Injectable oxygen keeps people alive without breathing | Hacker News Reader

Injectable oxygen keeps people alive without breathing

techandfacts.com

200 pointsTeMPOraL63 comments

Oxygenation is only part of the problem, so I'm a little wary of the title "Injectable oxygen keeps people alive without breathing" [emphasis added].

EDIT: The actual paper's [2] title and abstract reads "Boosting Oxygenation During Acute Respiratory Failure - A new microparticle-based oxygen-delivery technology has been developed for short-term resuscitation of pulmonary function" [emphasis added].

The real problem is ultimately ventilation, or gas exchange at the alveoli. When it's impaired, both oxygenation and removal of carbon dioxide are affected. One result is respiratory acidosis. There is some literature[1] indicating the body can tolerate such acidosis better in the absence of hypoxemia so the cited idea may have merit as a stopgap measure, but I'm not sure how effective this scheme would be in near or complete absence of ventilation - like the example cited where the little girl's lungs are full of blood.

[1] - Acute Respiratory Distress Syndrome: Adjuncts to Lung-Protective Ventilation; http://www.medscape.com/viewarticle/410886_2

[2] - http://stm.sciencemag.org/content/4/140/140fs21.abstract?sid...

Right, this definitely seems like it's really to be used when oxygenation is the main problem. I'm guessing they'll worry about the acidosis after they get your heart and lungs working again. I'm not so sure about the suggestion in the article that this is going to be used by divers.

this question exposes my ignorance of how lungs work, but in a situation where the lungs were in good working order, would carbon dioxide build up in them (to be breathed out)?

Only until the partial pressure of CO2 was in equilibrium between the volume of air in the lungs and the the body tissues. It's like bailing out a boat -- it only works if you empty the bucket periodically.

could you "breathe" a small volume of something inert in and out, and have a CO2 scrubber?

Presumably, if your lungs were working well enough for that to be an option, you could just breathe air.

The bigger problem is oxygenation, at least in the short term. You can worry about ventilation later.

Lack of oxygen delivery from the blood will kill the brain sooner than the acidosis. Specifically, if this substance actually existed in a working form usable by humans, I could imagine its frequent use in pulseless electrical activity arrest. In PEA arrest, you fix the arrest by fixing the underlying problem; hypoxemia is one of the catch-all problems, and such a technology could permit you to intervene on hypoxemia even before you get airway control.

Yeah, big cause of PEA is hypoxia - delivery of this substance directly to an end organ's (brain) vasculature reliably and quickly (albeit in the absence of efficient circulation) is an interesting thought.

A research article about work by the same researcher:

http://stm.sciencemag.org/content/4/140/140ra88

There have been several submissions of articles to Hacker News based on press releases from that researcher's lab that go far beyond the firm research findings here. This is preliminary research. Peter Norvig, director of research at Google, reminds readers of press releases about scientific research what to look for in his online essay, "Warning Signs in Experimental Design and Interpretation."

http://norvig.com/experiment-design.html

The preliminary experimental findings here are a LONG way from showing that human beings can breathe underwater to do work underwater without scuba apparatus, or that patients with severely damaged lung tissue can recover from that life-threatening condition.

Such a wet blanket you are! :-) Ok so the actual research doesn't live up to the press release, I for one wasn't particularly surprised by that.

I was pleasantly surprised though that they managed to get cell/oxygen transfer in bodily fluids without hemoglobin. One of the challenges of heart/lung machines is the variability of the oxygen absorption leading to variable oxygen levels during a procedure that have post operative effects. So if its even possible to replace the current oxygenation in a heart/lung machine with an injector/cleaner of oxygen laced nano-particles it seems plausible it would improve outcomes.

We will ignore for the moment that a "bad guy" would love to mix up a Malatov cocktail with a shot of this stuff for a bit more punch.

If this stuff was shelf stable one could imagine and AED that would be even better than the current setup, both keeping oxygen levels within spec and shocking the heart when needed, of course we still need to work on robo-insertion of IV needles [1].

[1] https://www.stanford.edu/group/sailsbury_robotx/cgi-bin/sali...

> “Some of the most convincing experiments were the early ones,” Dr. Kheir said. “We drew each other’s blood, mixed it in a test tube with the microparticles, and watched blue blood turn immediately red, right before our eyes.”

That sounds very unconvincing to me, considering that actual human blood is never blue, not even when deoxygenated.

Blood from arteries are light red, while blood from veins is dark red. I don't know, but could not 'blue blood' be a term used for deoxygenated blood?

Or just someone without medical training going by what they see, I mean I look at my veins in my arms and they look blue but I have no idea why that is.

That's just an optical effect caused by the fact that the veins are (normally at least) underneath the skin. Even oxygen poor blood is not blue.

Yeah I figured something like that.

I found this very detailed explanation, in a nutshell skin scatters light. https://www.imt.liu.se/edu/courses/TBMT36/pdf/blue.pdf

And this list of animals with actual blue blood, when its healthy and oxygenated not de-oxygenated: http://www.buzzfeed.com/donnad/10-animals-that-bleed-blue

You can try a little experiment... Cut a slim slice of ham and put it over something red. See for yourself.

Back in the days where men were made of iron and ships from wood...

... the only people with ski so thin that the veins could be seen through it were the "noble" ones. Looking at their hands it seeemed like they had blue blood.

At least that was the explanation of "blue blood" that I got when I was a kid ;-)

I'm really hoping that it's a euphemism for the press. Unfortunately this will keep people thinking blood can be blue :/

Blood can be blue-- if you're a hermit crab.

That line actually makes me doubt the authenticity of the article.

This technology will never allow you to "breathe". Breathing does two things, it adds oxygen and removes CO2. The human body requires about a liter of oxygen every 3 minutes. I don't know how big their syringe is, but I doubt they can inject this much. Also, they provide no mechanism for carbon dioxide removal. After a while, the carbon dioxide buildup in the body would become toxic. At most, they could keep a sedated patient fully oxygenated for about 10 minutes. Potentially useful in a medical emergency, but that's about it.

If you haven't heard it before, the Rule of 3 Survival usually applies.

3 minutes without air

3 hours without shelter (extreme conditions, hot or cold)

3 days without water

3 weeks without food

However, there have been documented cases of extraordinary human survival.

"Swedish Man Survives Two Months Inside Snow-Covered Car"

http://newsfeed.time.com/2012/02/21/swedish-man-survives-two...

and documented doubts about those cases http://www.telegraph.co.uk/news/worldnews/europe/sweden/9106...

ok, a better example. The point remains that the body can do amazing things to survive once it reaches the point of possibly no return.

"Cold comfort: hibernation helped man survive 24 days in wild"

http://www.smh.com.au/articles/2006/12/21/1166290678782.html

while i don't have a handy link doubting this one, there's not actually any proof that he really spent 24 days "hibernating"

It's a good rule but in extreme cases I'm sure it can go either way such as free-divers who can hold their breath for five to ten minutes when diving but the world record is 22 minutes (when not diving).

That's because as you descend, the partial pressure of oxygen increases. You require somewhere north of 0.10 Pa02 for consciousness; at sea level you have 0.21 Pa02. So you can consume enough oxygen at depth that when you rise you grey or black out; it's common enough that if you take a breath-hold diving course they will train you to 1 - know how it occurs; 2 - dive in pairs (always one up, one down); and 3 - make sure you are weighted so that your body is buoyant by 20 ft or so.

Also when under pressure the spleen shrinks substantially which raises the level of oxygen-enriched hemoglobin.

I've read plasma gets squished out of your blood and fills body cavities such as sinuses to keep your head from imploding.

there's also a reflex which causes your hearth rate and breathing to slow if you feel cold water on your face.

...who would be able to breathe underwater for 30 minutes at a time without coming above for air.

This seems like a loose interpretation of "breathe". But leads to a question I had -- assuming the injection described in the article works properly, what would the result of inhaling water be? I can't imagine it's very comfortable, but assuming the person's oxygen is handled by this injection, would the body adjust?

>> what would the result of inhaling water be? drowning? you have many reflexes built into you to prevent you being okay with liquid inhalation.

THe point is they wouldn't need to exhale or inhale. They just hold their breath for a long time

The breath reflex is controlled (in most people) by CO2 which is unaffected by this. You would not be able to hold your breath.

You could perhaps inhale and exhale a small amount of gas through a CO2 scrubber?

There is an oxygen reflex as well, but it's not as powerful as the CO2 reflex.

According to Wikipedia [1], water in the lungs has some nasty effects aside from just oxygen deprivation. Lungs have such a huge internal surface area to allow things to diffuse in and out of the bloodstream, including water. Unless you were breathing an isotonic saline solution, your blood would quickly become either too thick or too dilute to support life.

[1]: http://en.wikipedia.org/wiki/Drowning#Pathophysiology

You can't inhale water easily, there's a reflexive response to water hitting the face that prevents it.

This is true. It's a very unnatural experience, however it is possible to breath a liquid that can function as a transfer fluid for oxygen instead. Whether that's entirely safe is another matter.

http://chemistrydaily.com/chemistry/Liquid_breathing

no doubt. lots of other folks have raised questions about how to deal with the metabolic acidosis that would result.

I remember reading that they'd kept mice alive and supposedly healthy on the liquid oxygen, but haven't heard much about it beyond that.

Yes, it was in the news and I saw it on TV a few times. That was the work of Dr. Leland Clark : https://en.wikipedia.org/wiki/Leland_Clark

The reason we haven't heard much about it since is, unfortunately, he passed away in 2005. I don't know how far the current research has progressed without him, but I hope we can see more activity in the future carried on by his successors.

His product is still available though: http://www.oxycyte.com

See also the film "The Abyss" in which a rat is submerged in an oxygenated fluid, thus breathing the liquid. This technique is used for some military diving.

(https://en.wikipedia.org/wiki/Liquid_breathing)

> See also the film "The Abyss" in which a rat is submerged in an oxygenated fluid ...

And then a person, if the events in the film can be taken as reflecting reality.

Except during filming a real rat really was submerged in oxygenated fluid.

> Except during filming a real rat really was submerged in oxygenated fluid.

Yes, and even though I thought they might have gotten actor Ed Harris to also breathe the liquid, this account -- http://en.wikipedia.org/wiki/The_Abyss -- says he didn't.

Interestingly, the mouse scene had to be edited out for the version shown in Great Britain, on the ground that it constituted animal cruelty, something the British ... umm ... feel rather strongly about ... wait, let me try again ... about which the British feel rather strongly? Anyway, the mouse scene was something ... wait for it ... up with which the British refused to put. :)

It's not used because the available oxygen density from the liquid is too low - a rat might survive as its volume is smaller but I am not sure of any long term research, or even anything other than a rat that might have held its breath.

The abyss was making it up.

Yes that is the exact reason you can't fully use the method on humans. You could partially flood the lungs and that would help in some cased but not for diving.

According to this NYT article[1] the rat was indeed submerged in the movie (the scene wasn't faked). The article also states that it's been tested successfully on numerous animals - and even one human (although apparently they almost died in the process).

[1] http://www.nytimes.com/1989/08/06/movies/film-the-abyss-a-fo...

A small step toward the real thing: http://en.wikipedia.org/wiki/Respirocyte

How do they remove the CO2?

They don't, is my understanding. Not healthy, but healthier than no oxygen, so might be useful in some emergency situations.

It's saddening to see the potential uses go from saving a little girl's life to "military, coverts teams, even oil rig crews".

Researchers took years to whittle it down to the right oxygen concentration and size required to make it safe to inject. They used a sonicator that uses sound waves to blend the oxygen and fats together.

the manufacturing process sounds so simple. However if it will one day be in every hospital, these people will be millionaires with rights to the invention.

That sounds about as simple as ‘Just write a kernel and a userland and then use some glue to hold it together’. The relevant point here is the ‘size’/length of the oxygen-transporting molecules.

Could this be used to increase athletic performance?

Also, I'm wondering if there would be any negative effects from radically increasing the amount of oxygen your blood can hold. On the other hand, it would be like a superpower. I can imagine competitive free-divers using this or a future version of this to do some really impressive diving!

I'm a little confused by the text. Can this be used to sustain someone indefinitely without breathing?

It seems like that might be eventually possible, but for now the technology is limited to a few minutes - like until an airway passage could be cleared.

Nope. It gives the body/brain the O2 it needs to survive for a while, but CO2 will still build up, leading to:

http://en.wikipedia.org/wiki/Respiratory_acidosis

Probably. So a life-saving measure in extreme circumstances, but certainly not something you can use indefinitely.

"It could sustain patients between 15 and 30 minutes after experiencing respiratory failure."

Sounds like a candidate to go right next to epipens in "stuff that we're crazy for not putting in every first aid kit".

We have wasps around our farm and a fair bit of traffic, I was seriously seriously concerned about someone getting stung and going into anaphylactic shock. I looked into getting some Epipens. They are over 100 bucks a pen, and they don't have a long shelf life.

Turns out a more economical solution is Benadryl. Cheaper, you can smash it up, pour it in water and force it down someones throat if they can't drink.

Oh, yeah, the cost issue with EpiPens is a huge barrier. Getting a doctor to prescribe you one when you don't have a documented life-threatening allergy is another.

As far as I can tell, there's no fundamental reason for either of these issues. Epinephrine doesn't seem to be particularly expensive to produce, so my guess is that the auto-injectors are expensive simply because of the small scale of the market.

As for doctor reluctance, I don't know what's going on there. Our doctor said he didn't want to give us a prescription because he "didn't want us to use it instead of calling an ambulance". Ridiculous. An ambulance would easily take 10 minutes to reach us. Without oxygen, that's enough time for irreversible brain damage. (I'm also iffy on the wisdom of taking someone whose immune system you've just suppressed into a breeding ground for drug-resistant bacteria, but I digress).

Which brings me to one last thing: you cannot rely on benadryl as a solution in cases of anaphylaxis. For one thing, the onset orally is a minimum of 15 minutes. That's time you simply do not have if someone's airway has closed.

Worse, there isn't really good evidence that benadryl is effective at treating the symptoms of anaphylaxis in the first place. It is commonly used as an adjunct to epinephrine. But this seems to be on a "hey, it can't hurt" basis, given the lack of evidence.

For my part, $200/year (you should have two, in case the first is insufficient) is well worth it.

Thanks for the insight. I agree with your assessment. Though I think two pens might be overkill, I'll definitely get one as a present.

No pinchzoom on iPad. Why do sites like this go out of their way to disable useful functionality.

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