Analysis of the cardiovascular effects of hyperbaric oxygen therapy in diabetic patients

Abstract

During hyperbaric oxygen (HBO2) therapy in humans there are changes in cardiovascular physiology due to high pressure and hyperoxygenation. Peripheral vasoconstriction, bradycardia and a decrease in cardiac output are observed during HBO2 therapy. These physiological effects of HBO2 therapy on the cardiovascular system are tolerated in healthy people. However, patients with underlying cardiac disease may experience severe problems during HBO2 therapy, such as pulmonary edema and death. Cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may have negative effects on cardiovascular physiology in patients with DM. The present study aimed to examine the cardiovascular effects of HBO2 therapy in diabetic patients. The findings of NT-ProBNP, troponin I, electrocardiography (ECG) of diabetic patients who applied to the Ministry of Health University Gülhane Training Research Underwater and Hyperbaric Medicine Clinic were compared before and after the first HBO2 therapy session. When ECG findings were analyzed at the end of a session of HBO2 exposure, a statistically significant increase was observed in the QTc, QTc dispersion measurements (p < 0.001, p = 0.015, respectively). In cardiac enzymes there was statistically significant increase in troponin I values after an HBO2 therapy session, but no statistically significant change was observed in Pro-BNP (p = 0.009, p = 0.300, respectively). Short-term exposure to HBO2 therapy had statistically significant changes in troponin I, QT and QTc in patients with DM, which did not reach clinical significance. Despite very little evidence of cardiac dysfunction, we recommend caution HBO2 therapy in patients with DM and the need for further investigation of these measurements.