Elsevier

Surgery

Volume 158, Issue 2, August 2015, Pages 399-407
Surgery

Trauma/Critical Care
Hydrogen inhalation protects against acute lung injury induced by hemorrhagic shock and resuscitation

Presented at the 10th Annual Academic Surgical Congress in Las Vegas, Nevada, February 3-5, 2015.
https://doi.org/10.1016/j.surg.2015.03.038 Get rights and content

Introduction

Hemorrhagic shock followed by fluid resuscitation (HS/R) triggers an inflammatory response and causes pulmonary inflammation that can lead to acute lung injury (ALI). Hydrogen, a therapeutic gas, has potent cytoprotective, antiinflammatory, and antioxidant effects. This study examined the effects of inhaled hydrogen on ALI caused by HS/R.

Methods

Rats were subjected to hemorrhagic shock by withdrawing blood to lower blood pressure followed by resuscitation with shed blood and saline to restore blood pressure. After HS/R, the rats were maintained in a control gas of similar composition to room air or exposed to 1.3% hydrogen.

Results

HS/R induced ALI, as demonstrated by significantly impaired gas exchange, congestion, edema, cellular infiltration, and hemorrhage in the lungs. Hydrogen inhalation mitigated lung injury after HS/R, as indicated by significantly improved gas exchange and reduced cellular infiltration and hemorrhage. Hydrogen inhalation did not affect hemodynamic status during HS/R. Exposure to 1.3% hydrogen significantly attenuated the upregulation of the messenger RNAs for several proinflammatory mediators induced by HS/R. Lipid peroxidation was reduced significantly in the presence of hydrogen, indicating antioxidant effects.

Conclusion

Hydrogen, administered through inhalation, may exert potent therapeutic effects against ALI induced by HS/R and attenuate the activation of inflammatory cascades.

Section snippets

Animals

Male Sprague-Dawley rats weighing 300–500 g (6–9 weeks old) were purchased from Clea Japan, Inc. (Tokyo, Japan) and were kept in individual stainless steel cages in a temperature, humidity, and light-controlled room (23 ± 3°C; 55 ± 15%; 12-hour light–dark cycle) for 2–5 weeks before the experiments. During this period, all animals were provided standard food (AIN-93G diet; Oriental Kobo Corporation, Tokyo, Japan) and free access to water. All procedures involving rats were conducted in

Hydrogen improved tissue oxygenation and reduced oxidative damage

HS/R impaired pulmonary function and resulted in a remarkable decrease in Po2 levels 3 hours after resuscitation (Fig 2, A). Treatment with hydrogen after HS/R improved blood oxygenation (Fig 2, A). Neither HS/R nor hydrogen inhalation altered Pco2 levels (Fig 2, B), and there was no difference in vital signs, including blood pressure and heart rate, between the groups (data not shown). Blood lactate levels increased notably after HS/R, and this increase was suppressed significantly in the rats

Discussion

In the present study, we demonstrated that inhalation of 1.3% hydrogen significantly reduced lung injury after HS/R. Additionally, hydrogen administration did not affect the hemodynamic status during HS/R. Adjunctive therapy with inhaled hydrogen is promising and might be reasonable for lung disease as hydrogen can be easily delivered through the ventilation circuit and, thus, is straightforward therapeutic option.6, 7, 8, 16

In this study, we demonstrate an application of inhaled hydrogen

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    Supported by JSPS KAKENHI Grant Number #25462840.

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