Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats

Abstract Background Despite the benefits of extracorporeal cardiopulmonary resuscitation (ECPR) in cohorts of selected patients with cardiac arrest (CA), extracorporeal membrane oxygenation (ECMO) includes an artificial oxygenation membrane and circuits that contact the circulating blood and induce...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Tai Yin, Lance B. Becker, Rishabh C. Choudhary, Ryosuke Takegawa, Muhammad Shoaib, Koichiro Shinozaki, Yusuke Endo, Koichiro Homma, Daniel M. Rolston, Shuhei Eguchi, Tadashi Ariyoshi, Asami Matsumoto, Kentaro Oka, Motomichi Takahashi, Tomoaki Aoki, Santiago J. Miyara, Mitsuaki Nishikimi, Junichi Sasaki, Junhwan Kim, Ernesto P. Molmenti, Kei Hayashida
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Heart arrest Extracorporeal cardiopulmonary resuscitation Extracorporeal membrane oxygenation Hydrogen Ischemia reperfusion injury Medicine R
Acceso en línea:	https://doaj.org/article/d5cf875a25424634a17f2b652765232c
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d5cf875a25424634a17f2b652765232c
record_format	dspace
spelling	oai:doaj.org-article:d5cf875a25424634a17f2b652765232c2021-11-21T12:05:05ZHydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats10.1186/s12967-021-03129-11479-5876https://doaj.org/article/d5cf875a25424634a17f2b652765232c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12967-021-03129-1https://doaj.org/toc/1479-5876Abstract Background Despite the benefits of extracorporeal cardiopulmonary resuscitation (ECPR) in cohorts of selected patients with cardiac arrest (CA), extracorporeal membrane oxygenation (ECMO) includes an artificial oxygenation membrane and circuits that contact the circulating blood and induce excessive oxidative stress and inflammatory responses, resulting in coagulopathy and endothelial cell damage. There is currently no pharmacological treatment that has been proven to improve outcomes after CA/ECPR. We aimed to test the hypothesis that administration of hydrogen gas (H2) combined with ECPR could improve outcomes after CA/ECPR in rats. Methods Rats were subjected to 20 min of asphyxial CA and were resuscitated by ECPR. Mechanical ventilation (MV) was initiated at the beginning of ECPR. Animals were randomly assigned to the placebo or H2 gas treatment groups. The supplement gas was administered with O2 through the ECMO membrane and MV. Survival time, electroencephalography (EEG), brain functional status, and brain tissue oxygenation were measured. Changes in the plasma levels of syndecan-1 (a marker of endothelial damage), multiple cytokines, chemokines, and metabolites were also evaluated. Results The survival rate at 4 h was 77.8% (7 out of 9) in the H2 group and 22.2% (2 out of 9) in the placebo group. The Kaplan–Meier analysis showed that H2 significantly improved the 4 h-survival endpoint (log-rank P = 0.025 vs. placebo). All animals treated with H2 regained EEG activity, whereas no recovery was observed in animals treated with placebo. H2 therapy markedly improved intra-resuscitation brain tissue oxygenation and prevented an increase in central venous pressure after ECPR. H2 attenuated an increase in syndecan-1 levels and enhanced an increase in interleukin-10, vascular endothelial growth factor, and leptin levels after ECPR. Metabolomics analysis identified significant changes at 2 h after CA/ECPR between the two groups, particularly in d-glutamine and d-glutamate metabolism. Conclusions H2 therapy improved mortality in highly lethal CA rats rescued by ECPR and helped recover brain electrical activity. The underlying mechanism might be linked to protective effects against endothelial damage. Further studies are warranted to elucidate the mechanisms responsible for the beneficial effects of H2 on ischemia–reperfusion injury in critically ill patients who require ECMO support.Tai YinLance B. BeckerRishabh C. ChoudharyRyosuke TakegawaMuhammad ShoaibKoichiro ShinozakiYusuke EndoKoichiro HommaDaniel M. RolstonShuhei EguchiTadashi AriyoshiAsami MatsumotoKentaro OkaMotomichi TakahashiTomoaki AokiSantiago J. MiyaraMitsuaki NishikimiJunichi SasakiJunhwan KimErnesto P. MolmentiKei HayashidaBMCarticleHeart arrestExtracorporeal cardiopulmonary resuscitationExtracorporeal membrane oxygenationHydrogenIschemia reperfusion injuryMedicineRENJournal of Translational Medicine, Vol 19, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Heart arrest Extracorporeal cardiopulmonary resuscitation Extracorporeal membrane oxygenation Hydrogen Ischemia reperfusion injury Medicine R
spellingShingle	Heart arrest Extracorporeal cardiopulmonary resuscitation Extracorporeal membrane oxygenation Hydrogen Ischemia reperfusion injury Medicine R Tai Yin Lance B. Becker Rishabh C. Choudhary Ryosuke Takegawa Muhammad Shoaib Koichiro Shinozaki Yusuke Endo Koichiro Homma Daniel M. Rolston Shuhei Eguchi Tadashi Ariyoshi Asami Matsumoto Kentaro Oka Motomichi Takahashi Tomoaki Aoki Santiago J. Miyara Mitsuaki Nishikimi Junichi Sasaki Junhwan Kim Ernesto P. Molmenti Kei Hayashida Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
description	Abstract Background Despite the benefits of extracorporeal cardiopulmonary resuscitation (ECPR) in cohorts of selected patients with cardiac arrest (CA), extracorporeal membrane oxygenation (ECMO) includes an artificial oxygenation membrane and circuits that contact the circulating blood and induce excessive oxidative stress and inflammatory responses, resulting in coagulopathy and endothelial cell damage. There is currently no pharmacological treatment that has been proven to improve outcomes after CA/ECPR. We aimed to test the hypothesis that administration of hydrogen gas (H2) combined with ECPR could improve outcomes after CA/ECPR in rats. Methods Rats were subjected to 20 min of asphyxial CA and were resuscitated by ECPR. Mechanical ventilation (MV) was initiated at the beginning of ECPR. Animals were randomly assigned to the placebo or H2 gas treatment groups. The supplement gas was administered with O2 through the ECMO membrane and MV. Survival time, electroencephalography (EEG), brain functional status, and brain tissue oxygenation were measured. Changes in the plasma levels of syndecan-1 (a marker of endothelial damage), multiple cytokines, chemokines, and metabolites were also evaluated. Results The survival rate at 4 h was 77.8% (7 out of 9) in the H2 group and 22.2% (2 out of 9) in the placebo group. The Kaplan–Meier analysis showed that H2 significantly improved the 4 h-survival endpoint (log-rank P = 0.025 vs. placebo). All animals treated with H2 regained EEG activity, whereas no recovery was observed in animals treated with placebo. H2 therapy markedly improved intra-resuscitation brain tissue oxygenation and prevented an increase in central venous pressure after ECPR. H2 attenuated an increase in syndecan-1 levels and enhanced an increase in interleukin-10, vascular endothelial growth factor, and leptin levels after ECPR. Metabolomics analysis identified significant changes at 2 h after CA/ECPR between the two groups, particularly in d-glutamine and d-glutamate metabolism. Conclusions H2 therapy improved mortality in highly lethal CA rats rescued by ECPR and helped recover brain electrical activity. The underlying mechanism might be linked to protective effects against endothelial damage. Further studies are warranted to elucidate the mechanisms responsible for the beneficial effects of H2 on ischemia–reperfusion injury in critically ill patients who require ECMO support.
format	article
author	Tai Yin Lance B. Becker Rishabh C. Choudhary Ryosuke Takegawa Muhammad Shoaib Koichiro Shinozaki Yusuke Endo Koichiro Homma Daniel M. Rolston Shuhei Eguchi Tadashi Ariyoshi Asami Matsumoto Kentaro Oka Motomichi Takahashi Tomoaki Aoki Santiago J. Miyara Mitsuaki Nishikimi Junichi Sasaki Junhwan Kim Ernesto P. Molmenti Kei Hayashida
author_facet	Tai Yin Lance B. Becker Rishabh C. Choudhary Ryosuke Takegawa Muhammad Shoaib Koichiro Shinozaki Yusuke Endo Koichiro Homma Daniel M. Rolston Shuhei Eguchi Tadashi Ariyoshi Asami Matsumoto Kentaro Oka Motomichi Takahashi Tomoaki Aoki Santiago J. Miyara Mitsuaki Nishikimi Junichi Sasaki Junhwan Kim Ernesto P. Molmenti Kei Hayashida
author_sort	Tai Yin
title	Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
title_short	Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
title_full	Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
title_fullStr	Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
title_full_unstemmed	Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
title_sort	hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d5cf875a25424634a17f2b652765232c
work_keys_str_mv	AT taiyin hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT lancebbecker hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT rishabhcchoudhary hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT ryosuketakegawa hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT muhammadshoaib hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT koichiroshinozaki hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT yusukeendo hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT koichirohomma hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT danielmrolston hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT shuheieguchi hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT tadashiariyoshi hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT asamimatsumoto hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT kentarooka hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT motomichitakahashi hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT tomoakiaoki hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT santiagojmiyara hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT mitsuakinishikimi hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT junichisasaki hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT junhwankim hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT ernestopmolmenti hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats AT keihayashida hydrogengaswithextracorporealcardiopulmonaryresuscitationimprovessurvivalafterprolongedcardiacarrestinrats
_version_	1718419273605447680

Hydrogen gas with extracorporeal cardiopulmonary resuscitation improves survival after prolonged cardiac arrest in rats

Ejemplares similares