Schiavo Simone, Djaiani Carine, DeBacker Julian, Albertini Lisa, Santa Mina Daniel, Buryk-Iggers Stephanie, De Moraes Marcus Vinicius, Kanj Mohammad, Katznelson Rita
Hyperbaric Medicine Unit, Department of Anesthesiology and Pain Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada.
Division of Cardiology, Department of Medicine, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada.
Int J Environ Res Public Health. 2020 Oct 19;17(20):7586. doi: 10.3390/ijerph17207586.
Hyperbaric oxygen therapy (HBOT) is widely used to treat several pathologies. The hemodynamic changes during HBOT, particularly the magnitude of arterial blood pressure (ABP) increase, are not completely understood. No clinical predictors for HBOT-induced ABP increase have been described. The purpose of this study was to quantify ABP changes in patients undergoing HBOT and to examine their predictors. This retrospective longitudinal cohort study examined 3291 elective HBOT sessions. Non-invasive ABP was recorded before and after each session. The primary outcome was to quantify the HBOT-induced ABP rise. The secondary outcome was to determine the ABP-rise predictors among demographic and clinical variables. Overall, ABP increased significantly after HBOT; this finding was more evident in the hypertensive subgroup compared to the normotensive one (+6 vs. +16.2 mmHg). Clinical predictors of significant post-HBOT ABP change were history of hypertension and pre-session baseline ABP classification. This study demonstrates an absolute HBOT-induced ABP rise. This change is clinically relevant in patients with history of hypertension. A higher baseline ABP seems a risk factor for clinically relevant ABP change. Pre-session ABP should be used clinically as an indicator for strict ABP monitoring during HBOT; future studies are recommended to explore the ABP optimization before starting an HBO treatment.
高压氧疗法（HBOT）被广泛用于治疗多种病症。HBOT期间的血流动力学变化，尤其是动脉血压（ABP）升高的幅度，尚未完全明确。目前尚未有关于HBOT诱导ABP升高的临床预测因素的描述。本研究的目的是量化接受HBOT治疗患者的ABP变化并探究其预测因素。这项回顾性纵向队列研究检查了3291次择期HBOT治疗。每次治疗前后均记录无创ABP。主要结局是量化HBOT诱导的ABP升高。次要结局是在人口统计学和临床变量中确定ABP升高的预测因素。总体而言，HBOT后ABP显著升高；与血压正常亚组相比，这一发现在高血压亚组中更为明显（分别为+6 mmHg和+16.2 mmHg）。HBOT后ABP显著变化的临床预测因素是高血压病史和治疗前基线ABP分类。本研究证明了HBOT诱导的ABP绝对升高。这种变化在有高血压病史的患者中具有临床相关性。较高的基线ABP似乎是ABP发生临床相关变化的危险因素。治疗前ABP应在临床上用作HBOT期间严格ABP监测的指标；建议未来的研究在开始HBOT治疗前探索ABP的优化方法。
