Hyperbaric Oxygenation Augments Cutaneous Collateral Microcirculation and Autonomic Nervous Regulation in Diabetic Rats

Background:Problem wound healing remains challenging for plastic surgeon who deal with diabetic individuals with foot complications. Diabetic neuropathy and angiopathy are important factors contributing to diabetic foot ulceration. Effective treatments for diabetic motor, sensory, autonomic neural dysfunction and shortage of collateral circulation are lacking.Aim and Objectives:We hypothesized that programmed hyperbaric oxygenation would improve the cutaneous collateral circulation and autonomic nervous system modulation in individuals with diabetic mellitus. The purpose of this study was to validate the effect of hyperbaric oxygen on the dysfunctions of the autonomic nervous system and regional cutaneous microcirculation in diabetic rats.Materials and Methods:Wireless telemetric signals of systemic arterial pressure and pulse-pulse intervals were obtained from rats with streptozotocin-induced diabetes. We analyzed the effects of ten 60-minute hyperbaric oxygenation treatments (100% oxygen, and 3 absolute atmospheres) on daily blood pressure variability and heart rate variability. Cutaneous microcirculation was measured with laser Doppler flowmetry before and after epigastric flap elevation.Results:Hyperbaric oxygenation led to a significant reduction in systemic arterial pressure and low-frequency power of blood pressure variability and resulted in a significant increase in pulse-pulse interval and high frequency power of heart rate variability. Collateral cutaneous blood flow to the epigastric flaps significantly decreased in diabetic rats. The blood flow was significant increased in diabetic rats that underwent hyperbaric oxygenation.Conclusion:Hyperbaric oxygen therapy effectively increases the collateral cutaneous circulation in rats with streptozotocin-induced diabetes. It would be related to increasing of the cardiac vagal modulation and decreasing of the vascular sympathetic activities.