Giving COVID-19 patients pure oxygen (O2) may be brain-toxic

The current coronavirus epidemic is bringing a number of pervasive but concealed issue to the forefront. One of those issues is the peculiar choice of mainstream medicine for treating critically ill people with pure oxygen (O2) through breathing masks. The rationale behind the therapy is the apparent hypoxia seen in many/most critically ill COVID-19 patients. Yet, giving people pure oxygen has repeatedly been shown to not improve outcomes, especially in respiratory emergencies such as COVID-19/SARS. The most likely reason is the so-called Bohr effect – i.e. the oxygenation of tissues is proportional to the amount of CO2 they produce. In other words, while the presence of oxygen is crucial in order for hemoglobin to pick it up from the air a patient breathes and carry it around the body, that oxygen will only get released into tissues that have sufficient amount of CO2 in them and, consequently, in the ambient blood. If an organ/tissue does not produce/release sufficient CO2 it will not get sufficient oxygen released from hemoglobin, thus resulting in functional hypoxia despite the presence of plenty of oxygen carried by hemoglobin in the blood. The levels of CO2 depend on metabolic rate and are inversely correlated to levels of lactate. Thus, if a patient has low metabolic rate and/or elevated lactate levels they will experience functional hypoxia even if they get put on to 100% oxygen (O2) breathing therapy.  What’s worse, according to the study below putting a metabolically compromised (high lactate, low CO2) patient on pure oxygen therapy trigger a massive stress response through the HPA axis and interferes with the heart’s ability to maintain proper circulation and deliver hemoglobin/oxygen to the tissues that need it most. In other words, putting metabolically compromised patients on 100% O2 therapy has the exact opposite effects of what is being intended – i.e. it drastically exacerbates hypoxia instead of relieving it. Is there a remedy? Yes, yes, there is and it is called CO2. As the study aptly demonstrates adding just 5% CO2 to the O2 therapy prevents those stressful/hypoxic effects and allows oxygen to be properly delivered and used by the hypoxic organs/tissues/cells.

How is this relevant for COVID-19? Well, the vast majority of critically ill COVID-19 patients have various degrees of lactic acidosis and as such are critically low on CO2. Thus, giving them pure O2 therapy is one of the worst possible interventions medicine can provide, and likely hastens their demise. Lactic acidosis is often lethal and the pure O2 therapy worsens it, while CO2 treats it. If only those ER doctors remember what they learned in medical school and physiology classes…

“…Yet growing research suggests that inhaling straight oxygen can actually harm the brain. For the first time, a new UCLA brain-imaging study reveals why. Published in the May 22 edition of Public Library of Science (PLoS) Medicine, the findings fly in the face of national guidelines for medical practice and recommend a new approach adding carbon dioxide to the gas mix to preserve brain function in patientsFor decades, the medical community has championed 100 percent oxygen as the gold standard for resuscitation. But no one has reported what happens inside our brains when we inhale pure oxygen,” explained Ronald Harper, distinguished professor of neurobiology at the David Geffen School of Medicine at UCLA. “What we discovered adds to a compelling body of evidence for modifying a widely practiced standard of care in the United States….”When the children inhaled pure oxygen, their breathing quickened, resulting in the rapid exhalation of carbon dioxide from their bodies,” said coauthor Paul Macey, associate researcher in neurobiology. “The drop in carbon dioxide narrowed their blood vessels, preventing oxygen from reaching tissue in the brain and heart….All this activity awakened the hypothalamus, which regulates heart rate and hormonal outflow. Activation of the hypothalamus triggered a cascade of harmful reactions and released chemicals that can injure the brain and heart…. Several brain areas responded to 100 percent oxygen by kicking the hypothalamus into overdrive,” explained Harper. “The hypothalamus overreacted by dumping a massive flood of hormones and neurotransmitters into the bloodstreamThese chemicals interfere with the heart’s ability to pump blood and deliver oxygen — the opposite effect you want when you’re trying to resuscitate someone.” When the children inhaled the carbon dioxide-oxygen mix, the hypothalamus’ hyperactivity vanished from the MRI scan. “Adding carbon dioxide to the oxygen relaxed the blood vessels, allowed oxygen to reach the heart and brain, calmed the hypothalamus and slowed the release of dangerous chemicals,” said Macey. Pure oxygen kindles the match that fuels a forest fire of harm to the body,” said Harper. “But a little whiff of carbon dioxide makes it all go awayBased on their findings, the researchers strongly encourage healthcare providers to add carbon dioxide to oxygen dispensation, especially when resuscitating infants or administering oxygen for more than a few minutes. The new direction could hold particular implications for patients of stroke, heart attack, carbon monoxide poisoning and any long-term oxygen therapy.”