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Sunday, January 16, 2011

Hydrogen Inhalation Ameliorates Ventilator-Induced Lung Injury

HospiMedica International staff writers
January 13, 2010

A new study has found that inhaled hydrogen gas effectively reduces ventilator-induced lung injury (VILI)-associated inflammatory responses, at both a local and systemic level. 

Researchers at the University of Pittsburgh Medical Center (UPMC; PA, USA), the Taiwanese National Yang-Ming University School of Medicine (Taipei), and other institutions hypothesized that inhaled hydrogen therapy could ameliorate VILI, due to its antioxidant, anti-inflammatory, and antiapoptotic properties. To test the hypothesis, VILI was generated in male mice by performing a tracheostomy and placing the mice on mechanical ventilation (MV).The mice were randomly assigned to treatment groups and subjected to VILI with delivery of either 2% nitrogen or 2% hydrogen in air. Sham animals were given same gas treatments for two hours. The effects of VILI induced by less invasive and longer exposure to MV were also investigated. 

The results showed that ventilation at 30 mL/kg with 2% nitrogen in air for 2 hours resulted in deterioration of lung function, increased lung edema, and infiltration of inflammatory cells. In contrast, ventilation with 2% hydrogen in air significantly ameliorated these acute lung injuries. Hydrogen treatment also significantly inhibited upregulation of mRNA proinflammatory mediators and induced antiapoptotic genes. In the lungs treated with hydrogen, there was less malondialdehyde compared with lungs treated with nitrogen. Similarly, longer exposure to MV within lower tidal volume caused lung injury, including bronchial epithelial apoptosis; hydrogen improved gas exchange and reduced VILI-induced apoptosis. The study was published on December 25, 2010, in Critical Care.

“Although extensive studies on toxicity and safety are needed, hydrogen treatment of ventilated patients may be clinically feasible and would be easy to incorporate without alteration of interventional and surgical procedures,” concluded lead author Chien-Sheng Huang, MD, of the UPMC department of cardiothoracic surgery, and colleagues. 

Hydrogen is a stable molecule and does not react with other therapeutic medical gases at room temperature; thus, it may be administered as a combined gas with other therapeutic gases, or with inhaled anesthesia agents. Inhaled hydrogen gas has been safely utilized for treatment of decompression syndrome in divers, suggesting that hydrogen can be safely administered to patients. 

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