Perioperatively Inhaled Hydrogen Gas Diminishes Neurologic Injury Following Experimental Circulatory Arrest in Swine

Alexis R. Cole, BS; Dorothy A. Perry, MBCHB; Ali Raza, MD; Arthur P. Nedder, DVM; Elizabeth Pollack, DVM CANDIDATE; William L. Regan, CCP, LP; Sarah J. van den Bosch, MS; Brian D. Polizzotti, PHD; Edward Yang, MD; Daniel Davila, MD; Onur Afacan, MD; Simon K. Warfield, PHD; Yangming Ou, PHD; Brenda Sefton, PA; Allen D. Everett, MD; Jeffrey J. Neil, MD, PHD; Hart G.W. Lidov, MD, PHD; John E. Mayer, MD; John N. Kheir, MD

doi:10.1016/j.jacbts.2018.11.006

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Perioperatively Inhaled Hydrogen Gas Diminishes Neurologic Injury Following Experimental Circulatory Arrest in Swine

Alexis R. Cole, BS, Dorothy A. Perry, MBCHB, Ali Raza, MD, Arthur P. Nedder, DVM, Elizabeth Pollack, DVM CANDIDATE, William L. Regan, CCP, LP, Sarah J. van den Bosch, MS, Brian D. Polizzotti, PHD, Edward Yang, MD, Daniel Davila, MD, Onur Afacan, MD, Simon K. Warfield, PHD, Yangming Ou, PHD, Brenda Sefton, PA, Allen D. Everett, MD, Jeffrey J. Neil, MD, PHD, Hart G.W. Lidov, MD, PHD, John E. Mayer, MD, John N. Kheir, MD

JACC: Basic to Translational Science · 2019 · 4(2) · 176–187

MHID-8554516PMID: 31061920 DOI: 10.1016/j.jacbts.2018.11.006

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Abstract

This study used a swine model of mildly hypothermic prolonged circulatory arrest and found that the addition of 2.4% inhaled hydrogen gas to inspiratory gases during and after the ischemic insult signiﬁcantly decreased neurologic and renal injury compared with controls. With proper precautions, inhalational hydrogen may be administered safely through conventional ventilators and may represent a complementary therapy that can be easily incorporated into current workﬂows. In the future, inhaled hydrogen may diminish the sequelae of ischemia that occurs in congenital heart surgery, cardiac arrest, extracorporeal life-support events, acute myocardial infarction, stroke, and organ transplantation. (J Am Coll Cardiol Basic Trans Science 2019;4:176–87) © 2019 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Study details

Article type: Original Research
Disease / injury model: Experimental circulatory arrest (ischemia-reperfusion injury) in neonatal swine (modeling perioperative brain and kidney injury as seen in congenital heart surgery)
Duration: 3 days
Dose-dependent effect: No
Outcome: Positive
Findings: Perioperative inhalation of 2.4% hydrogen gas in neonatal swine undergoing experimental circulatory arrest significantly reduced neurologic and renal injury compared to controls, as measured by clinical, serological, radiological, and histopathological assessments. Hydrogen administration was safe and well-tolerated.

Classification

Research Topics: Cardiovascular Diseases Hydrogen Therapy Neurological Disorders Oxidative Stress Renal Diseases
Study Type: Animal Study
Species: Pig
Organs & Tissues: Blood Brain
Physiological Systems: Nervous
Biomarkers: Glial fibrillary acidic protein (GFAP)Histologic Brain Injury Score Neurologically intact survival by snds score <120 Serum creatinine Volume of white matter injury on T2 imaging
Methods of Administration: Inhalation
Countries: United States
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