Hyperbaric oxygen therapy reduces the severity of necrotizing enterocolitis in a neonatal rat model

J Pediatr Surg. 2009 Mar;44(3):534-40. doi: 10.1016/j.jpedsurg.2008.06.008.


Introduction: Hyperbaric oxygen (HBO) therapy is known to increase oxygen concentration in tissues leading to induction of an adaptive increase in antioxidants, stimulation of angiogenesis, improvement of white blood cell action, and regulation of inflammatory process. Therefore, we tested the potential beneficial effect of HBO in neonatal rat model of necrotizing enterocolitis (NEC).

Materials and methods: Thirty newborn Sprague-Dawley rats, provided by the Experimental Research Council, Gulhane Military Medical Academy, Ankara,Turkey, were randomly divided into 3 groups as follows: NEC, NEC + HBO, and control. Necrotizing enterocolitis was induced by enteral formula feeding and exposure to hypoxia after cold stress at 4 degrees C and oxygen. The NEC + HBO group received HBO at 2.8 atmosphere absolute (ATA) for 90 minutes daily for 3 days. The pups were killed on the fourth day, and their intestinal tissues were harvested for biochemical and histopathologic analysis. Blood samples were also obtained from the pups.

Results: The mortality rate was highest in the NEC group (3 pups in the NEC group vs 1 pup in the NEC + HBO group). Malondialdehyde and protein carbonyl content were significantly increased, whereas superoxide dismutase and glutathione peroxidase were significantly decreased in the NEC group. All these changes were similar to control levels in the NEC group by HBO treatment. Nitrate plus nitrite (NO(x)) levels and serum tumor necrosis factor alpha were increased in the NEC group and histopathologic injury score and apoptosis index in the NEC group were significantly higher than in the NEC + HBO group.

Conclusion: Hyperbaric oxygen significantly reduced the severity of NEC in our study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Animals, Newborn
  • Apoptosis / physiology
  • Disease Models, Animal
  • Enterocolitis, Necrotizing / pathology*
  • Enterocolitis, Necrotizing / prevention & control*
  • Hyperbaric Oxygenation*
  • Ileum / pathology
  • In Situ Nick-End Labeling
  • Intestines / pathology*
  • Lipid Peroxidation / physiology
  • Malondialdehyde / analysis
  • Oxidative Stress / physiology
  • Rats
  • Rats, Sprague-Dawley
  • Tumor Necrosis Factor-alpha / analysis


  • Tumor Necrosis Factor-alpha
  • Malondialdehyde