The predictive value of transcutaneous oxygen tension measurement in diabetic lower extremity ulcers treated with hyperbaric oxygen therapy: a retrospective analysis of 1,144 patients
| Autor: | Jon T. Mader, Gordon H. Otto, Paul J. Sheffield, Robert A. Warriner, Caroline E. Fife, Cem Buyukcakir, Tommy L. Love |
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| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Time Factors chemistry.chemical_element Dermatology Oxygen Severity of Illness Index Hyperbaric oxygen Predictive Value of Tests Severity of illness Outcome Assessment Health Care Medicine Humans Retrospective Studies Hyperbaric Oxygenation Wound Healing integumentary system business.industry Reproducibility of Results Retrospective cohort study Breathing gas Predictive value Diabetic Foot Surgery chemistry Predictive value of tests Anesthesia Breathing Female business Blood Gas Monitoring Transcutaneous Follow-Up Studies |
| Zdroj: | Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society. 10(4) |
| ISSN: | 1067-1927 |
| Popis: | The objective of this retrospective analysis was to determine the reliability of transcutaneous oxygen tension measurement (TcPO2) in predicting outcomes of diabetics who underwent hyperbaric oxygen therapy for lower extremity wounds. Six hyperbaric facilities provided TcPO2 data under several possible conditions: breathing air, breathing oxygen at sea level, and breathing oxygen in the chamber. Overall, 75.6% of the patients improved after hyperbaric oxygen therapy. Baseline sea-level air TcPO2 identified the degree of tissue hypoxia but had little statistical relationship with outcome prediction because some patients healed after hyperbaric oxygen therapy despite very low prehyperbaric TcPO2 values. Breathing oxygen at sea level was unreliable for predicting failure, but 68% reliable for predicting success after hyperbaric oxygen therapy. TcPO2 measured in chamber provides the best single discriminator between success and failure of hyperbaric oxygen therapy using a cutoff score of 200 mmHg. The reliability of in-chamber TcPO2 as an isolated measure was 74% with a positive predictive value of 58%. Better results can be obtained by combining information about sea-level air and in-chamber oxygen. A sea-level air TcPO2 < 15 mmHg combined with an in-chamber TcPO2 < 400 mmHg predicts failure of hyperbaric oxygen therapy with a reliability of 75.8% and a positive predictive value of 73.3%. |
| Databáze: | OpenAIRE |
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