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NCT Number: NCT07263399

Effect of Hydrogen Gas on Hyperbaric Oxygen Toxicity

The goal of this trial is to investigate whether adding a small fraction of hydrogen gas to an oxygen-enriched breathing mixture can reduce pulmonary oxygen toxicity (POT) in healthy and active divers from the Swedish Armed Forces. The main questions it aims to answer are:

* Does hydrogen gas reduce oxidative stress and changes in pulmonary function associated with prolonged hyperbaric oxygen exposure? * What are the underlying pathophysiological mechanisms of pulmonary oxygen toxicity?

Researchers will compare oxygen-enriched breathing gas with 1-2% hydrogen to oxygen-enriched gas with 1-2% nitrogen (control) to see if hydrogen provides protective effects against POT during hyperbaric exposure.

Participants will:

* Complete two hyperbaric exposure sessions (hydrogen vs. nitrogen), each lasting 240 minutes at 1.75 ATA * Undergo pulmonary function tests and sampling of blod and urin before and after each session * Serve as their own controls in a double-blind, randomized, crossover study design

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Key information

Age range

20 year–64 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Blekinge Institute of Technology, Karlskrona, Blekinge County, Sweden

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Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Military divers actively serving, aged 20-64 years
  • Meeting the Swedish Armed Forces physical standards for diving

Exclusion criteria

  • Ongoing infection or illness that may impact pulmonary function
  • Use of alcohol or smoking cigarettes within 48 hours
  • Diving with any breathing gas within 48 hours
  • Diving with oxygen-enriched gas (100% O₂) within 2 weeks
  • Use of medications that could affect oxidative stress, lung function, or neurological status
  • Medical history of serious diving-related injuries or long-term complications

Treatment and study plan

Inhaled Hydrogen-Enriched Oxygen Gas

Other

Participants will inhale a gas mixture consisting of 98-99% oxygen and 1-2% hydrogen via a breathing circuit during a single hyperbaric exposure. The exposure will be conducted at a partial pressure of 1.75 ATA for 240 minutes. The intervention aims to evaluate the protective effect of hydrogen gas against pulmonary oxygen toxicity.

Inhaled Nitrogen-Enriched Oxygen Gas

Other

Participants will inhale a gas mixture consisting of 98-99% oxygen and 1-2% nitrogen via a breathing circuit during a single hyperbaric exposure. The exposure will be conducted at a partial pressure of 1.75 ATA for 240 minutes. The intervention aims to evaluate the protective effect of hydrogen gas against pulmonary oxygen toxicity.

Primary outcomes

  1. Change in Vital Capacity (ΔVC)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    Absolute change in vital capacity (VC), calculated as the difference in liters (L) between pre-exposure and post-exposure spirometry values, measured after each hyperbaric oxygen exposure session.

Secondary outcomes

  1. Forced Expiratory Volume in One Second (FEV₁)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure

    As part of the spirometric and plethysmographic measurements, Forced Expiratory Volume in 1 second (FEV₁) will be analyzed. This represents the change (ΔFEV₁) in liters (L) between pre- and post-exposure spirometry, indicating expiratory flow capacity. Measurements follow ATS/ERS 2019 standards.

  2. Change in FEV₁/FVC ratio

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure

    As part of the spirometric and plethysmographic measurements, the ratio between Forced Expiratory Volume in 1 second and Forced Vital Capacity (FEV₁/FVC) will be calculated. The change (ΔFEV₁/FVC) is expressed as a percentage (%) to assess airflow limitation or restriction following hyperbaric oxygen exposure.

  3. Change in Forced Expiratory Flow 25-75% (FEF25-75%)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    As part of the spirometric and plethysmographic measurements, the mid-expiratory flow (FEF25-75%) will be assessed. This parameter reflects the mean expiratory flow between 25% and 75% of FVC and serves as an indicator of small airway function. Values are expressed in liters per second (L/s).

  4. Change in Peak Expiratory Flow (PEF)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    As part of the spirometric and plethysmographic measurements, Peak Expiratory Flow (PEF) will be analyzed. The change (ΔPEF) represents the maximum flow achieved during forced exhalation, measured in liters per second (L/s). This outcome evaluates large airway performance.

  5. Change in Inspiratory Capacity (IC)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    As part of the spirometric and plethysmographic measurements, Inspiratory Capacity (IC) will be determined. The change (ΔIC) in liters (L) reflects the maximal volume of air that can be inspired after a normal exhalation, providing insight into potential restrictive changes following exposure.

  6. Change in Total Lung Capacity (TLC)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    As part of the spirometric and plethysmographic measurements, Total Lung Capacity (TLC) will be assessed. The change (Δ TLC) in liters (L) represents the total volume of air contained in the lungs after maximal inspiration, used to detect restrictive or hyperinflation patterns following hyperbaric oxygen exposure.

  7. Residual Volume (Δ RV)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    As part of the spirometric and plethysmographic measurements, Residual Volume (RV) will be assessed. The change (Δ RV) in liters (L) represents the volume of air remaining in the lungs after maximal exhalation, used to detect gas-trapping or hyperinflation patterns associated with pulmonary oxygen toxicity

  8. Functional Residual Capacity (Δ FRC)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    As part of the spirometric and plethysmographic measurements, Functional Residual Capacity (FRC) will be assessed. The change (Δ FRC) in liters (L) represents the volume of air remaining in the lungs at the end of a normal tidal exhalation, used to detect early alterations in lung compliance or airway closure during hyperbaric oxygen exposure.

  9. Change in Diffusing Capacity for Carbon Monoxide (ΔDLCO)

    Time frame: Pre-exposure, 30-120 minutes post-exposure and 24-36 hours post-exposure.

    Absolute change in lung diffusing capacity for carbon monoxide (DLCO) , measured (mmol/min/lkPa) with single-breath DLCO test before and after each exposure, to evaluate alveolar-capillary gas exchange efficiency. DLCO values are adjusted for hemoglobin levels to improve measurement accuracy.

  10. Airway Resistance (Impulse Oscillometry, Tremoflo™)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    Assessment of central and peripheral airway resistance (R5, R20, X5) using impulse oscillometry (Tremoflo™) before and after exposure. Evaluates small airway mechanics related to hyperbaric oxygen exposure with or without hydrogen supplementation. Unit of Measurement: cmH₂O·s/L

  11. Index of Oxygen Stress (ΔiOS)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    Composite index derived from impulse oscillometry (Tremoflo™) representing the mean relative change from baseline in airway impedance parameters (R5, R20, X5). The Index of Oxygen Stress (iOS) quantifies oxidative stress-related changes in small airway mechanics following hyperbaric oxygen exposure with or without hydrogen supplementation.

  12. Change in Fractional Exhaled Nitric Oxide (ΔFeNO)

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    Measurement of airway inflammation and oxidative stress via fractional exhaled nitric oxide (FeNO) levels measured in parts per billion (ppb).

  13. Change in Exhaled Breath Particle Analysis (ΔPExA)

    Time frame: Pre-exposure and follow-up 24-36 hours post-exposure after each intervention.

    Change in exhaled particle count and biochemical composition (lipids, proteins, coagulation factors) reflecting epithelial lining fluid alterations.

  14. Blood and Urinary Biomarkers of Oxidative Stress and Inflammation

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    Analysis of venous blood and urine samples for biomarkers of oxidative stress (e.g., 8-isoprostane, MDA, 8-OHdG) and inflammation (e.g., IL-6, TNF-α) to evaluate systemic effects of hyperbaric oxygen exposure with or without hydrogen supplementation. Concentrations will be quantified in standard laboratory units, for example ng/mL, pg/mL, or other equivalent measures.

  15. Biomarkers of Neuronal Injury

    Time frame: Pre-exposure, 30-120 minutes post-exposure, and 24-36 hours post-exposure.

    Analysis of venous plasma samples for fluid biomarkers of neuronal injury (e.g., NfL, GFAP, Tau, UCH-L1) using NULISA™ or Simoa® HD-1 assay technologies, to evaluate central nervous system effects of hyperbaric oxygen exposure with or without hydrogen supplementation. Concentrations will be quantified in pg/mL.

Other outcomes

  1. Anthropometric Measurements (Weight, Height, Sex, Age, BMI)

    Time frame: Baseline (Pre-exposure, prior to first dive session)

    Anthropometric data will be recorded to assess body composition and physical characteristics of the study population and to enable adjustment for potential confounders in pulmonary function outcomes. This includes body weight (kg), height (cm), biological sex (M/F), age (years), and body mass index (BMI). These variables will not serve as primary endpoints but will describe baseline characteristics and support interpretation of within-subject changes in lung function.

Sponsors and collaborators

Lead sponsor

Blekinge Institute of Technology

Other

Collaborators

  • Göteborg University
  • Karolinska Institutet
  • Lund University
  • Swedish Armed Forces Diving and Naval Medicine Centre

Registry information

Official study title

Effect of Hydrogen Gas on Hyperbaric Oxygen Toxicity - A Randomized Controlled Cross-Over Trial

Important dates

Study start
2026
Primary completion
2029
Study completion
2030
First posted
Dec 4, 2025
Registry last updated
Dec 4, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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