Hydrogen Gas Reduces Seizures in Newborns After Birth Complications

Authors
Journal
Pediatric Research
Year
DOI
10.1038/s41390-024-03041-6
Study Type
Pig
Outcome
Positive
Peer Reviewed
Yes
Country
Japan
Health Condition
Hypoxic-Ischemic Encephalopathy
Body System
Nervous System

TL;DR

Adding hydrogen gas to cooling therapy reduced seizures and improved brain activity in newborn piglets that had suffered from a lack of oxygen.

Key Finding

Combining hydrogen gas with therapeutic cooling reduced seizure burden and abnormal brain electrical patterns 24 hours after oxygen deprivation in newborn piglets, compared to cooling therapy alone.

Summary

Researchers studied whether adding hydrogen gas to cooling therapy (a standard treatment for newborns who suffered oxygen deprivation at birth) could reduce seizures. Using newborn piglets, they compared cooling alone versus cooling plus hydrogen gas, measuring brain electrical activity for 24 hours after the injury. Adding hydrogen gas to cooling therapy reduced abnormal brain patterns and shortened seizure episodes compared to cooling alone.

Practical Takeaway

This early-stage animal study suggests hydrogen gas combined with cooling therapy may enhance protection against seizures in newborns with oxygen deprivation. However, this research was conducted only in piglets, and human trials would be needed before any clinical application. The findings are preliminary and cannot yet inform treatment decisions.

Abstract

Background: We previously reported that hydrogen (H2) gas combined with therapeutic hypothermia (TH) improved short-term neurological outcomes in asphyxiated piglets. However, the effect on seizure burden was unclear. Using amplitude-integrated electroencephalography (aEEG), we compared TH + H2 with TH alone in piglets 24 h after hypoxic-ischemic (HI) insult. Methods: After a 40-min insult and resuscitation, 36 piglets ≤24 h old were divided into three groups: normothermia (NT, n = 14), TH alone (33.5 ± 0.5 °C, 24 h, n = 13), and TH + H2 (2.1-2.7% H2 gas, 24 h, n = 9). aEEG was recorded for 24 h post-insult and its background pattern, status epilepticus (SE; recurrent seizures lasting >5 min), and seizure occurrence (Sz; occurring at least once but not fitting the definition of SE) were evaluated. Background findings with a continuous low voltage and burst suppression were considered abnormal. Results: The percentage of piglets with an abnormal aEEG background (aEEG-BG), abnormal aEEG-BG+Sz and SE was lower with TH + H2 than with TH at 24 h after HI insult. The duration of SE was shorter with TH + H2 and significantly shorter than with NT. Conclusions: H2 gas combined with TH ameliorated seizure burden 24 h after HI insult. Impact: In this asphyxiated piglet model, there was a high percentage of animals with an abnormal amplitude-integrated electroencephalography background (aEEG-BG) after hypoxic-ischemic (HI) insult, which may correspond to moderate and severe hypoxic-ischemic encephalopathy (HIE). Therapeutic hypothermia (TH) was associated with a low percentage of piglets with EEG abnormalities up to 6 h after HI insult but this percentage increased greatly after 12 h, and TH was not effective in attenuating seizure development. H2 gas combined with TH was associated with a low percentage of piglets with an abnormal aEEG-BG and with a shorter duration of status epilepticus at 24 h after HI insult.