Effects of hyperbaric oxygen therapy on vascular endothelial growth factor protein and mRNA in crush injury patients: A randomized controlled trial study

Abstract

Introduction: Limb injury is a major health concern that imposes a direct danger to both life and limb viability. At Kandou Hospital Manado, hyperbaric oxygen (HBO) therapy has been performed as an adjunctive treatment for crush injury although no study has yet directly compared outcomes of HBO versus conventional therapy. Documentation of the association between HBO therapy and the healing process of crush injury is necessary to reduce the gaps in the literature and to establish an evidence-based clinical use of HBO therapy. Methods: In this study, we assessed the changes in the vascular endothelial growth factor (VEGF) serum levels and VEGF mRNA expression as biomarkers of wound healing using ELISA and qRT-PC at four different measurement times: at baseline, after receiving initial treatment (debridement and limb-salvage surgeries), 2 h after the first session HBOT, and after a full 10 HBOT sessions. A randomized controlled trial (RCT) was used to enroll patients subjected to crush injury who were admitted to the Surgical Emergency Department (ER) of Kandou Hospital Manado, Indonesia. Results: VEGF serum levels increased significantly in patients suffering from crush injury who received HBO therapy versus the control group. The increased VEGF serum is expected to result in an acceleration time of wound healing and a reduction in amputation rate. Conclusion: There was a significant difference between crush injury patients who received conservative therapy versus those receiving HBO therapies; thus, there was an increased likelihood of an accelerated wound healing and a reduction in the risk of amputation. Highlights

Systemic lidocaine administration influences NF-kβ gene expression, NF-kβ and TNF- α protein levels on BALB/c mice with musculoskeletal injury

“…Protein levels of NF-kβ and TNF-α were detected by MPO Sandwich ELISA with Catalog No. Ls-F12149 and LSF12798 were purchased from Life Span Bio Sciences, Inc. (Seattle, USA) according to the manufacturer's instructions [ [21] , [22] , [23] , [24] ].…”

Predicting hyperbaric oxygen therapy success using the decision tree approach

“…This study is a secondary data analysis of information previously collected in two separate studies, each concerning the effects of HBOT on diabetic foot ulcers [ 21 ] and crush injury fractures [ 12 ]. This research is structured to analyze the HBOT approach from a new perspective, specifically, the development of an algorithm to determine therapy based on the algorithm's predictive ability using a decision tree analysis.…”

“…HBOT improves wound healing by increasing the rate of angiogenesis in injured tissues through increasing levels of vascular endothelial growth factor (VEGF). VEGF induces the re-epithelialization and migration of endothelial cells and the formation of granulated tissue, which are essential stages in the wound healing process [ 11 , 12 ].…”

“…HBOT as an adjuvant or complementary therapy is widely applied today [ 10 , 11 , [17] , [18] , [19] ]. Several studies demonstrate the effectiveness of HBOT in wound healing and inflammation [ 4 , 12 , 20 , 21 ].…”

The Use of Hyperbaric Oxygen Therapy for Ear Reconstruction: A Case Series

“…Hyperbaric Oxygen Therapy (HBOT) is one of them. This method uses 100% pure oxygen, which patients can inhale with pressure above 1 atmosphere absolute (ATA) in a chamber 7,8 . Many studies prove that this oxygen therapy provides the maximum effect for accelerating wound healing 9 .…”