“Yes, it is true. It is tough to consider oxygen as a “powerful and magical drug”, because it is freely available everywhere.”
Routine nasal Oxygen has little use in the management of STEMI. In fact, it can be harmful as it causes vasoconstriction. Hence current guidelines, has very strict advice about not giving oxygen unless systemic tissue hypoxia is documented.
Now, how about infusing Liquid oxygen right inside the LAD , the target zone , that is hit by hypoxia.?
This is not a new concept. G.W. Stone et al. tried this in 2009 itself.(Ref 1) For some reason, this was not followed up. How did we ignore basic fact myocyte hypoxia require Oxygen at that level. We were concentrating to reperfusing with blood, but what the cell need is not blood b but oxygen. Now,14 years later, some young researchers reaching out to this concept ,via liquid myocardial oxygen . Hope to be a possible breakthrough success .it was presented at the 2023 SCAI meeting in Phoenix. In this study, a 60-minute intracoronary infusion of liquid oxygen after pPCI reduced the infarct size and arrhymic risk .This study was sponsored by ZOLL® TherOx® .
A possible deterrent is the problematic and complex concept of reperfusion Injury. The term Oxygen radicals always sounds sinister .Really I can’t understand how a cell which get injured by the lack of a a particuar gas, get damaged by the same gas .(Oxygen in liquid from might behave differently as in this study ?) I think,its all in timing of delivery of oxygen, and if we start thinking like Einstein, then ,there is nothing called time.
Final message
Innovation and experimentation is must be allowed as liberally as possible. Breakthroughs happen accidentally at any time. Systemic oxygen may be harmful, but localised delivery of O2, might exactly be the thing, the dying tissues are waiting for. Sometimes we Ignore a good concept for no reason. Bias against drug companies also can be counterproductive.
Reference
Dr.S.Venkatesan MD 