Early application of therapeutic hypothermia, rapid achievement of target cooling temperature were key factors for improving survival and neurological outcomes. In the present situation, targeted Temperature Management (TTM) is applied to only a minority of post-cardiac arrest patients. We have been looking forward to seeing widely applicable therapeutic approaches. We previously demonstrated that both inhalation of 2% hydrogen gas and TTM (33°C), starting at the beginning of cardiopulmonary resuscitation and given for 2 hours after return of spontaneous circulation (ROSC), yielded comparable improvement in survival and neurological deficit after ROSC in a rat model of cardiac arrest. However, in a clinical setting, hypothermia is applied after ROSC. We have confirmed that the benefit of hydrogen inhalation is similar when begun after ROSC.
We would like to emphases a salutary effect of hydrogen gas inhalation on the neurological outcome after cardiopulmonary resuscitation independently of TTM in rats. Inhalation hydrogen gas therapy, either alone or in the combined with TTM, could represent a promising strategy to improve brain resuscitation for post cardiac arrest patients in the near future.