Do Late Phase Hyperbaric and Normobaric Oxygen Therapies have Effect on Liver Damage? An Experimental Sepsis Model

Abstract

Background: Sepsis is fatal presentation which affects many systems with possible progression to organ dysfunction and organ failure. Among these organs liver plays an important role in the prognosis of this syndrome. This study investigated the effects of hyperbaric oxygen (HBO) and normobaric oxygen (NBO) therapies on liver damage and oxidative stress in an experimental sepsis model. Materials and methods: Forty males Wistar rats were randomized into 4 groups as sham group (n=10), control (Sepsis+Cefepime) group (n=10), HBO (Sepsis+Cefepime+HBO) group (n=10), and NBO (Sepsis+Cefepime+NBO) group (n=10). Five days after sepsis induction, animals were sacrificed. The oxidative stress parameters, malondialdehyde (MDA) and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) for antioxidant response were measured in liver tissue. Neutrophil migration using myeloperoxidase (MPO) activity and its contribution to liver damage was evaluated. Results: While MDA levels in HBO group were found to be lower than those in the control group, and comparable to those in the sham group, no difference was detected in the MDA levels between the control and NBO groups. SOD levels in NBO group were detected to be significantly higher than the control group. GSH-Px enzyme activity in HBO and NBO groups was at similar levels. Even though MPO levels in HBO group appeared to be lower than the control group, the difference did not reach statistical significance. When MPO levels and histopathological examination were evaluated, it was observed that neither HBO nor NBO administration in addition to antibiotherapy provided decrease in neutrophil infiltration which has an important role in liver damage. Conclusion: The benefit of HBO in the treatment of sepsis in addition to the use of antibiotics has also been confirmed to be successful in this study. Furthermore the data obtained from NBO applications in this study, is thought to be potentially useful for sepsis treatment.

Oxygen therapy for sepsis and prevention of complications

“…These mechanisms include the "superinduction" of heme oxygenase-1, inhibition of nitric oxide (NO) production and prevention of lung damage caused by lipopolysaccharides, reduction of inflammatory mediators due to HBOT, modulation of nuclear factor-kappa B activity and inhibition of excessive myeloperoxidase production, suppression of bacterial growth in the small intestine, preservation of erythrocyte deformability, and acceleration of free radical acceptor synthesis to mitigate the effects of reactive oxygen species (ROS). Routine use of HBOT in addition to antibiotic therapy may increase survival in sepsis [ 35 ]. In addition, ozone therapy is highly effective in increasing animal survival after intraperitoneal pathogen inoculation [ 36 ].…”