Is pharmacological, H2S-induced 'suspended animation' feasible in the ICU?

Metabolic, Cardiac, and Renal Effects of the Slow Hydrogen Sulfide-Releasing Molecule GYY4137 During Resuscitated Septic Shock in Swine with Pre-Existing Coronary Artery Disease

“…As total CO 2 production did not increase, the higher glucose oxidation in the GYY4137 group supports the notion that GYY4137 treatment resulted in preferential carbohydrate utilization. Consistently, inhaled hydrogen sulfide also increased aerobic glucose oxidation in anesthetized and mechanically ventilated, hypothermic mice (6). Interestingly, in that study, normothermiaand/or sepsis blunted the shift in substrate utilization.…”

“…H 2 S was also reported to affect glucose metabolism:Increased gluconeogenesis in hepatocytes following stimulation with sodium hydrosulfide (NaHS) was demonstrated in vitro (4), whereas CSE (cystathionine γ-lyase) knockout mice revealed reduced gluconeogenesis (5). Previously, we demonstrated that inhaled H 2 S increased glucose oxidation in anaesthetized and mechanically ventilated mice during hypothermia, whereas both normothermiaand/or sepsis blunted this effect (6).…”

“…The metabolic properties of H 2 S in large animal modelsare controversial, inasmuch as both absence of metabolic effects (8)(9)(10) as well as reduced energy expenditure (11)were reported. Thus, therelevance and translatability of H 2 S effects reported in small animals has been questioned for large animal models or humans (6,12).…”

Is Pharmacological, H2S-induced ‘Suspended Animation’ Feasible in the ICU?

“…Finally, according to the currently available literature, neither inhalation of gaseous H 2 S nor injection of the soluble sulfi de salts, NaSH or Na 2 S, is likely to become part of clinical practice because of damage to the airway mucosa and possibly toxic peak sulfi de concentrations, respectively, but slow H 2 Sreleasing molecules may enable these limitations to be overcome. Hence, there is "nothing rotten about hydrogen sulfi de's medical promise" [50], and H 2 S clearly remains a "hot molecule" [51] in the fi eld of research for a possible pharmacological induction of suspended animation-like hypometabolism.…”

Environmental toxicology of hydrogen sulfide

“…It has been implicated in the regulation of blood pressure, neurotransmission, antiinflammatory action, aiding digestion, and other activities [7, 12, 14, 15, 23, 90]. Investigations looking into the role that H2S may play in suspended animation [91, 92] may have experienced a loss of interest as the effect in question appears diminished in larger animals [93]. To date, however, the majority of well-documented health effects arising from exposure to hydrogen sulfide remain negative, especially at levels above 1 ppm in air.…”