Intravenous oxygen: a novel method of oxygen delivery in hypoxemic respiratory failure?

Abstract

Hypoxemic respiratory failure is a common problem in critical care. Current management strategies, including mechanical ventilation and extracorporeal membranous oxygenation, can be efficacious but these therapies put patients at risk for toxicities associated with invasive forms of support. Areas covered: In this manuscript, we discuss intravenous oxygen (IVO), a novel method to improve oxygen delivery that involves intravenous administration of a physiologic solution containing dissolved oxygen at hyperbaric concentrations. After a brief review of the physiology behind supersaturated fluids, we summarize the current evidence surrounding IVO. Expert commentary: Although not yet at the stage of clinical testing in the United States and Europe, IVO has been used safely in Asia. Furthermore, preliminary laboratory data have been encouraging, suggesting that IVO may play a role in the management of patients with hypoxemic respiratory failure in years to come. However, significantly more work needs to be done, including definitive evidence that such a therapy is safe, before it can be included in an intensivist's arsenal for hypoxemic respiratory failure.

Oxygen delivery to the blood stream by the dialysis fluid during continuous renal replacement therapy ex vivo

“…Applying this method to the supplemental bicarbonate dialysis fluid, a significant increase in the pO 2 and simultaneous decrease in the partial pressure of carbon dioxide (pCO 2 ) were observed [8]. Gehlbach et al suggested that an intravenous (IV) supersaturated solution might also improve hypoxia in critically ill patients with respiratory failure [9].…”

Review of Oxygenation with Nanobubbles: Possible Treatment for Hypoxic COVID-19 Patients

“…51 , 52 IVO 2 is an alternative to invasive methods of alveolar gas exchange (such as ECMO), providing direct oxygen delivery through IV administration of a physiologic oxygen solution at concentrations exceeding normal atmospheric pressure to hypoxemic patients. 53 Historically, the first application of IVO 2 using simple gaseous oxygen was introduced by Nysten in the early 19th century. 54 In 1902, the first oxygen administration to a living human via the IV route was performed by Mariani.…”

“…However, recent studies have proven that IVO 2 delivered by NBs is a noninvasive technique that could be safe enough to be included in the arsenal for hypoxemic respiratory failure. 53 Another concern is related to premature oxygen release during the vascular injection of ONBs, which could be overcome by the development of various chemical or biological formulations to decline the surface tension and to improve the stability of ONBs in the human body. Free ONBs that are not coated and stabilized by any component in the shell structure dissolve quickly in the circulation, while the use of surfactants, lipids, proteins, and their combinations can avoid disproportionation, coalescence, and undesired oxygen release.…”

“…59 Additionally, by injection of an oxygensaturated solution into patients, deoxygenated hemoglobin (Hb) can bind to free O 2 molecules, thus instigating an increase in SpO 2 without any dependence on continuous oxygen delivery in vivo. 53 The best clinical route involves an IV infusion because of its ability to be delivered in large volumes at one time or spread out over long periods. The advent of oxygen-filled MBs and NB-based hyperbaric oxygen carriers has led to innovative approaches for the oxygenation of hypoxic tissues.…”

“…Oxygen therapy is a valuable therapeutic method that helps to maintain cell metabolism and preserve organ function in various clinical situations, especially in acute respiratory diseases, where the restoration of normal tissue oxygenation is needed . One of the major challenges is to overcome hypoxia and hypoxemia using a technology that reduces harm while supplying adequate oxygen in a cost-effective, biocompatible, and user-friendly manner. , IVO 2 is an alternative to invasive methods of alveolar gas exchange (such as ECMO), providing direct oxygen delivery through IV administration of a physiologic oxygen solution at concentrations exceeding normal atmospheric pressure to hypoxemic patients . Historically, the first application of IVO 2 using simple gaseous oxygen was introduced by Nysten in the early 19th century .…”