Hydrogen Gas Shows Promise for Brain Protection After Cardiac Arrest
- Authors
- Lei Huang, Patricia M. Applegate, Jason W. Gatling, Dustin B. Mangus, John Zhang, Richard L. Applegate 2nd
- Journal
- Medical Gas Research
- Year
- 2014
- DOI
- 10.1186/2045-9912-4-10
- Study Type
- clinical
- Peer Reviewed
- Yes
- Country
- United States
- Health Condition
- Cardiac Arrest
- Body System
- Cardiovascular
TL;DR
Scientists reviewed different treatments that might protect the brain after someone's heart stops, and found that using multiple treatments together (like special gases or certain medicines) works better than just trying one thing—but they need more real-world testing before doctors can use these treatments on patients.
Key Finding
Molecular hydrogen and hyperbaric oxygen demonstrated particularly encouraging results in preclinical studies for protecting the brain after cardiac arrest, though clinical evidence in humans remains limited.
Summary
This review examined treatments designed to protect the brain after cardiac arrest, when the brain is starved of oxygen. Researchers looked at studies testing various drugs, hormones, and gases—including molecular hydrogen—that target different stages of brain damage. The review found that molecular hydrogen and hyperbaric oxygen (breathing pure oxygen under pressure) showed promising results in animal studies, but more human research is needed before these treatments can be used in hospitals.
Practical Takeaway
While this review identifies molecular hydrogen as a potentially promising neuroprotective agent based on animal research, it is a literature review rather than a new study, and the authors emphasize that further clinical investigation is required before hydrogen can be applied to cardiac arrest patients. This early-stage evidence does not support any current medical use.
Abstract
Neurocognitive deficits remain a significant source of morbidity in survivors of cardiac arrest. We conducted a literature review of treatment protocols designed to evaluate neurologic outcome and survival following global cerebral ischemia associated with cardiac arrest. The search was limited to investigational therapies that were implemented either during cardiopulmonary resuscitation or after return of spontaneous circulation in studies that included assessment of impact on neurologic outcome. Given that complex pathophysiology underlies global brain hypoxic ischemia following cardiac arrest, neuroprotective strategies targeting multiple stages of neuropathologic cascades should promise to improve survival and neurologic outcomes in cardiac arrest victims. In Part II of this review, we discuss several approaches that can provide comprehensive protection against global brain injury associated with cardiac arrest, by modulating multiple targets of neuropathologic cascades. Pharmaceutical approaches include adenosine and growth factors/hormones including brain-derived neurotrophic factor, insulin-like growth factor-1 and glycine-proline-glutamate, granulocyte colony stimulating factor and estrogen. Preclinical studies of these showed some benefit but were inconclusive in models of global brain injury involving systemic ischemia. Several medical gases that can mediate neuroprotection have been evaluated in experimental settings. These include hydrogen sulfide, hyperbaric oxygen and molecular hydrogen. Hyperbaric oxygen and molecular hydrogen showed promising results; however, further investigation is required prior to clinical application of these agents in cardiac arrest patients.