Microcirculation and Hyperbaric Oxygen Treatment

Abstract

The microcirculation is anatomical and consists of arterioles, capillaries, and venules that perform metabolic requirements and oxygen distribution to the tissues. During physiological or pathological stress, it balances between the oxygen delivery and the demand. This delicate balance can play an important role in the progression of critical illnesses and has a role in the development of organ dysfunction. Reduced microvascular perfusion is seen in many diseases, and hyperbaric oxygen treatment (HBOT) has potentially beneficial effects on the microcirculatory environment. It has been shown that HBOT improves microcirculation independent from systemic hemodynamic parameters, which is a key therapeutic target in the critically ill patient. HBOT is emerging as an adjunct to traditional surgery and antibiotic therapy for the special kinds of problematic wounds or purpura fulminans, which are caused by meningococcal sepsis. HBOT also can increase oxygen supply to the ischemic tissue to reduce the extent of irreversible tissue damage in ischemic stroke, femoral head necrosis, diabetic foot ulcer, and carbon monoxide intoxication. In this chapter, we aim to describe microcirculation with its monitoring systems and to show the effectiveness of HBOT in different clinical settings, which are related to microcirculatory dysfunction.