Traditionally, industrial gases were thought as only useful in elements of anaesthesia, critical care and pulmonary medicine, but as we step into the 21st century, gases have taken an increasing important role in advances in medical procedures.

OXYGEN

Most people are aware that oxygen is essential for life. It is therefore oxygen that is given for treatment and prevention of a variety of cardiac, pulmonary and other conditions. Oxygen is applied under hyperbaric conditions (Hyperbaric Oxygen Therapy – HBO), which increases the amount of oxygen dissolved in the blood and improves microcirculation. This is therefore used to treat carbon monoxide and smoke intoxication as well as diving accidents. Hyperbaric oxygen therapy has also been commonly used for the last 30 years to improve the quality of life for people suffering from Multiple Sclerosis

The Supersonic gun

But as peoples' demands on medical technology change, so too does the role of medical gases in the latest wave of new aesthetic procedures. Most recentl is the introduction of a supersonic gun to blast away stretch marks and rid the skin of scars. The gun fires a mixture of oxygen and salt water at a rate that is faster than the speed of sound. The method is also proven to improve burn injuries and reduce acne.

Various clinical trials have shown that oxygen is known to speed up the healing process and is also believed to stimulate the development of collagen, which keeps skin supple. It is said that this increase in elasticity of the skin can even reduce wrinkles around the eyes.

The gun, which is due to be launched in the UK within the next six months, uses technology borrowed from the aviation industry to create a jet of gas and liquid travelling at supersonic speed. The secret is in the nozzle, which can propel the oxygen and saline at a speed of 200 metres a second.

A patient about to enter an MRI scanner///Photo courtesy of Beth Israel Deaconess Medical Centre

HELIUM

A more commonly known use of industrial gas in combination with medical technology is the MRI scanner, in use since the 1980s. Modern Magnetic Resonance Imaging device provides high resolution scans of the human body to be captured in a non-evasive manner. Magnetic fields required for the imaging techniques are produced by high-tech supraconductive magnets that need to operate at very low temperatures. Liquid helium is used to cool these magnets to near absolute zero temperatures.

A more recent adoption of helium is for cancer treatment. A new high-powered helium neon laser is being used in the PhotoDynamic Therapy of Cancer treatment. The technology adapted by the China-America Technology Corporation (CTC) was used for clinical PDT in China between 1992 until the end of 1994, in which time 44 cases of various cancers were cured.

The Heliox Cylinder

BOC have also taken strides to improve their range of medical gas technology. The company recently launched its new Heliox cylinder to aid the treatment of patients with airway obstructions, such as acute asthma. The Heliox 21 contains more than 33% of their existing model F. Heliox 21 comprises a mixture of 21% oxygen and 79% helium. It eliminates the need for an external regulator with a permanently live gauge that allows the user to check the cylinder contents.

Commenting on the latest model, Marketing Manager for BOC Medical, David Owens said, \\$quot;Heliox gas mixtures are typically three times less dense than air. The lower density reduced the amount of gas that can be taken into the lungs with each breath effort. This reduction in the effort of breathing can be seen by rapid reduction in the patient’s respiratory distress\\$quot;.

Light Sabre Surgery

Samuel Jackson as a Jedi Knight in Star Wars///Photo courtesy of ananova.com

Keyhole surgery is the latest medical procedure to benefit from Helium gas. The British made mini light sabre, also known as the Helica TC Thermal Coagulator, cuts through soft tissue whilst using a beam of hot gas to seal blood vessels instantly. This reduces blood loss and surgeons claim patients are leaving hospitals sooner and are active again within days of major procedures, such as hip replacements that used to take months to recover. The cutting tool uses a combination of helium gas and very low electrical power with carefully controlled power levels that allow extremely fine levels of cauterisation.

NITROUS OXIDE

Nitrous oxide (N2O) has been used for anaesthesia and pain relief since 1844. It has become a wide spread part of general anaesthesia in hospitals worldwide. N2O is used in combination with muscle relaxants, anaesthetics, and in the maintenance of inhalation anaesthesia.

A new-born baby on a paediatric ventilator///Photo courtesy of bbc.co.uk

INOmax®

Linde have also taken steps to remain at the forefront of medical gas technology. The company have patented a new technology called INOmax ® for the treatment of lung disorders. It is used for newborn babies with Hypoxic Respiratory Failure; where blood vessels in the lungs are constricted limiting blood flow from the heart to the lungs (termed \\$quot;pulmonary hypertension\\$quot;). As a result, when blood which is low in oxygen returns to the heart, it bypasses the lungs creating breathing problems. When inhaled INOmax causes the constricted lung vessels to relax resulting in an increase in blood flow form the heart to the lungs, and a decrease in the amount of blood that bypasses the lungs.

CARBON DIOXIDE & NITROGEN

Carbon dioxide (CO2) and nitrogen (N2) in liquid form produce very low temperatures as low as –76oC for CO2 and – 196oC for N2. Both medical gases can be used in cryotherapy, whilst N2 can also be used in cryobiology.

Carbon dioxide can be used for local analgesia by external application onto the skin surface. Nitrogen can be used in cryoconservation for long-term preservation of blood, blood components, body fluids or tissue samples and other cells. On the other side of the scale, cryosurgery nitrogen can be used for the removal of warts and wrinkles.

Cryoablation

The latest headline to hit the tabloids in the UK is the ‘Ice-cold cure for prostate agony’. This new treatment for prostate cancer uses a freezing process to destroy the tumour without many of the side affects associated with other treatments.

The new procedure – focal cryoablation, targets only the cancer. It spares healthy tissue in and around the gland, including the nerves involved in the bladder and sexual function. The operation works by injecting freezing gas directly into the cancerous area of prostate gland. Ice then forms inside the cancer cells. As the ice melts, cancer cells fill with water and die, whilst healthy cells remain unaffected.

Almost eight out of the ten men who had the new procedure did not become impotent and none were incontinent, two side effects often associated with previous treatments.

Whatever the ailment or problem, industrial gases have and will continue to enable medical innovations.