Ian Connellan
Ian Connellan is editor-in-chief of the Royal Institution of Australia.
Every year the evidence mounts of alcohol’s ravaging effects on the human body.
In 2018, The Lancet published an international team’s considerations of alcohol use in 195 countries and territories from 1990 to 2016. “We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero,” the authors write.
Meanwhile, the WHO estimates that as many as three million deaths occur every year as result of severe alcohol intoxication. It’s a simple equation: when blood-alcohol concentration reaches a certain level, the intoxication can damage organs and lead to death.
Now, a team from the University Health Network in Toronto, Canada, led by Joseph Fisher, has produced proof of concept of a simple method that could become a game-changer in rescue therapy for severe alcohol intoxication – over and above just “sobering up”. The study is published in Scientific Reports.
Normally, 90% of the alcohol in the human body is cleared exclusively by the liver at constant rate that can’t be increased. Currently there’s no other method – short of dialysis – by which alcohol can be removed from the blood.
This means the only options for treating life-threatening alcohol intoxication are supportive measures such as administering oxygen, intravenous fluids and breathing assistance, and treating any heart issues with drugs.
The Canadian team’s approach is simply to recruit the lungs to breathe out the alcohol. The harder the breathing, it was reasoned, the more alcohol is eliminated.
The pilot study found that hyperventilation eliminated the alcohol at least three times faster than through the liver alone.
“But you can’t just hyperventilate, because in a minute or two you would become light-headed and pass out,” says Fisher, an anaesthetist and senior scientist at the Toronto General Hospital Research Institute.
To counter this, he and his team use a device that allows patients to hyperventilate off the alcohol while returning precisely the amount of carbon dioxide to the body to keep it at normal levels in the blood – regardless of the extent of hyperventilation – thus staving off fainting.
The device is the size of a small briefcase and uses a valve system, some connecting tubes, a mask, and a small tank with compressed carbon dioxide.
“It’s very basic, low-tech device that could be made anywhere in the world: no electronics, no computers or filters are required,” says Fisher. “It’s almost inexplicable why we didn’t try this decades ago.”
The report says that the pilot study’s volunteer subjects – all of whom completed both test and control phases – found the prolonged hyperventilation effort “tedious but not uncomfortable or requiring great effort”.
The authors recommend follow-up validation studies to understand how this technology could be applied in a clinical setting.