Hyperbaric oxygen therapy in patients suffering from wounds in calciphylaxis: a narrative review.


Journal

Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc
ISSN: 1066-2936
Titre abrégé: Undersea Hyperb Med
Pays: United States
ID NLM: 9312954

Informations de publication

Date de publication:
Historique:
entrez: 17 3 2020
pubmed: 17 3 2020
medline: 2 1 2021
Statut: ppublish

Résumé

Calcific uremic arteriolopathy (calciphylaxis) is a rare and highly lethal vascular disease. Vascular calcification with calcium depositions lead to ischemic ulcers associated with gangrene, severe pain and poor healing. Although hyperbaric oxygen (HBO2) therapy has been used in the treatment of calciphylaxis, evidence of its effectiveness is limited. To determine whether HBO2 therapy has a beneficial effect in the healing of calciphylaxis ulcers. A search was made in PubMed using a comprehensive strategy to identify the effect of HBO2 on calciphylaxis wounds. Included in the analysis were studies published up to October 2018 involving a minimum of four patients receiving HBO2 therapy. Ten retrospective (case) series were included. This review included a total of 131 patients with calciphylaxis who were treated with HBO2 therapy; of these, 58 patients (45%) had full response on HBO2 with complete wound closure. Regarding partial response, 17 of the patients (13%) experienced substantial wound improvement on different wound scale scores. Patients with calcific uremic arteriolopathy can benefit from HBO2. More research is needed using standardized wound scores. Outcomes related to quality of life and pain relief should also be assessed.

Sections du résumé

Background
Calcific uremic arteriolopathy (calciphylaxis) is a rare and highly lethal vascular disease. Vascular calcification with calcium depositions lead to ischemic ulcers associated with gangrene, severe pain and poor healing. Although hyperbaric oxygen (HBO2) therapy has been used in the treatment of calciphylaxis, evidence of its effectiveness is limited.
Objective
To determine whether HBO2 therapy has a beneficial effect in the healing of calciphylaxis ulcers.
Methods
A search was made in PubMed using a comprehensive strategy to identify the effect of HBO2 on calciphylaxis wounds. Included in the analysis were studies published up to October 2018 involving a minimum of four patients receiving HBO2 therapy.
Results
Ten retrospective (case) series were included. This review included a total of 131 patients with calciphylaxis who were treated with HBO2 therapy; of these, 58 patients (45%) had full response on HBO2 with complete wound closure. Regarding partial response, 17 of the patients (13%) experienced substantial wound improvement on different wound scale scores.
Conclusion
Patients with calcific uremic arteriolopathy can benefit from HBO2. More research is needed using standardized wound scores. Outcomes related to quality of life and pain relief should also be assessed.

Identifiants

pubmed: 32176952
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

111-123

Informations de copyright

Copyright© Undersea and Hyperbaric Medical Society.

Déclaration de conflit d'intérêts

The authors of this paper declare no conflicts of interest exist with this submission.

Auteurs

Diana A Charaghvandi (DA)

Amsterdam University Medical Center, Amsterdam, The Netherlands.

David N Teguh (DN)

Department of Surgery/Hyperbaric Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.

Rob A van Hulst (RA)

Professor of Anesthesiology/Hyperbaric Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.

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