Oxygen safety?

[JohnS]

Is anyone familiar with this study?

What are your thoughts?

 

https://www.uclahealth.org/ucla-study-reveals-why-bad-things-happen-inside-the-brain-when-we-inhale-pure-oxygen

[CHfather]

Thanks, John'.

I'm now "familiar" with it, from having read the study itself, which is here -- https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0040173 -- and also from glancing through some articles that cite it.  I certainly have nothing definitive to say, except to suggest the following:

1. The study was done in 2007. You would think it would have been compelling enough to inspire significant follow-up and maybe an actual change in O2 delivery procedures for healthy adults, but I don't see that having happened (though I might not have looked in the right places). (I say "healthy adults" because there seem to be studies related to O2/CO2 for patients receiving anesthesia, and for children, and other special cases. The adverse effects of pure O2 on premature babies have been pretty well studied and accounted for in practice, as far as I can tell.)

2. If it didn't inspire follow-up or change, maybe it's because practitioners who have seen pure O2 administered to countless people have not noticed the adverse-sounding effects that the authors describe, or any practical consequences from those effects (just guessing).

3. This study was done on children.  It is hypothesized within the study, but not shown, that it will also apply to healthy adults. I can see a couple of articles that might be addressing that, but I can't access them to find out.  Of course, if you consider people with COPD to be outside the category of "healthy adults," I guess there aren't that many people aside from people with CH who regularly inhale pure O2 (high-flying military pilots??).

4. Specifically regarding CH: I don't think it is known exactly how O2 aborts CH, but one assumed factor is vasoconstriction.  I gather from reading this article that the vasoconstriction is caused (at least in part) by lack of CO2.  So could it be that the "negative" vasoconstriction side effect of pure O2 is actually a positive one for treating CH?  They also mention effects on the hypothalamus, which is considered a crucial brain area in relationship to CH.  Could it be that this hypothalamic reaction is also part of the treatment??????

Edited February 17, 2021 by CHfather

[spiny]

Bah Humbug! It will not allow me to cut and paste into this reply! So, starting over, for the third time now!!

Welcome to the board John!!! Sorry you have to be here, but very happy that you found us.

CHF got a reply in while I was fighting the system, so I will truncate mine a bit. 

Todays' COPD patients mostly use a cannula, not a mask. So, they are getting an O2 boost, but not breathing pure O2.

These are children. And they are talking about staying on the O2 for long periods of time. In the 60's/70's they could not acquire enough ultra pure O2 for premature infants and had to use the lower purity one. Imagine their shock when they found that they now had babies that were no longer being blinded by the O2 they were given in the hospital for weeks or months! Prior to that incident, preemies went blind. Babies and children respond differently than adults do with many things. 

Second, if you are concerned, then do some pre-breathing on your way to the O2. Inhale deep, hold, then exhale hard and fully, just like you should on your tank. Grab some caffeine on the way and slam that down. This will reduce the time needed on the tank most likely. 

Their MRI showed that it affected the hypothalamus. That is what is wrong with us according to current theory, so a good kick in the butt is what it needs apparently. O2 works!! Plain and simple. 

What are you doing for your head now? Some background would be helpful. Do you  have O2 to abort your hits? 

[Pebblesthecorgi]

Great reply's to a provocative article. 

 

Its reports like these taken out of context that provide inane arguments from reimbursement decision makers and scare off those who would potentially benefit from Oxygen to treat a cluster attack.  I have attached the original article which is "Hyperoxic Brain Effects Are Normalized by Addition of CO2".  The OP placed a link from a PR arm of UCLA (self promotion) to bring our attention and concern.  The PR department took great liberties with the content going so far as to state the info in being incorporated tin Europe to modify resuscitation.  In reality the article has only been referenced 10 times (since 2007) in other literature, mostly basic science and peripheral to O2 harm.   Please read the editor notes at the end of the article.   Basically there is no follow up and no real concern with O2 as it applies to safety and treating a cluster attack.  O2 clearly works much of the time, its not perfect and there a are a few variables that must be managed but properly delivered and used multiple studies support its efficacy and safety.

 

It is interesting to see the study does confirm O2 affects hypothalamic activity  which supports theories where clusters are propagated.  It also gives support to the notion of vasoconstriction being a mechanism of action.  I suspicion a change in hormonal milieu may also play a role and be an explanation for inconsistent response to therapy. 

oxygenandharm

[xxx]

Hey John,

CH Father's, Spiny's and Pebles' comments all hit the mark debunking the article in question.  There are studies and then there are articles about studies. While well designed studies/clinical trials as well as their published results and conclusions must conform to accepted standards, good science and format, articles do not.  This article was a POS.

While the cited study at PLoS provides what appears to be consistent results from their study of oxygen therapy breathing 95% O2 and 5% CO2 resulting in "normalized" cerebral blood flow and that hyperoxia breathing normobaric 100% oxygen results hypocapnia (too little blood CO2) with attendant vasoconstriction and reduced cerebral blood flow, it fails to tell the "rest of the story" as Paul Harvey used to say. 

This study fails to point out that even with the reduced cerebral  blood flow the authors opined would result in hypoxia (too little oxygen delivered to the brain) and the release of potentially threatening enzymes, hormones and other peptides, the actual oxygen content of the cerebral blood flow through the brain was more than sufficiently high to prevent ischemia.

So where does that leave CHers who have read this article and who need to use oxygen therapy as a CH abortive?  If you disregard the junk science in this article, and use the most effective oxygen therapy procedure available to abort your CH rapidly, you're in great shape.

The topic of oxygen therapy as a CH abortive is near and dear to my heart.  From 2005 when Dx'd as a Chronic CHer, until 2010 when I developed the anti-inflammatory regimen to prevent my CH very effectively, oxygen therapy was my only CH intervention. 

I developed a very effective method of rapidly aborting my CH in 2005 that uses oxygen flow rates of 25 yo 40 liters/minute.  This method of oxygen therapy essentially allows the CHer to hyperventilate with 100% oxygen to a safe and effective rapid abort.  As a patent holder of the Demand Valve Method of Oxygen Therapy issued by the USPTO in 2010,  I spent the better part of a year reading through hundreds of studies and RCTs involving the inhalation of 100% oxygen in developing the patent application.

The following link provides the abstract for one of these studies titled, The Influence of Arterial Oxygenation on Cerebral Venous Oxygen Saturation During Hyperventilation, by Matta, et al.,  published in 1994.  It concluded oxygen therapy at flow rates that support hyperventilation were not only safe, but it resulted in venous blood flow measured at the Jugular vein, indicated blood flow from the brain had twice the oxygen content of normobaric oxygenation. 

https://link.springer.com/article/10.1007/BF03015651

By the way, this is the very same principle of respiratory physiology that makes aborting CH using a oxygen demand valve with oxygen flow rates that support hyperventilation so safe and effective with average abort times of 7 minutes. 

You can achieve the same rapid abort times (7 minutes) by repeating the following sequence seven times. Each sequence involves hyperventilating with room air for 30 seconds at forced vital capacity tidal volumes followed by inhaling a lungful of 100% oxygen and holding it for 30 seconds.  The only difference between this method of oxygen therapy and the demand valve method is this method consumes one tenth the volume of oxygen or an average of 28 liters per CH abort where the demand valve method consumes an average of 280 liters of oxygen per abort.

Regarding oxygen safety.  It's very safe.  I was flying Navy fighters on and off aircraft carriers before they started Top Gun.  I have over 3000 hours flying Navy fighters and all of that flight time was spent breathing 100% oxygen from engine start through cat shot, missions lasting 1.8 hours or more in duration to landing back aboard ship chocked and tied down.  Then I took off the oxygen mask and turned off the oxygen.  I would also note that during high G-force maneuvering in aerial combat, I routinely sucked down 100% oxygen at flow rates above 40 liters/minute.  I passed my annual flight physicals every year of my 24 years of Naval Service.   Moreover I'm still here at 76 and in very good health having used oxygen therapy daily for 5 years and I still pass my annual physicals.

Several hundred thousand Navy and Marine Corps pilots flying tactical fighter and attack aircraft have been breathing 100% oxygen on all missions since 1943 when US and UK engineers cockroached (copied) the oxygen regulator design from a German bF-109 Messerschmidt that crash landed in the UK.  It took only a few months to retrofit this new design into Naval aircraft.  Bottom line, all these Navy and Marine Corps pilots have passed their annual physicals yearly since then with PA and lateral chest X-Rays indicating no adverse effects.

Finally, think about the following.  Navy and Marine Corps Pilots are required to breath 100% oxygen on all flights.  NASA requires Astronauts breath 100% oxygen during suited EVA operations as well as during launch and reentry.  Would they do this if breathing 100% oxygen was inherently unsafe?  Let that sink in for a while.

Take care,

V/R, Batch