Abstract
OBJECTIVES: Autologous blood transfusion techniques are well applied in surgery, but the red blood cells (RBCs) collected during laparoscopic surgery may forfeit their ability to oxygenate. O(3) is a potent oxidation gas. This study investigates whether O(3) could improve the oxygen-carrying capacity of RBCs, reduce inflammatory reactions, and offer organ protection. METHODS: We established a hemorrhagic shock model in rabbits, and simulated CO(2) pneumoperitoneum and O(3) were applied before autologous blood transfusion. Perioperative mean arterial pressure and arterial blood gas were recorded, blood gas and RBC morphology of collected blood were analyzed, plasma IL-6, ALT, AST, CRE, and lung histopathology POD0 and POD3 were tested, as well as postoperative survival quality. RESULTS: Autologous blood that underwent simulated CO(2) pneumoperitoneum had a lower pH and SaO(2) and a higher PaCO(2) than the control group. After O(3) treatment, PaO(2) and SaO(2) increased significantly, with unchanged pH values and PaCO(2). RBCs in autologous blood were drastically deformed after CO(2) conditioning and then reversed to normal by O(3) treatment. Rabbits that received CO(2)-conditioned autologous blood had a compromised survival quality after surgery, higher plasma IL-6 levels, higher lung injury scores on POD0, higher ALT and AST levels on POD3, and O(3) treatment alleviated these adverse outcomes. CONCLUSION: O(3) can restore RBC function, significantly improve blood oxygenation under simulated CO(2) pneumoperitoneum, offer organ protection, and improve the postoperative survival quality in the rabbit hemorrhage shock model.