Abstract
Therapeutic medical gas is pharmaceutical gaseous molecules which offer solutions to medical needs. In addition to traditional medical gases including oxygen and nitrous oxide, a number of medical gases have been recently discovered to play protective roles in various disease conditions. In particular, nitric oxide, carbon monoxide, hydrogen sulphide and hydrogen are found to be endogenously generated in human body and mediate signaling pathway as biological messengers, and shown to have potent cytoprotective effects. These gaseous agents were referred as “signaling gaseous molecules” and recently have come to the forefront of research. Acute respiratory distress syndrome (ARDS), a diffuse heterogeneous lung injury characterized by hypoxemia, non cardiogenic pulmonary edema, is caused by various etiologies including local/systemic inflammation and oxidative stress. Recently, the potent antioxidant and anti-inflammatory effects of hydrogen gas were discovered and a number of experimental studies have shown hydrogen gas can prevent ARDS. Medical gases can be administered in a straightforward way simply by providing the gas for the patients to inhale using a ventilator circuit. The ability to administer medical gas inhalationally makes it extremely attractive from a feasibility standpoint for translation into a human clinical setting. Herein, we summarize the recent advances of therapeutic medical gas research and discuss their clinical feasibility, typically such as nitric oxide, carbon monoxide, hydrogen sulfide, and hydrogen. Although further investigations are required, medical gas may provide a huge impact as a novel and innovative therapeutic tools for ARDS in emergency/critical care medicine.
