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

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. In addition, cardiac complications may occur in patients with diabetes mellitus (DM). Therefore, HBO2 therapy may negatively affect 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, and 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 and QTc dispersion measurements (p≺0.001 and p = 0.02, respectively). In cardiac enzymes, there was a 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 = 0.3, 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 in using HBO2 therapy in patients with DM and emphasize the need for further investigation of these measurements.

The outcomes of COVID-19 measures in a hyperbaric oxygen therapy centre during the pandemic.

BACKGROUND: A hyperbaric oxygen (HBO) treatment session carries a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission since patients stay in a closed area for 2 hours. The primary aim of this study was to evaluate the effects of the preventive measures taken in the HBO centre. MATERIALS AND METHODS: This study evaluated the measures taken during the coronavirus disease 2019 (COVID-19) pandemic for multiplace hyperbaric chamber operated in department (Health Sciences University-Gulhane Research and Training Hospital, Ankara, Turkey) between March 16th, 2020 and December 31st, 2020. The medical records of patients who underwent HBO treatment during this period were evaluated retrospectively. Their demographic attributes, the presence of risk factors, HBO indications, HBO session data, and COVID-19 inquiry forms were analysed. RESULTS: A total of 122 patients underwent HBO treatment, and 150 people were subjected to pressure tolerance test (PTT). No COVID-19 case was treated with HBO in our department. The hyperbaric chamber was operated 608 times in total. Of these, 9.7% (n = 59) procedures were carried out under emergency conditions, and 10% (n = 61) were PTTs. Accordingly, 59.8% (n = 73) of the HBO-treated patients were considered at risk for a severe clinical presentation of SARS-CoV-2. SARS-CoV-2 was detected in 5.7% (n = 7) of the HBO-treated patients during the HBO treatment period. Besides, two inside attendants (14.3%) were diagnosed with COVID-19. There were only two concurrent cases in the same session among SARS-CoV-2 positive cases. The records revealed that these patients were sitting three seats away from each other. Another patient was sitting in between the two infected patients but was not diagnosed with SARS-CoV-2. CONCLUSIONS: There is no clear evidence that these two patients infected each other; on the contrary, since no other patient was infected with SARS-CoV-2 in the same session, we may suspect that the infections were coincidental. The measures taken in our department seem to suffice in preventing in-session transmission of COVID-19 and similar infectious diseases in an HBO centre.

Effects of N-acetylcysteine, deferoxamine and selenium on doxorubicin-induced hepatotoxicity.

The aims of our study were to evaluate the antioxidant defence mechanisms of liver tissue challenged by doxorubucin (DOX) and to compare the possible protective effects of N-acetylcysteine (NAC) (n=10), deferoxamine (DOF) (n=10), DOF+NAC (n= 10) and selenium (n=9) on doxorubicin-induced hepatotoxicity. Fifty-six male rats (Mean weight = 250 ± 50 g) randomly divided into five groups. Animals in study groups were pretreated with a single dose of Dox, which was administered intravenously. Control group (n=7) was treated with intravenous saline injection. Selenium was given intraperitoneally. Blood and urine samples were collected before sacrifice. Liver tissue samples were collected and tissue superoxide dismutase (SOD), glutathione peroxidase (GSH-px), CAT activity, MDA, Zn, iron and copper were determined. DFO decreased lipid peroxidation significantly. DFO and NAC decreased CAT activity significantly. Antioxidant regimes increase SOD activities significantly. DOF and NAC increase GSH-px activities and copper levels significantly. Beneficial effect of selenium seems to result from its stimulation of SOD but not to GSH-px. It has been found that DOF, NAC and selenium have protective effects on Dox-induced hepatocellular damage. DOF+NAC did not result additional benefit.