Protective Effects of Hydrogen-Rich Saline Against Hemorrhagic Shock in Rats via an Endothelial Glycocalyx Pathway

Background/Objective: The endothelial glycocalyx is a gel-like layer on the vascular endothelial surface that is crucial for maintaining vascular homeostasis. Massive bleeding leads to the shedding of the glycocalyx, which can lead to vascular leakage during fluid administration. Recently, the beneficial effect of hydrogen inhalation in the treatment of hemorrhagic shock has been reported. However, the efficacy of hydrogen-rich saline in protecting the glycocalyx remains unclear. In this study, we investigated the effects of hydrogen-rich saline on glycocalyx degeneration. Methods: Rats under general anesthesia were divided into five groups: the sham, hemorrhagic shock, normal saline, colloid solution, and hydrogen-rich saline groups (n = 6 for each group). Blood was withdrawn, and blood pressure was maintained at 30-35 mmHg for 60 min. After inducing hemorrhagic shock in this way, each infusion product was administered intravenously to maintain blood pressure at 80 mmHg for 60 min. Glycocalyx thickness was assessed using the GlycoCheck system. Results: The use of hydrogen-rich saline significantly improved the survival rate (p < 0.05), and glycocalyx degeneration was significantly suppressed (p < 0.001), indicating the protective effect of hydrogen on the glycocalyx. Conclusion: Intravenous administration of hydrogen-rich saline in hemorrhagic shock attenuates glycocalyx degeneration compared to conventional fluid resuscitation, which can improve survival rates.