Early post-operative hyperbaric oxygen therapy modifies neutrophile activation

BACKGROUND/AIMS: To investigate the effect of acute hyperbaric oxygen thera py (HBOT) on postoperative sinusoidal endothelial cell (SEC) damage caused by activated neutrophils. METHODOLOGY: 12 non-cirrhotic patients (Group H), who underwent elective he patectomy for liver cancer, were given 2 courses of HBOT: 2.0 atm with inha lation of 100% oxygen, for 60min, at 3 hours and 24 hours after hepatectomy ; they were then compared with the 12 patients (Group C) who had been treat ed to maintain normal hemodynamic values. RESULTS: In group H, peak levels of polymorphonuclear leukocyte elastase (P MNE) and thrombomodulin (TM) were clearly diminished and delayed compared t o Group C. All subjects in Group C showed more than a 10% increase in CD18 12 hours after surgery; however, in Group H, the elevation of CD18 expressi on was clearly suppressed compared to Group C. No patient in Group H had po st-operative hyperbilirubinemia or hepatic failure; however, 3 had post-ope rative hyperbilirubinemia and 1 had intraperitoneal infection in Group C. CONCLUSIONS: Our results provide direct evidence that HBOT, especially at 3 hours after hepatectomy, has favorable effects on the activation of neutro philes decreasing SEC injury.