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The predictive value of transcutaneous oxygen tension measurement in diabetic lower extremity ulcers treated with hyperbaric oxygen therapy: a retrospective analysis of 1144 patients

2002; Wiley; Volume: 10; Issue: 4 Linguagem: Inglês

10.1046/j.1524-475x.2002.10402.x

1524-475X

Caroline E. Fife, Cem Buyukcakir, Gordon Otto, Paul J. Sheffield, Robert A. Warriner, Tommy Love, Jon T. Mader,

Wound Healing and Treatments

The objective of this retrospective analysis was to determine the reliability of transcutaneous oxygen tension measurement (TcPO 2 ) in predicting outcomes of diabetics who underwent hyperbaric oxygen therapy for lower extremity wounds. Six hyperbaric facilities provided TcPO 2 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 TcPO 2 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 TcPO 2 values. Breathing oxygen at sea level was unreliable for predicting failure, but 68% reliable for predicting success after hyperbaric oxygen therapy. TcPO 2 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 TcPO 2 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 TcPO 2 < 15 mmHg combined with an in‐chamber TcPO 2 < 400 mmHg predicts failure of hyperbaric oxygen therapy with a reliability of 75.8% and a positive predictive value of 73.3%. (WOUND REP REG 2002;10:198–207)