Anal oxygen administration may save lives

Allegra Wisking
May 16, 2021

The COVID-19 pandemic has shown the need for better means of medical ventilation. In recent years, researchers have been exploring the possibility of anally administering oxygen, offering an alternative to other methods of artificial ventilation - e.g. tracheal intubation. They were inspired by various species of fish, including the weather loach, that breathe through their bottoms and absorb the oxygen via their highly vascular guts.

Food for Thought

Why would anally administered oxygen be favourable over current methods of artificial ventilation?

Interventions such as tracheal intubation are invasive and uncomfortable for the patient. Though rectal administration sounds worse, it is actually much gentler on the body. Usually patients requiring artificial ventilation already have a lot of stress on their body due to the condition they are suffering from, therefore the least intrusive intervention is desirable to reduce any additional stresses. Do you think these potential benefits outweighs the embarrassment and discomfort a patient may feel?

Has this therapy been approved for clinical use yet?

So far, only pre-clinical testing has taken place: experiments to test the potential of this therapy have only been carried out on mice and pigs. Before such therapy becomes clinically available, much more experimentation and rigorous trials will have to be carried out. Scientists are hoping to begin clinical trials next year. Clinical trials are typically divided into 4 phases: phase I, II, III and IV. Phase I uses a small group of individuals to identify a safe dosage range and determine any potential side effects. In phase II trials, the safe therapy or drug identified in phase I is tested on a larger group of individuals with the condition that the drug or therapy is intended to treat. This helps to determine the therapeutic efficacy of the therapy or drug. If the results from phase II are encouraging, phase III trials take place. These trials involve a much larger cohort of individuals, with a range of individual characteristics. Following positive results, regulatory approval for the therapy or drug is sought. If this is secured, phase IV trials take place; these comprise of post-market surveillance over an extended time period. Why do you think validity and reliability are crucial in these trials? What are some reasons this therapy may not be approved for clinical use?

Practice Interview QUestions
  1. Discuss the pros and cons of animal testing in medical research.

    Hint: which ethical principles should we consider!
  2. Why is it important to test a drug or therapy on a range of individuals before it is used clinically? Can you think of any reasons why dosages may be different between different groups of individuals? 

    Hint: consider factors such as the age, sex and ethnicity of a patient, as well as whether they have other health conditions.
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