Abstract: Spirometric Changes in Smokers Versus Non-Smokers with Chronic Wounds Undergoing Hyperbaric Oxygen Therapy (WOCN Society 41st Annual Conference (June 6- June 10, 2009))
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3444 Spirometric Changes in Smokers Versus Non-Smokers with Chronic Wounds Undergoing Hyperbaric Oxygen Therapy

Takkin Lo , Loma Linda Univeristy Medical Center, MD, MPH, Loma Linda, CA
Nancy Cortes Delamora, MD , Loma Linda University Medical Center, Research Intern, Loma Linda, CA
Noha Daher, DrPH , Loma Linda Medical Center, Biostatistician, Loma Linda, CA
Patrick Moore , Loma Linda Univeristy Medical Center, RCP, RRT, Loma Linda, CA
Introduction: Patients undergoing hyperbaric oxygen therapy (HBOT) have had inconsistent changes in pulmonary mechanics as reported in the literature. Additionally, there are no studies thus far comparing former smokers versus lifetime non-smokers undergoing HBOT to determine whether it contributes to decrements in lung function. The objective of this study is to examine physiological changes in lung function  of smokers versus non-smokers with chronic wounds undergoing HBOT.

Method: Standard pulmonary spirometric parameters were collected on patients before and after their HBOT courses, which ranged from 20-60 treatments per patient. Former smokers were considered if they had a minimum of 10 pack-year smoking history.  Patients were treated for the following wound conditions: Diabetic foot ulcer, refractory osteomyelitis and compromised graft/flap. Standard wound care practices were provided by a wound/HBOT specialist throughout the study period. 

Results: Thirty-four patients, 24 males and 10 females, with an average age of 60, were enrolled.  Sixteen were former smokers and 18 were lifetime non-smokers. Results were analyzed with the Mann-Whitney Test for statistical analysis. P-values were not significant in both groups.
SPIROMETRIC CHANGES IN SMOKERS VERSUS NON-SMOKERS
Respiratory Parameters
Smoker Pre-treatment
Smoker Post-Treatment
P-value
Non-smoker Pre-treatment
Non-smoker Post-treatment
P-value
Maximum Vital Capacity
3.49
3.31
NS
3.08
3.32
NS
Tidal Volume
0.92
0.92
NS
0.92
0.60
NS
Forced Vital Capacity (FVC)
3.53
3.46
NS
3.33
3.58
NS
Forced Expiratory Volume at one second (FEV1)
2.81
2.52
NS
2.51
2.49
NS
FEV1/FVC
0.79
0.72
NS
0.74
0.69
NS
Peak Expiratory Flow
464.14
408.28
NS
377.33
354.33
NS
Forced Expiratory Flow 25%-75%
2.81
2.01
NS
2.07
1.62
NS

Conclusion:  There is no statistical significant change in any of the lung mechanics of former smokers and lifetime non-smokers patients undergoing long-term HBOT for treatment of chronic wounds.  

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