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• For ages one has been thinking of treating hypoxemia by oxygenation through lungs.
• It is a well known fact that oxygen is deleterious to lungs and specially to injured lungs
and the group firmly believes that exposing lungs to high concentration of oxygen and time
at high pressure could be harmful.
• Lungs when injured would need some healing time and exposing them to high
concentration and pressure of oxygen may in fact delay this basic aim of therapy.
• · The RDS group has been formed to promote new concept and research in the
direction of offering partial support to respiratory system through the membrane
other than lung.
• We would appreciate if you can give a patient thought to our selfless concept and
unique idea, undertaken for the benefit of mankind and help us in spreading the word
further.
As we know Respiratory failure is the inability of the lungs to perform their basic task
of gas exchange, the transfer of oxygenfrom inhaled air into the blood and the transfer of
carbon dioxide from the blood into exhaled air.
Causes
Our Thought
The original thought came while observing an earth worm. It is wonderful that in
earthworm the entire respiration is through the skin. An earthworm has no respiratory
organ. It takes in oxygen directly through its skin and gives off carbon dioxide.
Earthworms rely on their moist bodies for oxygen to diffuse into the blood circulating
near the surface of their skin. The reason that earthworms come to the surface when the
ground is water saturated is because it needs the air circulating in the soil to diffuse
enough oxygen into their blood.
Another support for this theory is the respiratory system of the amphibian Frog, as partial
support for respiration through skin is seen possible in frog. An extensive network of
blood vessels runs throughout the frog’s skin. Oxygen can pass through the membranous
skin, thereby entering directly into the blood. When a frog submerges beneath the water,
all its respiration takes place through the skin. Oxygen is obtained directly from the
water. Though it can breathe by simply opening its mouth and letting air flow into its
windpipe.
3. In most situations the lungs are damaged and they are exposed to high concentrations
of oxygen.
4. At times lungs are exposed to supra normal pressure. This is done with full knowledge,
accepting the risk of life threatening risk of air leak and known risk of broncho pulmonary
dysplasia.
Q.1. The question that arises is “Is there no alternative to getting oxygen in the
body and also save the lungs?”
• At the moment we are possibly blocked with the idea that there is no alternative to the
lungs as source of oxygen even if they are damaged and even if this means significant
amount of risk to life.
Q. 2 Secondly we ask “Is there no surface which could take at least partly
over the function of gas exchange?”
• Intravenous oxygenators have been tried and they do result in increasing the arterial
oxygenation.
• At the moment what we expect from such a surface is a part support to say
oxygenation.
• Patient with PaO2 of around 40 and on ventilatory settings which don’t look very good
have an option to either accept the risk of ventilator associated lung injury or may be die of
hypoxemia.
Ultimately the answer to this question at the moment is no, we don’t by pass the lung
completely but try and look for a membrane through which oxygen may be driven in.
We concluded that
• Laparoscopist,s know this well that carbon dioxide easily passes through peritoneum
and the moment carbon dioxide is put in the peritoneal cavity end tidal CO2 increases.
• If this happens our patients with respiratory failure would be treated by nephrologists
rather than by intensivists.
Any other membrane can be thought, we have studied skin as a membrane for
oxygen transport.
8) Hyperoxia is unlikely.
2. In patients with shock this would almost certainly not work, until the efforts are made
to improve the circulation.
1) With open mind give a thought to the issue of trans cutenious gas transport, it may
or may not work but surely needs a serious attention.
2) Contribute your ideas, and if you know some one who has similar interests please
let us know.
3) This is a non profit making organization and we would welcome some one who
could help us grow with their support.
5) Even if the remarks are contrary to what we think, please pen them for us.