What is Micro-Circulation?

The microcirculation is anatomical and consists of arterioles, capillaries, and venues that perform metabolic requirements and oxygen distribution to the tissues. During physiological or pathological stress, it balances oxygen delivery and 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.

Microcirculation is a functional system that allows the adequate supply of oxygen according to cellular metabolic demands.

Reduced microvascular perfusion is seen in many diseases, and hyperbaric oxygen has potentially beneficial effects on the microcirculatory environment.
It has been shown that hyperbaric oxygen improves microcirculation dependent on systemic hemodynamic parameters, which is a key therapeutic target in critically ill patients.

HBO & Micro-Circulation

HBO is emerging as an adjunct to traditional surgery and antibiotic therapy for special kinds of problematic wounds.
HBO can also 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.

Microcirculation plays a critical role in the physiological process such as oxygen supply to vital organs, nutritional exchange, and modulation of inflammation. The most important function of microcirculation is the regulation of flow within the different organs. Microcirculatory changes include various mechanisms such as retribution of blood flow from the skin and the splanchnic area to the brain or heart, or endothelial activation and injury.

In a study published in Annals of the Rheumatic Diseases, Pavlov-Dolijanovic et al. analyzed the effects of hyperbaric oxygen on the quality of life and state of microcirculation in patients with systemic sclerosis. 18 female patients were included in the work and the cohort underwent intense hyperbaric oxygen sessions. Data from the study indicated that hyperbaric oxygen has high efficacy in terms of alleviating systemic sclerosis.

Serbian et al. published a study discussing the functional changes in microcirculation during a hyperbaric oxygen session. Seven healthy volunteers made up the study group. The demonstrators concluded that hyperbaric oxygen significantly improves tissue oxygenation, despite vasoconstriction.

Another study published in BMC Critical Care evaluated the microcirculatory effects of hyperbaric oxygen in septic patients. Based on the theory that if microcirculation dysfunction is the key to the development of multiple organ failure in sepsis, microcirculation should be a key therapeutic target. The study demonstrated a significant improvement in microcirculation by hyperbaric oxygen.

Numerous studies have shown that despite a decrease in flow caused by vasoconstriction, hyperoxygenation of the arteries causes an increase in PO2 in the tissues. The uptake and transport of oxygen in ischemic areas increase with hyperbaric oxygen because there is an increase in oxygen concentration.

Another mechanism for recovering damaged microcirculation is angiogenesis and vasculogenesis which occur as a long-term response to hypoxia. Microcirculation is repaired by increasing the production of Hypoxia Inducible Factor (HIF) and the consequent gradient of vascular endothelial growth factor and other cytokines involved in vascular repair. Hyperbaric oxygen also induces an increase in HIF with angiogenesis and vasculogenesis that produces repair in the vasculature of different organs where schema may have produced damage to the microcirculation.

In conclusion, data suggests that hyperbaric oxygenation produces physiological effects with a high impact on microcirculation that translate into tissue regeneration and a decrease in inflammation associated with hypoxia and recovery of ischemic organs and tissues.

View the Studies

Hyperbaric Cardiovascular Effects

https://www.ncbi.nlm.nih.gov/books/NBK482231/

Microcirculation and Hyperbaric Oxygen Treatment

https://www.intechopen.com/chapters/60271

THE EFFECTS OF HYPERBARIC OXYGEN THERAPY TO QUALITY OF LIFE AND STATE OF MICROCIRCULATION IN PATIENTS WITH SYSTEMIC SCLEROSIS – A PILOT STUDY

https://ard.bmj.com/content/79/Suppl_1/1596.2

Functional changes in microcirculation during hyperbaric and normobaric oxygen therapy

https://pubmed.ncbi.nlm.nih.gov/20112529/

Evaluation of hyperbaric oxygen therapy effects in hard-to-heal wounds using thermal imaging and planimetry

https://link.springer.com/article/10.1007/s10973-019-09129-0