Cardiologists believes that injecting oxygen into the bloodstream could be the answer to saving lives. One of the biggest problems faced by doctors dealing with critically ill patients is how to keep them breathing.if there is no oxygen in the blood,the gas will not get to the vital organs and thats when cardiac arrests or brain injuries occur,of course,there are machines which help to keep blood oxygenated but they arent always readily available and can take a considerable time to set up.
What if doctors were simply able to inject oxygen into the blood?until now,restoring the oxygen level of the bloodwith a jab has been out of the question because potentially fatal air bubbles can form in the syringe.
However,a study by Dr John Kheir,a cardiologist at boston children's hospital in the Us,might be able to change all that.He was inspired to act after he needlesly lost a young patient with pneumonia. Her damaged lungs were filled with blood but ,by the time the doctors had set up a heart -lung bypass machine she'd suffered severe brain damage owing to a lack of oxygen.
i was frustrated that all we had needed to do was to provide oxygen to her blood for just a few minutes and that could have prevented her death said Dr Kheir.
Many patients die every year from critically low oxygen levels.The typical treatment for these patient involves increasing the amount of oxygen they receive by the placement of a breathing tube or by using a heart lung by pass machine.
The problem is these measures take time to put into place,and during this time,low oxygen levels can cause the heart to function poorly,lowering blood pressure and causing cardiac arrest or brain injury. Dr Kheir has now developed a jab which can be used by paramedics to inject patients safely with oxygen.
First responders face challenges that include difficulty in maintaining or obtaining an airway that results in a loss of critical time said Prof John F Beshai,director of pacemaker and defribilator services at the University of chicago. Advances in resuscitation that can maintain adequate oxygenation of tissues and organs just long enough to get the patient to a centrewhere further life-savinf measures can be implemented would be a major breakthrough.
However Dr Duncan Young,senior lecturer in anaesthetics at the University of Oxford is less positive and foresees a possible stumbling block in getting funding for the treatment,which would only ever benefit a small group of people. He said it could help only those in a situation in which simple measuresto maintain blood oxygen levels have failed and who have acess to a secondary long term solution such as a heart-lung machine or extracorporeal membrane oxygenation(ECMO)services.
The number of patients this could actually help is very small said Dr Young This drug could only be used in specialist centres.
However there are only five ECMO centres in the UK.It would also have to be stable in storage,which would be unlikely,as oxygen is a highly reactive chemical.
Addittionally,the nature of the treatment means that it could be used only in cases where the patient's blood was still circulating efficiently. Studies in humans were conducted in the 1990s to see if similar agents could reduce the size of heart attacks,but with no real sucess said Prof John Cleland,from Hull York Medical School.
The bigger issue may be less about whether an oxygenated blood substitute can be created but rather what should it be used for.
The patient still needs to have blood circulating around the body for these agents to work and deliver the oxygen.
However there's no denying the importance of Dr kheir's study.
His peers admit its conscequences could be huge if he gets US Food and Drug Administration approval.
The concept of the therapy seems sound said Allen S Anderson from the university of Chicago Medical Centre.While many of the patients would ultimately need ECMO and many centres dont have this technology,there are some scenarios where the theraphy might be useful without the need for ecmo.
And for those of us practising in centres with ECMO-we 've all had patients in whom it couldnt be started rapidly enough to prevent brain damage.
Buying 20to 30 minutes of time could be the difference between life and death.
1.The encapsulated oxygen bubbles were then suspended in a liquid emulsion,which meant they were unable to form larger bubbles which could block blood flow.
2.Dr Kheir and his team then injected rabbits with this "lipid foam" and found out that by doing so they were able to normalise the blood oxygen levels of the animals.
3.To test how these microparticles fared in a more extreme situation,Dr Kheir and his team then completely blocked the rabbit's tracheas before immediately injecting the particles.The rabbits stayed alive for 15minutes without taking a single breath.
WHATS NEXT
Dr Kheir and his team are refining the suspension aspect of the procedure.They hope to make an application to the US Food and Drug Administration within the next few years.This could,in theory see this treatment become widely available.
source;METRO
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