Hydrogen Gas Prevents Throat Damage from Breathing Tubes During Surgery
- Authors
- Guo Mu, Shuai Chen, Xinyu Chen, Qiang Li, Bin Lu, Xuan Yu
- Journal
- Free Radical Biology & Medicine
- Year
- 2024
- DOI
- 10.1016/j.freeradbiomed.2024.08.035
- Study Type
- Human
- Outcome
- Positive
- Peer Reviewed
- Yes
- Country
- China
- Health Condition
- Post-operative sore throat
- Body System
- Respiratory
TL;DR
Breathing in hydrogen gas can protect the throat from damage caused by the cuff of a breathing tube during surgery.
Key Finding
Hydrogen inhalation reduced airway damage from breathing tube compression by blocking a cellular death pathway and lowering harmful reactive oxygen species, and hydrogen-enriched saline in the tube cuff reduced postoperative sore throat in surgical patients.
Summary
When a breathing tube is inserted during surgery, the inflatable cuff around the tube can compress and damage the airway lining. This study found that this damage occurs through a process called oxidative stress (harmful chemical reactions) that triggers cell death. Researchers discovered that hydrogen gas inhalation reduced these harmful chemical reactions and prevented cell death by blocking a specific cellular pathway (NLRP3-GSDMD). In patients undergoing surgery, using hydrogen-enriched saline to inflate the breathing tube cuff reduced sore throat after the procedure.
Practical Takeaway
This early evidence suggests hydrogen may help protect the airway during intubation procedures, particularly for reducing postoperative sore throat. However, the study's sample size and duration were not reported, making it difficult to assess the strength of these findings. More research with larger patient groups and longer follow-up is needed before hydrogen can be recommended as a standard protective strategy.
Abstract
The cuff of endotracheal tube (ETT) is an indispensable device for establishing an artificial airway, yet cuff-induced compression often causes damage to the airway mucosa. The mechanism of this damage involves mucosal compression ischemia and the oxidative stress injury following reperfusion. Currently, there is a lack of effective strategies to protect the mucosa. Hydrogen, as a natural antioxidant, has demonstrated significant potential in the prevention and treatment of oxidative stress injuries. This study aimed to determine the protective effects of hydrogen on compressed airway mucosa. We found that the damage to the airway mucosa caused by ETT cuff compression was associated with oxidative stress-induced pyroptosis of airway epithelial cells. Inhalation of hydrogen effectively reduced the levels of reactive oxygen species, significantly ameliorating changes in epithelial cell pyroptosis, and this protective effect is linked to the inhibition of the NLRP3-GSDMD pathway. Further cellular studies, involving knockdown and overexpression of NLRP3, clarified that hydrogen exerts its protective effects on the airway mucosa by inhibiting epithelial cell pyroptosis. Additionally, we observed that using hydrogen-rich saline to inflate the ETT cuff in patients under general anesthesia significantly reduced postoperative sore throat. This study confirms that hydrogen effectively enhances tolerance of airway mucosa to oxidative stress injuries, offering a potential preventive and therapeutic strategy for protecting the airway mucosa in patients undergoing endotracheal intubation.