Ozonation of blood during extracorporeal circulation. I. Rationale, methodology and preliminary studies
Bocci V, Di Paolo N, Garosi G, et al. International Journal of Artificial Organs, 1999.
- Study type
- Animal study
- Animals studied
- None (animal study)
- Population
- Saline and swine blood circulated through an oxygen-ozone gas exchanger in vitro, then sheep given extracorporeal circulation
- Published
- 1999, International Journal of Artificial Organs
- Identifiers
- PMID 10532435
What the authors reported
Dialysis-type membranes proved unsuitable for exposing blood to oxygen-ozone, so the authors used hydrophobic ozone-resistant hollow fibers. In saline, swine-blood and sheep tests they report that 10 µg/mL ozone produced biochemical effects, heparin was not an ideal anticoagulant, and sheep had no adverse effects after 50 min at 20 to 40 µg/mL, though the exchanger clogged with cells.
What limits this result
Bench and sheep development work on an extracorporeal gas-exchanger circuit, not the EBOO procedure as given to patients, and no clinical outcomes. The abstract does not say how many sheep were studied, describes no control group, and gives no numeric biochemical results. Abstract only.
How ozone acts on blood and cells, how blood filters work, the laboratory and device-development studies behind the EBOO circuit, and studies that measure markers in the blood rather than how patients fare. None of these shows whether EBO2 helps patients. One study rarely settles a medical question; our guides weigh each paper against the rest of the evidence.
How the study was done
- Design
- Feasibility study of exposing blood ex vivo to oxygen-ozone through a gas exchanger: saline tests, swine blood in vitro, then experiments in sheep
We investigated whether exposure of blood ex-vivo to oxygen-ozone (O2-O3) through a gas exchanger is feasible and practical.
- Setting
- Institute of General Physiology, University of Siena, Italy (author affiliation)
- Read from
- Read from the abstract only; where this page says nothing about an item, the abstract does not report it. Read on October 2, 2026.
Source: Abstract on PubMed
Study arms
| Group | Participants | What they received |
|---|---|---|
| Normal saline (bench test) | Not reported | Run through the system to measure hydrogen peroxide production at ozone concentrations from 5 to 40 microg/ml |
| Swine blood circulated in vitro | Not reported | Used to evaluate critical parameters of the system, including the anticoagulant |
| Sheep given extracorporeal circulation (number not stated) | Not reported | Several experiments to define anticoagulant dose (sodium citrate, ACD), priming solution, blood flow per minute, and the volume and concentration of the oxygen-ozone mixture |
Source: Abstract on PubMed
Procedure as reported
- Ozone concentration
- 20 to 40 microg/ml in the sheep (the higher concentrations tested)
The sheep showed no adverse effects even after 50 min of extracorporeal circulation at higher O3 concentrations (20 to 40 microg/ml)
- Session length
- Up to 50 min of extracorporeal circulation in sheep
The sheep showed no adverse effects even after 50 min of extracorporeal circulation
- Anticoagulant
- Sodium citrate (ACD); heparin found not ideal for this system
defined optimal anticoagulant dose (sodium citrate, ACD)
- Filter
- Hydrophobic O3-resistant hollow fibers in a polycarbonate housing, membrane area about 0.5 m2
In the paper's own units, not converted.
Source: Abstract on PubMed
What it measured
- Dialysis-type semipermeable membranes as the gas exchanger
- Found unsuitable because they are hydrophilic and vulnerable to ozone
- Heparin as the anticoagulant (swine blood in vitro)
- Not an ideal anticoagulant for this system
- Lowest ozone concentration with biochemical effects
- As low as 10 microg/ml was effective by the biochemical parameters (no figures in the abstract)
- Gas exchanger performance during perfusion in sheep
- Became less effective (low pO2 values) because of progressive clogging with cells
Source: Abstract on PubMed
Safety as reported
The sheep showed no adverse effects, even after 50 min of extracorporeal circulation at 20 to 40 microg/ml
Source: Abstract on PubMed
Where we cite this study
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