.

The Evidence:

Outcome Time to outcome Control group HBO group P-value

Mean blood flow
reduction on
dependency (2.4ATA) 3 wks 27.5% 44.8% 0.027


Comments:
1. Abstract only, few details.
2. Unusual comparison group
3. It is not clear if the increased vasoconstriction occurred only after 15 treatments, or was present during all hyperbaric oxygen exposures.
4. Clinical significance is unknown

Expiry date:April 2003

References:
1. Abidia A, Laden G, McCollum P. Hyperbaric oxygen therapy improves reflex vasoconstriction induced by leg dependency in patients with diabetic neuropathy. Undersea and Hyperbaric Medicine 2000;27(suppl):44.



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