1
|
Johnsen HM, Hiorth M, Klaveness J. Molecular Hydrogen Therapy-A Review on Clinical Studies and Outcomes. Molecules 2023; 28:7785. [PMID: 38067515 PMCID: PMC10707987 DOI: 10.3390/molecules28237785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
With its antioxidant properties, hydrogen gas (H2) has been evaluated in vitro, in animal studies and in human studies for a broad range of therapeutic indications. A simple search of "hydrogen gas" in various medical databases resulted in more than 2000 publications related to hydrogen gas as a potential new drug substance. A parallel search in clinical trial registers also generated many hits, reflecting the diversity in ongoing clinical trials involving hydrogen therapy. This review aims to assess and discuss the current findings about hydrogen therapy in the 81 identified clinical trials and 64 scientific publications on human studies. Positive indications have been found in major disease areas including cardiovascular diseases, cancer, respiratory diseases, central nervous system disorders, infections and many more. The available administration methods, which can pose challenges due to hydrogens' explosive hazards and low solubility, as well as possible future innovative technologies to mitigate these challenges, have been reviewed. Finally, an elaboration to discuss the findings is included with the aim of addressing the following questions: will hydrogen gas be a new drug substance in future clinical practice? If so, what might be the administration form and the clinical indications?
Collapse
Affiliation(s)
- Hennie Marie Johnsen
- Department of Pharmacy, University of Oslo, Sem Sælands Vei 3, 0371 Oslo, Norway
- Nacamed AS, Oslo Science Park, Guastadalléen 21, 0349 Oslo, Norway
| | - Marianne Hiorth
- Department of Pharmacy, University of Oslo, Sem Sælands Vei 3, 0371 Oslo, Norway
| | - Jo Klaveness
- Department of Pharmacy, University of Oslo, Sem Sælands Vei 3, 0371 Oslo, Norway
| |
Collapse
|
2
|
Wang T, Xiang Q, Bian J. Promising gas therapies for severe COVID-19. JOURNAL OF INTENSIVE MEDICINE 2021; 1:99-102. [PMID: 36943807 PMCID: PMC8157123 DOI: 10.1016/j.jointm.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/21/2021] [Accepted: 05/05/2021] [Indexed: 06/18/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic is a worldwide catastrophe, thoroughly challenging the healthcare systems. A growing number of victims suffer from a remarkable acute respiratory distress syndrome (ARDS) that necessitates admission to the intensive care unit (ICU), but there are no satisfactory treatments. Various gas therapies including nitric oxide, ozone, hyperbaric oxygen, hydrogen, and heliox have been employed in the fight against the pandemic and have improved clinical outcomes. However, the potential roles of these gases in COVID-19 treatment need to be verified in well-designed randomized controlled trials. This paper reviews advances in gaseous therapy of COVID-19.
Collapse
|
3
|
Koppurapu VS, Puliaiev M, Doerschug KC, Schmidt GA. Ventilated Patients With COVID-19 Show Airflow Obstruction. J Intensive Care Med 2021; 36:696-703. [PMID: 33706592 PMCID: PMC8142384 DOI: 10.1177/08850666211000601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: Many patients with coronavirus disease 2019 (COVID-19) need mechanical ventilation secondary to acute respiratory distress syndrome. Information on the respiratory system mechanical characteristics of this disease is limited. The aim of this study is to describe the respiratory system mechanical properties of ventilated COVID-19 patients. Design, Setting, and Patients: Patients consecutively admitted to the medical intensive care unit at the University of Iowa Hospitals and Clinics in Iowa City, USA, from April 19 to May 1, 2020, were prospectively studied; final date of follow-up was May 1, 2020. Measurements: At the time of first patient contact, ventilator information was collected including mode, settings, peak airway pressure, plateau pressure, and total positive end expiratory pressure. Indices of airflow resistance and respiratory system compliance were calculated and analyzed. Main Results: The mean age of the patients was 58 years. 6 out of 12 (50%) patients were female. Of the 21 laboratory-confirmed COVID-19 patients on invasive mechanical ventilation, 9 patients who were actively breathing on the ventilator were excluded. All the patients included were on volume-control mode. Mean [±standard deviation] ventilator indices were: resistive pressure 19 [±4] cmH2O, airway resistance 20 [±4] cmH2O/L/s, and respiratory system static compliance 39 [±16] ml/cmH2O. These values are consistent with abnormally elevated resistance to airflow and reduced respiratory system compliance. Analysis of flow waveform graphics revealed a pattern consistent with airflow obstruction in all patients. Conclusions: Severe respiratory failure due to COVID-19 is regularly associated with airflow obstruction.
Collapse
Affiliation(s)
- Vikas S Koppurapu
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, 21782University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Maksym Puliaiev
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, 21782University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Kevin C Doerschug
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, 21782University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Gregory A Schmidt
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, 21782University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| |
Collapse
|
4
|
Shchelkanov MY, Kolobukhina LV, Burgasova OA, Kruzhkova IS, Maleev VV. COVID-19: etiology, clinical picture, treatment. ACTA ACUST UNITED AC 2020. [DOI: 10.15789/2220-7619-cec-1473] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Whereas the XX century marked the history of acute respiratory disease investigation as a period for generating in-depth system of combating influenza viruses (Articulavirales: Orthomyxoviridae, Alpha-/Betainfluenzavirus) (based on environmental and virological monitoring of influenza A virus in its natural reservoir — aquatic and semi-aquatic birds — to supervising epidemic influenza), a similar system is necessary to build up in the XXI century with regard to especially dangerous betacoronaviruses (Nidovirales: Coronaviridae, Betacoronavirus): Severe acute respiratory syndrome-related coronavirus (SARS-CoV) (subgenus Sarbecovirus), Severe acute respiratory syndrome-related coronavirus 2 (SARSCoV-2) (Sarbecovirus), Middle East respiratory syndrome-related coronavirus (MERS-CoV) (Merbecovirus). This became particularly evident after pandemic potential has been revealed in 2020 by the SARS-CoV-2. This review provides an insight into the historic timeline of discovering this virus, its current taxonomy, ecology, virion morphology, life cycle, molecular biology, pathogenesis and clinical picture of the etiologically related COVID-19 (Coronavirus disease 2019) as well as data available in the scientific literature on the anti-SARS-CoV-2-effectiveness of passive immunotherapy and most debated drugs used to treat COVID-19: Chloroquine, Hydroxychloroquine, Nitazoxanide, Ivermectin, Lopinavir and Ritonavir, Camostat mesilate, Remdesivir, Ribavirin, Tocilizumab, Anakinra, corticosteroids, and type I interferons. The pathogenesis of SARS-CoV-2 infection implicates decreased efficacy of artificial respiration, which, in this case might be replaced by more efficient extracorporeal membrane blood oxygenation supplemented with nitrogen oxide and/or Heliox inhalations.
Collapse
Affiliation(s)
- M. Yu. Shchelkanov
- International Scientific and Educational Center for Biological Security of Rospotrebnadzor;
Federal Scientific Center of East Asia Terrestrial Biodiversity, Far Eastern Branch of RAS;
Center of Hygiene and Epidemiology in the Primorsky Territory
| | - L. V. Kolobukhina
- D.I. Ivanovsky Institute of Virology of the N.F. Gamaleya National Scientific Center of Epidemiology and Microbiology, Russian Ministry of Public Health
| | | | - I. S. Kruzhkova
- D.I. Ivanovsky Institute of Virology of the N.F. Gamaleya National Scientific Center of Epidemiology and Microbiology, Russian Ministry of Public Health
| | - V. V. Maleev
- Central Research Institute of Epidemiology and Microbiology of Rospotrebnadzor
| |
Collapse
|
5
|
Mammas IN, Drysdale SB, Rath B, Theodoridou M, Papaioannou G, Papatheodoropoulou A, Koutsounaki E, Koutsaftiki C, Kozanidou E, Achtsidis V, Korovessi P, Chrousos GP, Spandidos DA. Update on current views and advances on RSV infection (Review). Int J Mol Med 2020; 46:509-520. [PMID: 32626981 PMCID: PMC7307844 DOI: 10.3892/ijmm.2020.4641] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/15/2020] [Indexed: 12/11/2022] Open
Abstract
Respiratory syncytial virus (RSV) infection represents an excellent paradigm of precision medicine in modern paediatrics and several clinical trials are currently performed in the prevention and management of RSV infection. A new taxonomic terminology for RSV was recently adopted, while the diagnostic and omics techniques have revealed new modalities in the early identification of RSV infections and for better understanding of the disease pathogenesis. Coordinated clinical and research efforts constitute an important step in limiting RSV global predominance, improving epidemiological surveillance, and advancing neonatal and paediatric care. This review article presents the key messages of the plenary lectures, oral presentations and posters of the '5th workshop on paediatric virology' (Sparta, Greece, 12th October 2019) organized by the Paediatric Virology Study Group, focusing on recent advances in the epidemiology, pathogenesis, diagnosis, prognosis, clinical management and prevention of RSV infection in childhood.
Collapse
Affiliation(s)
- Ioannis N Mammas
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | | | - Barbara Rath
- Vienna Vaccine Safety Initiative, D‑10437 Berlin, Germany
| | - Maria Theodoridou
- First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece
| | - Georgia Papaioannou
- Department of Paediatric Radiology, 'Mitera' Children's Hospital, 15123 Athens, Greece
| | | | - Eirini Koutsounaki
- Neonatal Department, 'Alexandra' Maternity Hospital, 15123 Athens, Greece
| | - Chryssie Koutsaftiki
- Paediatric Intensive Care Unit (PICU), 'Penteli' Children's Hospital, 15236 Penteli, Greece
| | - Eleftheria Kozanidou
- 2nd Department of Internal Medicine, 'St Panteleimon' General Hospital of Nikaia, 18454 Piraeus, Greece
| | - Vassilis Achtsidis
- Department of Ophthalmology, Royal Cornwall Hospitals, Cornwall TR1 3LQ, UK
| | - Paraskevi Korovessi
- Department of Paediatrics, 'Penteli' Children's Hospital, 15236 Penteli, Greece
| | - George P Chrousos
- First Department of Paediatrics, University of Athens School of Medicine, 11527 Athens, Greece
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| |
Collapse
|
6
|
Guan WJ, Wei CH, Chen AL, Sun XC, Guo GY, Zou X, Shi JD, Lai PZ, Zheng ZG, Zhong NS. Hydrogen/oxygen mixed gas inhalation improves disease severity and dyspnea in patients with Coronavirus disease 2019 in a recent multicenter, open-label clinical trial. J Thorac Dis 2020; 12:3448-3452. [PMID: 32642277 PMCID: PMC7330772 DOI: 10.21037/jtd-2020-057] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chun-Hua Wei
- Department of Respiratory Medicine, Weifang Wei'en Hospital, Weifang, China.,Department of Respiratory Medicine, Wuhan Hanyang Hospital, Wuhan, China
| | - Ai-Lan Chen
- Department of Cardiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,Department of Respiratory and Critical Care Medicine, Wuhan Hankou Hospital, Wuhan, China
| | - Xiao-Cong Sun
- Intensive Care Unit, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.,Intensive Care Unit, Shishou Hospital of Traditional Chinese Medicine, Shishou, China
| | - Guang-Yun Guo
- Department of Respiratory and Critical Care Medicine, Wuhan Pulmonary Hospital, Wuhan, China
| | - Xu Zou
- Department of Respiratory and Critical Care Medicine, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China.,Department of Infectious Diseases, Leishenshan Hospital, Wuhan, China
| | - Jin-Dong Shi
- Department of Infectious Diseases, Leishenshan Hospital, Wuhan, China.,Department of Respiratory and Critical Care Medicine, Shanghai Fifth People's Hospital, Shanghai, China
| | - Pei-Zhen Lai
- Institute of Biochemistry and Molecular Biology, College of Medicine, National Taiwan University, Taipei
| | - Ze-Guang Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Nan-Shan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
7
|
Hertzog JH, Burr KL, Stump A, Brown JM, Penfil S, McMahon K. Impact of Helium-Oxygen Administered via High Velocity Nasal Insufflation on Delivery of Inhaled Nitric Oxide. J Pediatr Intensive Care 2020; 9:261-264. [PMID: 33133741 DOI: 10.1055/s-0040-1710057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022] Open
Abstract
Inhaled nitric oxide (iNO) may be continued during the transition from invasive to noninvasive respiratory support. Upper airway obstruction from laryngeal edema following extubation and lower airway obstruction from asthma and bronchiolitis may be managed with inhaled helium. The coadministration of helium with iNO and the impact on delivered amounts of iNO have not been extensively studied. A bench model simulating a spontaneously breathing infant received iNO at varying preset doses delivered with either helium-oxygen or nitrogen-oxygen via a Vapotherm unit. iNO levels were measured at the simulated trachea. Results from the two conditions were compared using t-tests. When nitrogen-oxygen was used, there was no difference between preset and measured iNO levels. A significant difference was present when helium-oxygen was used, with a 10-fold increase in measured iNO levels compared with preset values. The use of helium resulted in a significant increase in measured iNO at the level of the simulated trachea. Clinicians must be aware that iNO will not be delivered at prescribed doses when used with helium under the conditions used in this study.
Collapse
Affiliation(s)
- James H Hertzog
- Respiratory Care Services, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States.,Division of Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States.,Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| | - Katlyn L Burr
- Respiratory Care Services, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
| | - Angela Stump
- Respiratory Care Services, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
| | - Joel M Brown
- Respiratory Care Services, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States
| | - Scott Penfil
- Department of Pediatrics, Samuelson Children's Hospital at Sinai, Baltimore, Maryland, United States
| | - Kimberly McMahon
- Division of Critical Care Medicine, Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States.,Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, United States
| |
Collapse
|
8
|
Nascimento MS, Santos É, Prado CD. Helium-oxygen mixture: clinical applicability in an intensive care unit. EINSTEIN-SAO PAULO 2018; 16:eAO4199. [PMID: 30427479 PMCID: PMC6223943 DOI: 10.31744/einstein_journal/2018ao4199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/24/2018] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate if distress respiratory decreases after using helium-oxygen mixture in pediatric patients diagnosed with bronchospasm. Methods This is a retrospective, non-randomized study that included patients diagnosed with bronchospasm, who received a helium-oxygen mixture at three time points (30, 60, and 120 minutes) according to the organization protocol singular, and were admitted to the intensive care unit, from January 2012 to December 2013. This protocol includes patients with bronchospasm who sustained a modified Wood score of moderate to severe, even after one hour of conventional treatment. Results Twenty children were included in the study. The mean score of severity of the disease at the initial moment was 5.6 (SD:2.0), and at moment 120 minutes, it was 3.4 (SD: 2.0). The severity score showed a significant improvement as of 30 minutes (p<0.001). Conclusion The use of helium-oxygen mixture proved to be effective in diminishing the respiratory distress score for children with airway obstructions; it should be considered a supplementary therapeutic option, together with drug therapy, in specific clinical situations.
Collapse
Affiliation(s)
| | - Érica Santos
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | | |
Collapse
|