Enteral ventilation through the anus – save lives with buttocks breathing

Hold on to your bum because this is a pretty weird piece; have you ever heard of rectal ventilation? Until recently, no one had really thought of putting these words together. Thanks to the pandemic, ventilation has become a household issue. As the Delta variant continues to spread, intensive care beds fill up and there aren’t enough ventilators. Researchers in Japan have come up with a solution called enteral ventilation through the anus, also known as EVA. Basically, it’s a procedure that increases blood oxygen levels through the intestinal tract. It may sound bizarre, but the technique has been so successful that the next step is human experimentation. In case the world wasn’t strange enough for you, here are the details of this new treatment.

Enteral ventilation via the anus aka EVA

Image courtesy Asahi Shimbun

Enteral ventilation through the anus is a new technique developed by Tokyo Medical and Dental University. The procedure is similar to an enema and is used to deliver oxygen to the body through the distal intestine. This medical procedure is groundbreaking, especially when damage to the lung tissue prevents the exchange of air. It doesn’t mean the future can breathe through our bums for everyone. However, when someone has difficulty breathing, it means that we have another way of getting oxygen into their system. In combination with lung ventilation, this new method could save many lives.

How did they get behind-the-scenes breathing?

The inspiration for the treatment came from observing the animal kingdom and studying drug absorption methods. The researchers observed and studied animals that take in oxygen through the intestines, paying special attention to those creatures that only do so in emergencies. Catfish, sea cucumbers and ball-weaving spiders can absorb oxygen through their intestines in survival situations.

Image courtesy of the Australian Museum

Ryo Okabe is one of the researchers who developed and studied the process; he explains how the idea for this new method came to the group. “The rectum has a network of fine blood vessels just below the surface of its lining, which means that drugs given through the anus are easily absorbed into the bloodstream. We asked ourselves whether oxygen could also be released into the bloodstream in the same way. “

This is how enteral ventilation works via the anus – gas or liquid

There are basically two ways of increasing oxygen through enteral ventilation: using oxygen in liquid or gaseous form. Either option will work, but gas is more invasive than liquid. To absorb oxygen in gaseous form, the rectum must be rubbed and inflamed to increase blood flow. Since this would be too uncomfortable, the researchers used oxygenated perfluorodecalin (PFD), a safe liquid that contains large amounts of oxygen and carbon dioxide. Animal experiments have been carried out and have proven extremely successful.

According to researcher Ryo Okabe, “We used experimental models of respiratory failure in mice, pigs, and rats to try two methods: bringing oxygen into the rectum in gaseous form and infusing an oxygen-rich liquid by the same route.”

Can’t argue with the results

The results of the tests for this procedure were pretty incredible. After enteral ventilation via the anus, the blood oxygen values ​​rose and the behavior normalized. Using cell staining, the researchers confirmed that the oxygen supply within cells throughout the body improved. In addition, minimal amounts of PFD residues were absorbed with the liquid oxygen and the intestinal bacteria were undisturbed.

Takanori Takebe, another researcher and co-author of this study, had this to say on the subject. “Patients with shortness of breath can use this method to support their oxygen supply in order to reduce the negative effects of oxygen deficiency during treatment of the underlying disease. Enteral ventilation proved to be very promising in our asphyxia-like experimental model. The next steps will be to test the safety of the EVA approach with a deeper mechanistic understanding of how it works and determine its effectiveness in humans in a clinical setting. “

Footnote (s)

https://doi.org/10.1016/j.medj.2021.04.004
https://www.asahi.com/ajw/articles/14350603