Studies on the effect of hydrogen peroxide enema on the arterial oxygen partial pressure in the hypoxic cats

의학과/박사[한글] [영문] Cyanosis in patients with congenital heart disease such as large ventricular septal defect is due to a shunt of desaturated blood, and this desaturated blood may also contribute to hypoxemia in pulmonary diseases such as hyaline membrane disease. The partial pressure of oxygen in the blood of these cases cannot be increased by increasing the respiratory rate or by oxygen inhalation. To combat oxygen want in blood the extrapulmonary respiration has been attempted. Oliver and Murphy (1920) treated patients of severe influenzal pneumonia with intravenous hydrogen peroxide as a source of oxygen. Lorincz et al. (1948) investigated the effect of hydrogen peroxide on the blood of several animals and concluded it was of little therapeutic value because of the formation of oxygen emboli. Feldman et al. (1966) reported that cats have been kept alive for a period up to one hour under the ventilatory arrest by an infusion of hydrogen peroxide into the thoracic aorta. Stern and Brennock. (1967) investigated the effect of the continuous intravenous hydrogen peroxide infusion using concentration of 6, 3, and 1.5% hydrogen peroxide, and reported that there were massive emboli during the course of the infusion in dogs but not in cats. Up to 20% of the animal's oxygen consumption could be supplied by intravenous hydrogen peroxide without circulatory and respiratory collapse due to formation of bubbles. (Fuson et al.1967), but they observed severe methemoglobinemia and suggested that it was hazardous technique. Urschel et al. (1966) suggested possible future applications to systemic hypoxia through the experiments employing diluted hydrogen Peroxide givers by peritoneal or rectal administration or pulmonary nebulization. Morgan et al. (1968) investigated the effectiveness of intraperitoneal administration of 0.3%hydrogen peroxide in hypoxic rabbits and suggested that this method for the Purpose of extrapulmonary oxygenation was ineffctive and hazardous. Recently Yun (1969) investigated the effectiveness of hydrogen peroxide on dogs, and reported that 0.4% hydrogen peroxide administration by a single enema resulted in elevation of arterial oxygen tension without gas bubbies or methemoglobinemia. Paik (1970) investigated the effects on liver of 0.75% hydrogen peroxide in rabbits and found transient gas bubbles in the portal vein and mesenteric vessels without liver damage. The present investigation is aimed at studying the effect of 0.5% hydrogen peroxide enema in hypoxic cats and to demonstrate its effectiveness as an adjunct in extrapulmonary oxygenation. In this experiment 40 adult eats of either sex were used and divides in experimental (30 cats)and control groups (10 cats) by random sampling. Under general anesthesia with injection of seconal (30 mg/kg) intraperitoneally, the right femoral artery was exposed and a polyethylene tube was introduced and fixed with suture for easy blood sampling. A long rectal tube was inserted and sutured at the anus to prevent the leakage from the infusion of hydrogen peroxide or phygiologic saline with small amounts of blood. Tracheostomy was performed, and a cannula was connected to the respirator (Model 607, Harvard Apparatus Co.) to control the respiratory rate and tidal volume. The respiration was made with room air, and then with hypoxic gas of 10% oxygen in 90% nitrogen. Under arterial desaturation with hypoxic gas an enema was given made up of 0.5% hydrogen peroxide (10 cc/kg) and blood(1 cc/kg) in the experimental group, and with physiologic saline (10 cc/kg) and blood (1 cc/kg)in control group through the enema tube. The blood samples were collected during air breathing, during hypoxic breathing, and then15, 45, and 75 minutes after enema respectively. pH, Po^^2 and Pco^^2 were measured with Astrup's Radiometer(1960) and hematocrit wag measured in each sample. Pulse rate and blood pressure were recorded at the time of each sampling. 1. The values of arterial pH were 7.345, 7.331, 7.329, 7.337, and 7.336 in experimental group and 7.338, 7.337, 7 337, 7.341, and 7.339 in control group on air breathing, hypoxic state, and 15, 15, and 75 minutes after enema under continuous hypoxic state. In this experiment no differences were found in arterial pH of both groups. 2. The values of arterial Po^^2 were 95.29, 60.71., 77.57, 81.73, and 80.25 mmHg in experimental group and 93.55, 61.18, 60.96, 71.40, and 61.48 mmHg in control group on air breathing, hypoxic state, and 15, 45, and 75 minutes after enema under continuous lower oxygenated air breathing state. It showed there was significant diminution of arterial Po^^2 at hypoxic gas respiration than air respiration in both groups while there was a significant elevation of arterial Po^^2 in the experimental group than in the control group after enema under a continuous hypoxic state. 3. The values of arterial Pco^^2 were 33.06, 34.88, 34.61, 33.04, and 33.64 mmHg in experimental group, and 34.13, 34.18, 33.99, 34.61, and 34.32mmHg in control group on air breathing, hypoxic state, and 15,45, and 75 minutes after enema under continuous hypoxic state. There were no differences of arterial Pco^^2 in experimental and control group under air breathing, hypoxic state and enema. 4. The values of hematocrit were 36.96, 37.65, 37.31, 37.58, and 37.32? in experimental group and 37.49, 37.71, 37.67, 37.44, and 35.67% in control group on air breathing, hypoxic state, and 15, 47, and 75 minutes after enema under continuous hypoxic state. In this experiment there were no differences in hematocrit of both groups. From the results obtained by theme experiments the single enema with blood and hydrogen peroxide could be used to increase arterial oxygen partial pressure of cats in the hypoxic state, and it may be useful in raising oxygen tension in hypoxia due to various causes.restrictio