University of Freibrurg, Bad Krozingen, Germany
  

Guidelines for evidence-based carbondioxide balneotherapy of the association Europ�enne de carbocrenotherapye

(Association of European Carbon Dioxide Therapy AEC)

Hartmann B.

University of Freibrurg, Bad Krozingen, Germany

Basics

Transcutaneous application of carbon dioxide has the following undisputed physiological and therapeutic effects:

1. Rightward shift of oxihaemoglobin dissociation curve,
2. Reduction of bllod viscosity,
3. Dilation of precapillaries,
4. Restoral of patency of closed or stenosed capillaires,
5. Stimulation of heat and
6. Inhibition of cold receptors of the skin,
7. Antisepsis.

These effect from the basic for the therapeutic use of carbon deioxide.

The following key therapeutic parameters have been identified: CO2-Concentration, starting from 400mg/l water temperature of application in water or gas in humidity of 90% and 28C, Area of application, Application time (more than 30 min!) and frequency and number of serial application as intensive cure.

The Following indications are identified as evidence based therapy by prospective controlled clinical studies under blinded conditions:

1. Arterial occlusive disease in all clinical stages I-IV.
2. Microcirculatory disorders of aetiology,
3. Cerebral insufficiency,
4. Arterial hypertension,
5. Algodystrophy
6. Pain therapy,
7. Venous incompatency of all stages incl. Venous ulcers,
8. Non-healing skin wounds especially in diabetes mellitus.

In these cases CO2 in an alternative to other treatment regimens, including pharmacological or physical therapy, surgery or other invasive treatments. In the classical European Spa&Health Resort Medicine, carbon dioxide applications is the basis of treatment combined with other evident treatments like head-out immersion, water exercise, and other physical treatments especially low frequent ultrasound. In these combinations as well as in a combinations of multiple disorders, there is a lack of studies of the evidence or effectiveness of this therapy.

The AEC coordinates and develops multi-centric and multinational studies for carefully selected indications and for patients suffering from multiple disorders especially in gerontology.