Doppler Evaluation of Lower Limb Arterial Hemodynamics Before and After Hyperbaric Oxygen Therapy

AbstractObjectiveHyperbaric oxygen therapy (HBOT) is widely used as an adjunctive treatment for chronic ulcers, yet its effects on macrovascular arterial hemodynamics remain poorly understood. This study aimed to evaluate the immediate impact of HBOT on lower-limb arterial flow parameters using duplex Doppler ultrasound in patients with ulcers.MethodsThis prospective pre–post cohort study included 28 patients with lower-limb ulcers who underwent HBOT according to a standardized protocol. Doppler ultrasound measurements were performed before and two minutes after treatment. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and flow volume (FV) were assessed in the common femoral and popliteal arteries. Statistical analysis was conducted using paired comparisons with Bonferroni correction.ResultsThe mean age of participants was 65.2 years, and 64.3% were male. No statistically significant changes were observed in any of the evaluated hemodynamic parameters after HBOT. In the common femoral artery, PSV increased from 115 to 117.4 cm/s (p = 0.764), EDV from 12.8 to 15.1 cm/s (p = 0.423), and FV from 1847 to 1923 mL/min (p = 0.291). In the popliteal artery, PSV decreased from 76.4 to 74.8 cm/s (p = 0.635), EDV increased from 8.3 to 8.8 cm/s (p = 0.555), and FV decreased from 718 to 658 mL/min (p = 0.111). All comparisons remained non-significant after Bonferroni correction.ConclusionHyperbaric oxygen therapy (HBOT) does not modify macrovascular hemodynamic parameters of the lower limbs in patients with ulcers. The clinical benefits result from the increased oxygen dissolved in plasma and tissues, maintaining tissue oxygenation even in the absence of detectable changes in arterial blood flow.KeywordsHyperbaric oxygen therapy; Doppler ultrasound; Peripheral arterial disease; Hemodynamics; Diabetic foot ulcer.