Early post-operative hyperbaric oxygen therapy modifies neutrophile activation.
OBJECTIVE
To investigate the effect of acute hyperbaric oxygen therapy (HBOT) on post-operative sinusoidal endothelial cell (SEC) damage caused by activated neutrophils.


METHODS
12 non-cirrhotic patients (Group H), who underwent elective hepatectomy for liver cancer, were given 2 courses of HBOT: 2.0 atm with inhalation of 100% oxygen, for 60 min, at 3 hours and 24 hours after hepatectomy; they were then compared with the 12 patients (Group C) who had been treated to maintain normal hemodynamic values.


RESULTS
In group H, peak levels of polymorphonuclear leukocyte elastase (PMNE) and thrombomodulin (TM) were clearly diminished and delayed compared to Group C. All subjects in Group C showed more than a 10% increase in CD18 12 hours after surgery; however, in Group H, the elevation of CD18 expression was clearly suppressed compared to Group C. No patient in Group H had post-operative hyperbilirubinemia or hepatic failure; however, 3 had post-operative hyperbilirubinemia and 1 had intraperitoneal infection in Group C.


CONCLUSIONS
Our results provide direct evidence that HBOT, especially at 3 hours after hepatectomy, has favorable effects on the activation of neutrophiles decreasing SEC injury.
Ueno
S
S
First Department of Surgery, Kagoshima University School of Medicine, Japan.
Tanabe
G
G
Kihara
K
K
Aoki
D
D
Arikawa
K
K
Dogomori
H
H
Aikou
T
T
D018821:CD18 Antigens / Q000097:blood; D004730:Endothelium, Vascular / Q000276:immunology; D006498:Hepatectomy; D006801:Humans; D006931:Hyperbaric Oxygenation; D019272:Leukocyte Elastase / Q000097:blood; D008099:Liver / Q000098:blood supply; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D018375:Neutrophil Activation / Q000276:immunology*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000276:immunology*; D011379:Prognosis; D011446:Prospective Studies; D018180:Thrombomodulin / Q000097:blood
D018821:CD18 Antigens; D018180:Thrombomodulin; D019272:Leukocyte Elastase