Scientists from Lobachevsky University together with doctors from the Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev of Nizhny Novgorod have developed a method for protecting organs during cardiac surgeries using nitric oxide and molecular hydrogen, the Scientific Russia portal reports.
The substances are fed into the artificial blood circulation machine. The effectiveness of the method has been proven in clinical practice, the results of the study have been published in leading Russian and international journals, and the development has been patented.
During high-tech heart surgeries, blood is removed into an external artificial circuit. A number of damaging processes are triggered: surgical trauma, inflammatory response, oxidative stress. With oxidative stress, active toxic forms of oxygen appear, which damage the structures of the heart muscle, affect DNA biomolecules, lipids, proteins, cell membranes and cellular organelles. Nitric oxide regulates microcirculation, affects vascular tone, improves blood supply and oxygen delivery to the heart. However, nitric oxide is not effective enough to prevent the action of reactive oxygen species.
Molecular hydrogen has an antioxidant effect and is used to treat diseases associated with reactive oxygen species. It reacts with free hydroxyl radicals and converts them into a neutral water molecule.
“Nitric oxide is well known and has been used for a long time. Molecular hydrogen has long been considered an inert gas, but in 2007 it was shown to have an antioxidant effect. Therefore, when we began research on the combined use of molecular hydrogen and nitric oxide, we counted on the synergy of these two gases: it is due to the organoprotective effect of nitric oxide and the reduction of oxidative processes with the help of molecular hydrogen. Thus, the favorable results we obtained from using two gases are achieved by improving tissue trophism and reducing oxidative stress, resulting in a decrease in the number of postoperative complications, and a reduction in the length of stay in intensive care and in hospital. This is important not only for patients, but is also aimed at solving the economic component for the hospital associated with reducing the cost of treatment,” Anna Deryugina, the author of the study and head of the Department of Physiology and Anatomy at the Institute of Biology and Biomedicine at UNN, told the Scientific Russia portal.
The study by scientists and doctors from Nizhny Novgorod on the introduction of nitric oxide and molecular hydrogen into the extracorporeal circuit during cardiac surgery is being conducted for the first time in the world, and a well-developed methodology is needed for widespread implementation. At the moment, scientists have studied the process of action of two gases during surgery and artificial blood circulation, but to improve efficiency, it is necessary to study the effect of gases before surgery and at the stage of postoperative rehabilitation.
“We are studying how the introduction of nitric oxide and molecular hydrogen will affect the preparation of the patient for surgery, and how the combined action of the two gases will help reduce the risks of complications associated with oxidative stress and inflammation in the postoperative period. Two groups are working on the research: doctors directly study the clinical effects, our research is largely aimed at identifying the mechanisms of action of these gases. Joint work will allow us to assess the possibilities of the integrated use of molecular hydrogen and nitric oxide. This approach will ensure the detailed development of protocols and technology for their use for widespread implementation,” said Anna Deryugina. In particular, scientists together with doctors will have to practice the introduction of gases to the patient in the postoperative period to develop a strategy for correcting the body’s condition.