Hydrogen inhalation therapy alone may not alleviate intestinal mucosal damage in NOMI without total-layer necrosis: An experimental swine model study.

AIM: Hydrogen inhalation therapy, a novel therapy for reducing oxidative stress in post-cardiac arrest syndrome, was beneficial for superior mesenteric artery (SMA) occlusion. We assessed the efficacy and feasibility of hydrogen inhalation therapy in swine models of critically ill conditions leading to non-occlusive mesenteric ischemia (NOMI) without acute surgical intervention.

METHODS

NOMI was induced in eight 3- to 4-month-old female swine under general anesthesia. We defined the initiation of epinephrine administration via the SMA as T = 0 and the initiation of phlebotomy as T = -30 relative to this point. Hemorrhagic shock was induced by combining phlebotomy (T = -30 to -10), continuous systemic norepinephrine administration (T = -30 to 240), and continuous epinephrine injection through the SMA (T = 0-240). The extent of mesenteric ischemia was assessed through gross observation of the intestinal serosa, biomarkers, intestinal pathology, and computed tomography angiography.

RESULTS

Control (n = 4) and hydrogen (n = 4) groups with similar baseline characteristics were included. All animals survived until euthanasia (T = 240). The serosa became dark during local epinephrine administration. At T = 240, lactate levels in the control and hydrogen groups were 7.4 (4.7-11.3) and 5.6 (5.0-6.4) mmol/L, respectively, while median 8-hydroxy-2'-deoxyguanosinelevels were 0.15 (0.14-0.18) and 0.15 (0.13-0.16) ng/mL. The pH, base excess, and potassium levels were similar. No significant differences existed in the ischemic grade of the intestinal tract at any time or site.

CONCLUSION

Although critically ill conditions can trigger NOMI, the model used in this study did not involve transmural necrosis. Under such conditions, hydrogen inhalation therapy did not reduce histological ischemic damage.