FEV1 and HBO

Hi, I have a patient with a wagner 4 DFU in need of HBO to reduce her risk of amputation as she had a failed revascularization attempt, pulmonary disease. CT showing mild bronchiectasis, no blebs, PFT 6 months ago show and FEV1=46% predicted. Previous guidelines we used make this a no go, with >50% cutoff for treatment with slow compression/decompression and bronchodialation prior. I was thinking of repeating her PFT as she is not symptomatic. I wanted to get your experience regarding this. Thanks

Feb 3, 2023 by Bill Khoury,

1 replies

Jeff Mize
RRT, CHT, UHMSADS

Dr. Khoury,
Thanks for your question. Our approach would be based on the risk / benefit of treatment, the patient’s current condition in collaboration with the other specialists (Cardiology, Pulmonology). As well we would not necessarily focus on the PFT results, nor did we utilize “hard parameters” (e.g., Carbon Monoxide Poisoning) as the guideline to provide treatment or disqualify the patient for treatment. A similar example would be a patient with CHF and poor Ejection Fraction. Below are links to similar curbside consult questions and two articles about the Effect of HBO on Pulmonary Functions.
• https://woundreference.com/app/post?id=791
• https://woundreference.com/app/post?id=268

Effect of hyperbaric exposure on pulmonary functions in hyperbaric chamber inside attendants: Levent Demir , Mustafa Avci - Undersea Hyperb Med.2022 Second Quarter;49(2):161-169: PMID: 35580483

Hyperbaric oxygen treatment and pulmonary function: F Pott , P Westergaard, J Mortensen, E C Jansen. Undersea Hyperb Med. 1999 Winter;26(4):225-8: PMID: 10642068

I hope this helps, have a great evening!

Jeff

Feb 3, 2023

* Information provided without clinical evaluation and is not intended as a replacement for in-person consultation with a medical professional. The information provided through Curbside Consult is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

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