Immunomodulation by extracorporeal ozone-based bactericide system in porcine Pseudomonas aeruginosa septic shock
Rundgren H, Sjöholm J, Juric S, et al. Scientific Reports, 2025.
- Study type
- Animal study
- Animals studied
- 13 animals
- Population
- 13 swine with P. aeruginosa septic shock, allocated to extracorporeal ozone treatment (7) or no ozone treatment (6)
- Published
- 2025, Scientific Reports
- Identifiers
- PMID 40562794, DOI 10.1038/s41598-025-07408-5
What the authors reported
In pigs with P. aeruginosa septic shock (7 ozone, 6 none), one pass through the system cut viable bacteria by 53%, but bacteria in peripheral blood and survival (median 134 vs 159 min) did not differ. IL-1β, IL-4, IL-6, IL-8 and IFN-γ fell with ozonation, complement did not; hemoglobin, hematocrit, noradrenaline doses, breathing rate and peak airway pressure were lower with ozone.
What limits this result
Not the EBOO procedure: a prototype that cools blood and mixes it with oxygen-ozone gas, at about 50 mL/min (about 2 L over 4 hours), in pigs. Small 4-hour feasibility study; groups were allocated, not stated as randomized, and with no ozone-free control circuit ozone is not separated from cooling or circuit effects. Funded by Sangair; two authors own or work for Sangair.
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
- 4-hour swine sepsis model: P. aeruginosa infusion with or without extracorporeal ozone treatment (groups allocated)
- Setting
- Section for Experimental Traumatology, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden (corresponding author's affiliation)
- Read from
- Read from the full text of the paper. Read on October 2, 2026.
Source: Abstract on PubMed
Study arms
| Group | Participants | What they received |
|---|---|---|
| P. aeruginosa infusion and ozone treatment | 7 | P. aeruginosa infusion with extracorporeal ozone treatment |
| P. aeruginosa infusion, no ozone treatment | 6 | P. aeruginosa infusion without ozone treatment |
Source: Abstract on PubMed
Procedure as reported
- Ozone concentration
- Below 100 g/m3 (gas flow 15 mL/min)
The ozone concentration was maintained below 100 g/m 3 , with a gas flow rate of 15 mL/min.
- Blood volume
- Approximately 2 L of blood over the 4-h experimental period
the extracorporeal ozone treatment was administered at a flow rate of 50 mL/min, treating approximately 2 L of blood over the 4-h experimental period
- Session length
- Mean (SD) 134 (67) min
- Blood flow
- Average 50 mL/min
blood was drawn from the venous circulation of the swine at an average flow rate of 50 mL/min
- Anticoagulant
- Heparin: 4000 IU IV 15 min before ozone therapy, then 33 IU/kg/h throughout the treatment period
4000 IU of heparin was administered intravenously 15 min before ozone therapy began, followed by a continuous infusion of 33 IU/kg/h throughout the treatment period.
- Filter
- SangAsept blood ozonation prototype (patent no. WO2016/043649)
In the paper's own units, not converted.
What it measured
- Viable P. aeruginosa after a single pass through the system
- Decreased by 53%, mean 2193 to 1023 CFU/mL; mean of differences -1170 (95% CI -1689 to -651, P < 0.0001)
- Viable bacteria in peripheral venous blood, ozone vs no ozone
- No difference between groups (P = 0.68)
- Cytokines
- IL-1β, IL-4, IL-6, IL-8 and IFN-γ decreased by ozonation; TNFa, IL-2 and IL-10 were not affected
- Classical and alternative complement pathways
- Not affected
- Hemoglobin, hematocrit, and noradrenaline doses
- Decreased in the ozone treatment group
- Breathing frequency and pulmonary peak airway pressure
- Decreased in the ozone treatment group
- Survival
- Median 134 min with ozone treatment and 159 min without; no statistical difference
- Methemoglobin
- Did not increase
Methemoglobin levels did not increase, consistent with findings from our previous investigation
Safety as reported
The authors state the system was compatible with an intensive care environment and did not induce any observable physiological adverse effects
Source: Full text on PubMed Central
Follow-up
Animals euthanized at the end of the experiment or at the time of circulatory collapseAt the end of the experiment, or at the time of circulatory collapse, the animals were euthanized with 40 mL pentobarbital sodium (Alfatal Vet 100 mg/mL)
Source: Full text on PubMed Central
Funding and conflicts
Funded by an unrestricted grant from Sangair AB (Sweden)
Source: Full text on PubMed Central
Where we cite this study
Does EBO2 (EBOO) Work? The Evidence, Study by Study
Every study in our EBO2 (EBOO) library in one place: design, size, what was measured and found, its limits, and a check for any study a clinic cites.
EBO2 (EBOO) for Lyme Disease: Clinic Claims, the Missing Evidence, and Standard Care
Nearly half the EBO2 (EBOO) clinics we read list Lyme disease. What they claim, why no study has tested ozone against Lyme, and what CDC lists as care.
What Does the EBO2 (EBOO) Filter Actually Remove?
What the EBO2 (EBOO) filter removes: what papers measured, what is theory borrowed from dialysis, what clinics claim, and what a filtrate lab report must show.