Verrazzo

Oxygen-ozone, but not hyperbaric oxygen, altered some rheological parameters in patients with peripheral occlusive vascular disease.

Clinical Bottom Line: 1. The administration of hyperbaric oxygen did not alter rheological parameters from baseline.

Appraised by: Mike Bennett, Dept. of Diving and Hyperbaric Medicine, Prince of Wales Hospital Sydney; Tuesday, 22 December, 1998

Clinical Scenario: A patient with peripheral occlusive arterial disease. Three-part Question: For patients with peripheral occlusive arterial disease, does the administration of hyperbaric oxygen compared to an oxygen/ozone protocol, result in any significant alteration in rheological parameters? Search Terms: hyperbaric oxygenation, peripheral arterial disease, ozone.

The Study: Non-blinded randomised controlled trial with intention-to-treat. Patients with peripheral occlusive arterial disease, Fontaine grade II to IV, presenting to an outpatient hyperbaric medicine facility for assessment. Control group (N =15;15 analysed): Five treatments over ten days involving ozonized autotransfusion of 100mls of blood reaching 6,000micrograms of ozone aerogation each treatment. Experimental group (N =15;15 analysed): Five treatments over 10 days of 100% oxygen at 2ATA for 60 minutes.

The Evidence: Non-Event Outcomes Time to outcome Ozone group HBO group P-value

Erythrocyte Filterability 11 days 1.02 0.58 <0.005 (mls/min)

Blood viscocity (Shear rate/sec) 11 days 4.15 4.92 <0.05

Comments: 1. Clinical significance of these findings is unknown. 2. Raised plasma levels of a product of lipid peroxidation (malonyldialdehyde) in the ozone group suggest a possible mechanism. 3. Neither group produced an alteration in haematocrit, fibrinogen levels or thrombin time.

Expiry date:April 2003 References: 1. Verrazo G, Coppola L, Luongo C, Sammartino A, Giunta R, Grassia A, Ragone R, Tirelli A. Hyperbaric oxygen, oxygen-ozone therapy, and rheological parameters of blood in patients with peripheral occlusive arterial disease. Undersea and Hyperbaric Medicine 1995; 22:17-22.

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