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Peritoneal lavage with hydrogen-rich saline can be an effective and practical procedure for acute peritonitis

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Abstract

Purpose

Acute peritonitis has remained a fatal disease despite of recent advances in care and treatment, including antibiotic and anticoagulant treatments. The cause of death is mostly sepsis-induced multiple organ failure. Oxidative stress can play an important role in this situation, but antioxidant therapy to capture any excessive reactive oxygen species has not yet been fully established.

Methods

Two experiments were performed. In the first experiment, we confirmed the effects of peritoneal lavage with hydrogen-rich saline (HRS) after a cecal ligation and puncture (CLP) operation in rats. In the second experiment, the changes in the hemodynamic state following this procedure were observed in a porcine model of abdominal sepsis to evaluate its safety and utility.

Results

Peritoneal lavage with HRS significantly improved the survival after CLP in rats, and it ameliorated the levels of sepsis-induced organ failure. Moreover, it showed anti-inflammatory and anti-apoptosis as well as antioxidant effects. The second experiment demonstrated the potential safety and feasibility of this procedure in a large animal model.

Conclusion

This procedure can improve survival after sepsis through mitigating the sepsis-induced organ failure by inhibiting oxidative stress, apoptosis, and inflammatory pathways. Peritoneal lavage with HRS may therefore be an effective, safe, and practical therapy for patients with acute peritonitis.

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Acknowledgements

This work was carried out at the Research Facilities for Laboratory Animal Science, Natural Science Center for Basic Research and Development (N-BARD), Hiroshima University.

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Authors and Affiliations

  1. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Haruki Sada, Hiroyuki Egi, Kentaro Ide, Hiroyuki Sawada, Yusuke Sumi & Hideki Ohdan

  2. Department of Surgery, Kure Medical Center and Chugoku Cancer Center, National Hospital Organization, Hiroshima, Japan

    Haruki Sada

  3. Department of Gastrointestinal Surgery and Surgical Oncology, Ehime University Graduate School of Medicine, 454 Shizukawa, Toon, Ehime, 791-0295, Japan

    Hiroyuki Egi

  4. Center for Medical Education, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Minoru Hattori

  5. Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Kazuhiro Sentani, Naohide Oue & Wataru Yasui

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  1. Haruki Sada
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  2. Hiroyuki Egi
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Correspondence to Hiroyuki Egi.

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Conflict of interest

Haruki Sada, Hiroyuki Egi, Kentaro Ide, Hiroyuki Sawada, Yusuke Sumi, Minoru Hattori, Kazuhiro Sentani, Naohide Oue, Wataru Yasui and Hideki Ohdan declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving animals were in accordance with the ethical standards of institution or practice at which the studies were conducted. All experiments using rats were performed under protocols approved by the Institutional Animal Care and Use Committee of Hiroshima University (number: A14-133-4) and those for pigs were approved by the Animal Care and Use Committee of Intervention Technical Center (IVTeC), Japan (number: IVT 16-10).

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Sada, H., Egi, H., Ide, K. et al. Peritoneal lavage with hydrogen-rich saline can be an effective and practical procedure for acute peritonitis. Surg Today 51, 1860–1871 (2021). https://doi.org/10.1007/s00595-021-02271-z

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  • DOI: https://doi.org/10.1007/s00595-021-02271-z

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