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In what sounds like science fiction but may someday save lives, US and Japanese scientists have successfully conducted the first human safety trial of a strange-sounding method that provides oxygen via the rectum. The technique, known as enteral ventilation, may bring new hope to patients struggling with grave lung disease or blockages in the airway.

The research, appearing in the medical journal Med, tested whether oxygen could be delivered safely into the human body through the large intestine via a specially developed oxygen-carrying liquid called perfluorodecalin. Previous animal experiments in mice and pigs had found the method, colloquially nicknamed "butt breathing," was successful at raising oxygen levels when lung function was impaired.

Scientists drew inspiration from water animals like loaches and turtles, which are able to breathe oxygen through their guts in low-oxygen conditions. "This is the first human data, and the results are limited solely to demonstrating the safety of the procedure, not its effectiveness," Dr. Takanori Takebe of Osaka University, a lead author of the study, said. “Now that we’ve established tolerance, the next step will be to evaluate how effective the process is in delivering oxygen to the bloodstream.”

How It Works

The method works similarly to an enema, providing oxygen-infused fluid directly into the large intestine, where gas may travel through the intestinal wall into the circulatory system. The process might bypass damaged or inflamed lungs altogether and serve as a secondary oxygen delivery route.

The first clinical trial was done in 27 healthy Japanese men who were between 20 and 45 years old. They were given different amounts, a maximum of 1,500 milliliters, of non-oxygenated perfluorodecalin via rectal catheter and instructed to hold it for one hour.

Although some experienced abdominal bloating and minor discomfort, none suffered from serious side effects or complications. "In a trial involving 27 healthy male volunteers, the authors determined that rectal administration of this liquid was safe and well tolerated," the study noted.

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Future Applications

Researchers think that, if shown to work, the procedure might assist patients with respiratory failure from pneumonia, acute lung injury, or COVID-19-like diseases, conditions in which traditional ventilators fall short.

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By the COVID-19 pandemic, we had seen how scarce mechanical ventilation was and how frequently patients died due to the unavailability of oxygen delivery systems," said Dr. Takebe. "Enteric breathing may be a last-resort solution when other methods do not work." The subsequent stage of research will entail oxygenating the perfluorodecalin liquid prior to administration to assess the effectiveness of oxygen being absorbed and circulated in the blood.

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