Verrazzo G

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.