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1.2% Hydrogen gas inhalation protects the endothelial glycocalyx during hemorrhagic shock: a prospective laboratory study in rats

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Abstract

Purpose

Hydrogen gas (H2) inhalation improved the survival rate of hemorrhagic shock. However, its mechanisms are unknown. We hypothesized that H2 protected the endothelial glycocalyx during hemorrhagic shock and prolonged survival time.

Methods

83 Sprague–Dawley rats were anesthetized with isoflurane. The animals were randomly assigned to 5 groups: room air with no shock, 1.2% H2 with no shock, room air with shock (Control-S), 1.2% H2 with shock (H21.2%-S), and 3.0% H2 with shock (H23.0%-S). Shock groups were bled to a mean arterial pressure of 30–35 mmHg and held for 60 min, then resuscitated with normal saline at fourfold the amount of the shed blood volume.

Results

The syndecan-1 level was significantly lower in the H21.2%-S [8.3 ± 6.6 ng/ml; P = 0.01; 95% confidence interval (CI), 3.2–35.8] than in the Control-S (27.9 ± 17.0 ng/ml). The endothelial glycocalyx was significantly thicker in the H21.2%-S (0.15 ± 0.02 µm; P = 0.007; 95% CI, 0.02–0.2) than in the Control-S (0.06 ± 0.02 µm). The survival time was longer in the H21.2%-S (327 ± 67 min, P = 0.0160) than in the Control-S (246 ± 69 min). The hemoglobin level was significantly lower in the H21.2%-S (9.4 ± 0.5 g/dl; P = 0.0034; 95% CI, 0.6–2.9) than in the Control-S (11.1 ± 0.8 g/dl). However, the H23.0%-S was not significant.

Conclusions

Inhalation of 1.2% H2 gas protected the endothelial glycocalyx and prolonged survival time during hemorrhagic shock. Therapeutic efficacy might vary depending on the concentration.

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Acknowledgements

The authors thank I. Ohta, Y. Kumakiri, and Y. Tokunaga (Hamamatsu University School of Medicine) for their technical assistance with the electron microscopy. We thank T. Ojima (Hamamatsu University School of Medicine) for his statistical assistance. We thank Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. This work was supported by JSPS KAKENHI (Grant Numbers JP19K09371 and JP18K08885).

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan

    Tsunehisa Sato, Soichiro Mimuro, Takasumi Katoh, Tadayoshi Kurita, Sang Kien Truong, Kensuke Kobayashi, Hiroshi Makino, Matsuyuki Doi & Yoshiki Nakajima

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  1. Tsunehisa Sato
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  2. Soichiro Mimuro
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  3. Takasumi Katoh
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TS, SM, and KK. The first draft of the manuscript was written by TS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Soichiro Mimuro.

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Sato, T., Mimuro, S., Katoh, T. et al. 1.2% Hydrogen gas inhalation protects the endothelial glycocalyx during hemorrhagic shock: a prospective laboratory study in rats. J Anesth 34, 268–275 (2020). https://doi.org/10.1007/s00540-020-02737-3

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  • DOI: https://doi.org/10.1007/s00540-020-02737-3

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