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Ahmad Y. Sheikh, AB; Jeffrey J. Gibson, MD; Mark D. Rollins, MD, PhD; Harriet W. Hopf, MD; Zamirul Hussain, PhD; Thomas K. Hunt, MD

Arch Surg. 2000;135:1293-1297.

Hypothesis  Hyperbaric oxygen (HBO) therapy increases vascular endothelial growth factor (VEGF) levels in wounds.

Design  Wounds were monitored for oxygen delivery during HBO treatment, and wound fluids were analyzed for VEGF and lactate on days 2, 5, and 10 following wounding.

Setting  Experimental animal model.

Interventions  Rats were randomized to HBO therapy and control groups. The HBO therapy was administered for 90 minutes, twice daily with 100% oxygen at 2.1 atmospheres absolute. Treatment was administered for 7 days following wounding.

Main Outcome Measures  Vascular endothelial growth factor, PO₂, and lactate levels in wound fluid were measured on days 2, 5, and 10.

Results  Wound oxygen rises with HBO from nearly 0 mm Hg to as high as 600 mm Hg. The peak level occurs at the end of the 90-minute treatment, and hyperoxia of lessening degree persists for approximately 1 hour. The VEGF levels significantly increase with HBO by approximately 40% 5 days following wounding and decrease to control levels 3 days after exposures are stopped. Wound lactate levels remain unchanged with HBO treatment (range, 2.0-10.5 mmol/L).

Conclusions  Increased VEGF production seems to explain in part the angiogenic action of HBO. This supports other data that hypoxia is not necessarily a requirement for wound VEGF production.

From the Departments of Surgery (Drs Hopf and Hunt), Anesthesia and Perioperative Care (Dr Hopf), and Restorative Dentistry (Dr Hussain), University of California Medical School (Mr Sheikh), San Francisco; the Department of Surgery (Dr Gibson), University of California, Davis; and the Department of Plastic Surgery (Dr Rollins), University of Pittsburgh, Pittsburgh, Pa.

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