O2 & CO2 AS DRUGS? PRESENTATION NOW ONLINE
SPEAKER SPOTLIGHT ~ MERVYN SINGER
Oxygen and carbon dioxide as drugs
"It may be argued that such measures as the administration of oxygen are at best only palliative and of no real use, since they do not remove the cause of the physiological condition, As a physiologist, I cannot for a moment agree with this reasoning. The living body is no machine, but an organism constantly tending to maintain or revert to the normal; the respite afforded by such measures as the temporary administration of oxygen is not wasted, but utilised for recuperation." Thus spake the great Oxford physiologist, John Scott Haldane, a century ago.
Was Haldane right? Clearly, yes, but to paraphrase Paracelsus, 400 years earlier, "All things are poison and nothing is without poison, only the dose permits something not to be poisonous."
So, we need to work out when hyperoxia is beneficial or deleterious, when maintaining normoxaemia is better or worse than the adaptive responses initiated by hypoxaemia, and how best to deliver the oxygen. Do we need a ventilator or an extracorporeal circuit to deliver the oxygen yet at a considerable cost in terms of collateral damage? How about intestinal, rectal or even intravenous routes of delivery?!? Yes – there is a supportive literature!
Likewise, hypercarbia may have merit as a therapy, either by direct effects on regional blood flow or by inducing adaptive effects, for example on the Bohr oxyhaemoglobin curve, immunomodulation and inhibition of fibroproliferation. On the other hand, a high carbon dioxide is also associated with harm, e.g. increased bacterial virulence, muscle wasting and decreased alveolar fluid reabsorption.
So what's the answer? What is truth? To cite Bob Dylan "The answer, my friend, is blowin' in the wind" But, alas, the wind can and does blow in different directions.
Join Mervyn Singer for this enlightening presentation...
Keynote Lecture ~ BEYOND GAS EXCHANGE: O2 & CO2 AS DRUGS
Monday September 29th, 2014, 08:00 – 08:25, room Barcelona
SEE THE FULL PRESENTATION HERE:
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