Application of Molecular Hydrogen in Heart Surgery under Cardiopulmonary Bypass

Abstract

The aim of this work was to study the effect of molecular hydrogen on oxidative processes in cardiac surgery patients with acquired valve heart disease applied during surgery under cardiopulmonary bypass (CPB). Materials and Methods. The study involved 20 patients (16 men and 4 women) with acquired heart valve disease who were operated on under CPB. Two groups of patients were formed. In group 1 (n=11), anesthesia included inhalations of molecular hydrogen, which was supplied to the breathing circuit of the ventilator at a concentration of 1.5-2.0% immediately after tracheal intubation and throughout the operation. In group 2 (n=9), inhalation of molecular hydrogen was not performed. Blood sampling was taken at 4 stages: immediately after anesthesia induction, before CPB and after its termination, and also one day after the operation. The intensity of the processes of lipid peroxidation was evaluated by the level of diene (DC) and triene (TC) conjugates, Schiff bases (SB). Results. In the patients of group 1, the arterial blood samples showed a decrease in the level of TC and SB, as compared to the first stage of the study, before the initiation of CPB and one day after the operation. An increase in the level of DC and TC was detected after the termination of CPB (p<0.05). In the venous blood samples, an increase in the level of DC was noted before the initiation of CPB, which was restored by the third stage of the study (p<0.05). At the same time, after the termination of CPB, a tendency towards a decrease in TC and SB was observed, which persisted one day after the operation. In the patients of group 2, an increase in the concentration of SB in the arterial blood samples was recorded during the study as compared to the first stage. The level of TC and SB in the venous blood samples increased one day after the operation. Conclusion. Intraoperative inhalation of molecular hydrogen leads to a decrease in the oxidative stress manifestation, it being most pronounced one day after the operation. This suggests that molecular hydrogen can be used in cardiac surgery as an effective and safe antioxidant.

The first experience of the combined use of nitric oxide and molecular hydrogen for cardiac surgery in high-risk patients

“…По данным клинического исследования, посвя щенного изолированному применению молекуляр ного водорода в ходе операции в условиях ИК [17], выявлено снижение концентрации продуктов пере кисного окисления липидов в постоперационном периоде, что связывается с проявлением прямого антиоксидантного действия молекулярного водоро да и возможным опосредованным влиянием его через модуляцию концентрации активных форм кислорода, являющихся естественными сигнальными мессенд жерами и имеющих важное значение для регуляции деятельности клеток.…”

“…Тем не ме нее известно, что молекулярный водород связывает свободные радикалы гидроксила и пероксинитрита. Повреждающее воздействие этих радикалов на кри тически важные биомолекулы нуклеиновых кислот, липопротеидов мембран клеток и клеточных органелл приводит к ПМ при операциях в условиях ИК [13].…”

Combined Administration of Nitric Oxide and Hydrogen into Extracorporeal Circuit of Cardiopulmonary Bypass as a Method of Organ Protection during Cardiac Surgery

“…However, the emphasis was made there on the cardioprotective effect of the preparation during cardiac-surgical intervention, but the influence of nitric oxide on the LPO processes and erythrocyte condition has not been investigated, although a systemic damaging effect of the LPO products on a cell is well Previous clinical studies devoted to the isolated application of molecular hydrogen in cardiac surgery are limited to its inhalation application at the stages before or after CPB. The analysis of the results of venous and arterial blood tests has shown that the decrease in LPO product concentration in the postoperative period in the group of patients receiving hydrogen inhalations was associated with a direct antioxidative action of the molecular hydrogen and its possible indirect impact by modulating the concentration of reactive oxygen species being natural signaling messengers important for the regulation of cell activity [10]. Besides, the application of molecular hydrogen has been shown to maintain the ATP concentration and to increase statistically significantly the 2,3-DPG content in arterial blood erythrocytes relative to the control group [16].…”

“…Besides, molecular hydrogen is known to bind free radicals of hydroxyl and peroxynitrite. The action of these radicals on the critically important biomolecules of nucleic acids, lipoproteins of the cell membranes, and cellular organelles leads to the damage of myocardium during operations with CPB [10]. Presently, there are no clinical investigations devoted to the combined application of nitric oxide and hydrogen during the operations with CPB, which determines the significance of the research.…”

Molecular hydrogen exposure improves functional state of red blood cells in the early postoperative period: a randomized clinical study

“… 10 11 12 We have previously shown the anti-oxidant effect of H 2 in cardiac surgery patients. 13 Moreover, it has been reported that H 2 also has anti-inflammatory properties, protective effects against cell death, and anti-allergic effects and stimulates energy metabolism in model animal experiments. 14 Studies of H 2 application in animal model experiments have shown that inhalation of H 2 gas significantly reduces reperfusion brain injury caused by ischemia, 15 or myocardial infarction.…”