[abstract] TISSUE OXYGENATION AND N-ACETYLCYSTEINE IN PATIENTS WITH DIABETIC FOOT ULCERS

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[abstract] TISSUE OXYGENATION AND N-ACETYLCYSTEINE IN PATIENTS WITH DIABETIC FOOT ULCERS

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Title: [abstract] TISSUE OXYGENATION AND N-ACETYLCYSTEINE IN PATIENTS WITH DIABETIC FOOT ULCERS
Author: Efrati, S; Fishlev, G; Berger, Y; Bass, A; Bar-Haim, A; Abu-Hamed, R; Fygenzo, M; Golik, A; Gal, N
Abstract: BACKGROUND: Hyperbaric oxygen (HBO) increases tissue oxygenation and serves as an adjunct therapy for chronic, nonhealing diabetic wounds. However, some of the patients treated by HBO have insufficient increase or even paradoxical decrease in tissue O2 concentration due to vasoconstriction mechanism. The purpose of this study was to evaluate the effect of N-Acetylcysteine (NAC), a thiol-containing antioxidant that can increase NO bioavailability, on tissue oxygenation and oxidative stress in patients with diabetic foot ulcers candidate for HBO therapMATERIALS AND METHODS: Fifty diabetic patients with grade 2 or 3 foot ulcers underwent two standard HBO evaluations within 5 days interval. Patients were randomly assigned to receive at the 1st or at the 2nd interval NAC 1200mg/d in two divided dosages for 5 days before, and 1200 mg in 20 minutes interval during the HBO exposure. Foot ulcer oxygenation was measured at the beginning and at the end of each HBO exposure, and blood samples were taken for oxidative stress status evaluatioRESULTS: After breathing 100percent O2 at 2 ATM without NAC the tissue O2 of 17 patients (30.9percent) was less than 200mmHg (mean 78+/-16mmHg) and NAC treatment increased it to above 200mmHg in 12/17 patients (mean tissue O2 334+/-67mmHg), (pless than0.001). The trend in the antioxidant status during the HBO therapy had also significantly changed with NAC administration from -15+/-7percent to +4+/-3percent (pless than0.01). In the 33 patients in whom the tissue O2 increased above 200 mmHg (mean 440+/-180mmHg) without NAC, NAC had no further significant effect on tissue O2. All patients who had tissue O2greater than200mmHg, with or without NAC, completed at least 4 weeks of treatment and the cure rate was 66.6percent and 72.7percent in the patients that needed NAC and patients that did not need NAC, respectivelCONCLUSIONS: NAC therapy ameliorates the possible vasoconstriction effect of HBO therapy in patients with diabetic foot ulcer. Its effect is mediated, at least in part, through its antioxidant and NO effects.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/3623
Date: 2006

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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