Protection of the endothelium and endothelial glycocalyx by hydrogen against ischaemia-reperfusion injury in a porcine model of cardiac arrest

Article type: Research Article

Authors: Astapenko, David^{a; b; c; *} | Hyspler, Radomir^{b; d} | Ticha, Alena^d | Tomasova, Adela^{b; d} | Navratil, Pavel^{b; e} | Zrzavecky, Marek^b | Byreddy, Bhavya^b | Sedlacek, Petr^b | Radochova, Vera^f | Skulec, Roman^{a; b; g; h; i} | Hahn, Robert G.^j | Lehmann, Christian^{k; l; m; n} | Malbrain, Manu L.N.G.^{o; p; q} | Cerny, Vladimir^{a; b; c; g; h; k; r; s; t}

Affiliations: [a] Department of Anesthesiology, Resuscitation, and Intensive Care Medicine, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic | [b] Faculty of Medicine in Hradec Kralove, Charles University, Prague Czech Republic | [c] Faculty of Health Studies, Technical University in Liberec, Liberec, Czech Republic | [d] Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic | [e] Department of Urology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic | [f] Faculty of Military Health Sciences, University of Defence, Brno, Czech Republic | [g] Department of Anesthesiology, Perioperative Medicine, and Intensive Care Medicine, University of J. E. Purkyne in Usti nad Labem, Masaryk Hospital in Usti nad Labem, Usti nad Labem, Czech Republic | [h] Institute of Postgradual Education in Healthcare, Prague, Czech Republic | [i] Department of Emergency Medicine, Hospital Bory, Bratislava, Slovak Republic | [j] Karolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden | [k] Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada | [l] Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada | [m] Department of Pharmacology, Dalhousie University, Halifax, NS, Canada | [n] Department of Physiology and Biophysics, Dalhousie University, Halifax, NS, Canada | [o] First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland | [p] Medical Data Management, Medaman, Pas, Geel, Belgium | [q] International Fluid Academy, Lovenjoel, Belgium | [r] Department of Anesthesiology, Perioperative Medicine and Intensive Care, Hospital Bory, Bratislava, Slovak Republic | [s] Department of Anesthesiology and Resuscitation, University Hospital Kralovske Vinohrady, Prague, Czech Republic | [t] Constantine the Philosopher University in Nitra, Faculty of Social Sciences and Health Care, Nitra, Slovak Republic

Correspondence: [*] Corresponding author: David Astapenko, M.D., Ph.D., MBA. Tel.: +420 608 177 374; E-mail: [email protected].

Abstract: BACKGROUND:Hydrogen is a potent antioxidant agent that can easily be administered by inhalation. The aim of the study was to evaluate whether hydrogen protects the endothelial glycocalyx layer after successful cardiopulmonary resuscitation (CPR). METHODS:Fourteen anesthetized pigs underwent CPR after induced ventricular fibrillation. During CPR and return of spontaneous circulation, 2% hydrogen gas was administered to seven pigs (hydrogen group) and seven constituted a control group. Biochemistry and sublingual microcirculation were assessed at baseline, during CPR, at the 15th, 30th, 60th, 120th minute. RESULTS:All seven subjects from the hydrogen group and six subjects in the control group were successfully resuscitated after 6–10 minutes. At baseline, there were no statistically significant differences in examined variables. After the CPR, blood pH, base excess, and lactate showed significantly smaller deterioration in the hydrogen group than in the control group. By contrast, plasma syndecan-1 and the measured variables obtained via sublingual microcirculation did not change after the CPR; and were virtually identical between the two groups. CONCLUSION:In pigs, hydrogen gas inhalation during CPR and post-resuscitation care was associated with less pronounced metabolic acidosis compared to controls. However, we could not find evidence of injury to the endothelium or glycocalyx in any studied groups.

Keywords: Hydrogen, sudden cardiac arrest, post-resuscitation care, microcirculation, endothelial glycocalyx

DOI: 10.3233/CH-231768

Journal: Clinical Hemorheology and Microcirculation, vol. 85, no. 2, pp. 135-146, 2023