Physiological basis for treatment of diabetic foot syndrome complicated by distal arterial ischemia of the lower extremities using inhalation of a heated oxygen-helium mixture (literature review)

Relevance. Currently, the issues of treatment of type 1 and type 2 diabetes mellitus are along with serious pathologies of the cardiovascular system, bronchopulmonary diseases and are a major medical and social problem. According to the Endocrinological Research Center, as of January 1, 2023, type 2 diabetes mellitus occupies a leading place in terms of morbidity in Russia. It accounts for 92.33% of the total number of patients with diabetes in the Russian Federation registered at the dispensary (4.58 million people). The total number of patients with diabetes in the Russian Federation registered at the dispensary as of 01.01.2023, according to the Federal Register of Diabetes Mellitus, amounted to 4,962,762 (3.31% of the population of the Russian Federation) and their number is steadily increasing in rapid progression. Diabetic foot is a serious problem that requires an interdisciplinary approach in treatment and prevention. In the XXI century, it is important to understand that the treatment of diabetic foot requires not only blood glucose control, but also the use of modern diagnostic and therapeutic methods, including surgery. The purpose of the study. The purpose of this scientific study is to improve the clinical results of treatment of patients with diabetic foot syndrome by developing a new method of complex (combined) surgical treatment based on the results of the physiological response of the human body to inhalation of a heated helium-oxygen mixture. To investigate the physiological properties of a heated oxygen-helium mixture in terms of its effect on central and peripheral hemodynamics in various phases of the wound process. To compare the effectiveness of therapy in patients using national clinical guidelines and therapy using an oxygen-helium mixture. To develop an optimal treatment plan for patients with diabetic foot syndrome complicated by diabetic angiopathy, both at the hospital stage and in the outpatient clinic. Materials and methods. The authors have made a detailed analysis of Russian and foreign literature. The literature review is devoted to the physiological and pathophysiological aspects of the effect of a heated oxygen-helium mixture on the treatment of complications of diabetes mellitus, especially ulcerative lesions of the lower extremities. Conclusion. From the data obtained from the study, it can be concluded that the identification of a clinically important property of a heated oxygen–helium mixture will help improve the effectiveness of combined treatment and the quality of life of patients. To open up new opportunities for the use of heated oxygen-helium mixtures in clinical practice, as a result, to reduce the inpatient bedday and outpatient duration of therapy, to reduce the disability of patients from crippling surgical interventions.