Ozone Improves Oxygenation and Offers Organ Protection after Autologous Blood Transfusion in a Simulated Carbon Dioxide Pneumoperitoneal Environment in a Rabbit Hemorrhagic Shock Model.

OBJECTIVES

Autologous blood transfusion techniques are well applied in surgery, but the red blood cells (RBCs) collected during laparoscopic surgery may forfeit their ability to oxygenate. O is a potent oxidation gas. This study investigates whether O could improve the oxygen-carrying capacity of RBCs, reduce inflammatory reactions, and offer organ protection.

METHODS

We established a hemorrhagic shock model in rabbits, and simulated CO pneumoperitoneum and O were applied before autologous blood transfusion. Perioperative mean arterial pressure and arterial blood gas were recorded, blood gas and RBC morphology of collected blood were analyzed, plasma IL-6, ALT, AST, CRE, and lung histopathology POD0 and POD3 were tested, as well as postoperative survival quality.

RESULTS

Autologous blood that underwent simulated CO pneumoperitoneum had a lower pH and SaO and a higher PaCO than the control group. After O treatment, PaO and SaO increased significantly, with unchanged pH values and PaCO. RBCs in autologous blood were drastically deformed after CO conditioning and then reversed to normal by O treatment. Rabbits that received CO-conditioned autologous blood had a compromised survival quality after surgery, higher plasma IL-6 levels, higher lung injury scores on POD0, higher ALT and AST levels on POD3, and O treatment alleviated these adverse outcomes.

CONCLUSION

O can restore RBC function, significantly improve blood oxygenation under simulated CO pneumoperitoneum, offer organ protection, and improve the postoperative survival quality in the rabbit hemorrhage shock model.