A basic study on molecular hydrogen (H2) inhalation in acute cerebral ischemia patients for safety check with physiological parameters and measurement of blood H2 level.
BACKGROUND
In animal experiments, use of molecular hydrogen ( H2) has been regarded as quite safe and effective, showing benefits in multiple pathological conditions such as ischemia-reperfusion injury of the brain, heart, kidney and transplanted tissues, traumatic and surgical injury of the brain and spinal cord, inflammation of intestine and lung , degenerative striatonigral tissue and also in many other situations. However, since cerebral ischemia patients are in old age group, the safety information needs to be confirmed. For the feasibility of H2 treatment in these patients, delivery of H2 by inhalation method needs to be checked for consistency.


METHODS
Hydrogen concentration (HC) in the arterial and venous blood was measured by gas chromatography on 3 patients, before, during and after 4% (case 1) and 3% (case2,3) H2 gas inhalation with simultaneous monitoring of physiological parameters. For a consistency study, HC in the venous blood of 10 patients were obtained on multiple occasions at the end of 30-min H2 inhalation treatment.


RESULTS
The HC gradually reached a plateau level in 20 min after H2 inhalation in the blood, which was equivalent to the level reported by animal experiments. The HC rapidly decreased to 10% of the plateau level in about 6 min and 18 min in arterial and venous blood, respectively after H2 inhalation was discontinued. Physiological parameters on these 3 patients were essentially unchanged by use of hydrogen. The consistency study of 10 patients showed the HC at the end of 30-min inhalation treatment was quite variable but the inconsistency improved with more attention and encouragement.


CONCLUSIONS
H2 inhalation of at least 3% concentration for 30 min delivered enough HC, equivalent to the animal experiment levels, in the blood without compromising the safety. However, the consistency of H2 delivery by inhalation needs to be improved.
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Hirohisa
H
Ono
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Yoji
Y
Nishijima
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Naoto
N
Adachi
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Masaki
M
Sakamoto
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Yohei
Y
Kudo
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Kumi
K
Kaneko
Department of Surgery, University of Pittsburgh, Pittsburgh, USA.
Atsunori
A
Nakao
Department of Neurosurgery, Nishijima Hospital, Oooka, Numazu City, Sizuoka, Japan.
Takashi
T
Imaoka