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(14) Later in 2004, NBs were investigated as ultrasound (US) contrast agents. Nanobubbles (NBs) are spherical stable gas-containing vesicles suspended in an aqueous solution, which were directly observed in 2000 for the first time by atomic force microscopy. In this regard, some cutting-edge technologies such as hyperbaric oxygen therapy, high-flow nasal cannula, (13) and the intravenous (IV) delivery of liquid oxygen carriers, such as ultrafine oxygen nanobubbles (ONBs), have been considered in this field.
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(11,12) Because of the lack of ventilation equipment in many health care centers, the development of alternative techniques is an urgent critical care challenge in the supply of medical equipment. (8−10) In more critical cases, increasing the supply of oxygen using mechanical lung ventilation, noninvasive positive-pressure ventilation, or other invasive methods, such as extracorporeal membranous oxygenation (ECMO), becomes necessary. (7) At the first stage, pure oxygen breathing through nasal tubes or a facemask is usually employed. (5,6) More than 75% of COVID-19 hospitalized patients require supplemental oxygen therapy.
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(3)īecause the sustained hypoxia caused by COVID-19 can cause major health problems, like compromised cellular aerobic metabolism, increased levels of DNA breaks, accumulation of DNA replication errors, instability and mutagenesis of the genome, brain damage, and cardiac cell death and arrest, the administration of oxygen therapy is required. (4) Therefore, deficient oxygen levels are often found in COVID-19 patients and result in subsequent adverse clinical outcomes if left untreated. (3) In this situation, their lungs do not fully oxygenate the blood, although these patients claim to feel almost well, to the extent that doctors debate whether to intubate them or not. (2) On the other hand, this virus produces a phenomenon called “silent hypoxia”, wherein patients can function relatively normally but are measured with much lower oxygen levels than anticipated (∼50–80% saturation, while the normal saturation level is 95% or higher). Within the cells, this is even lower, ranging from 1.3 to 2.5%, while in most tissues, cellular hypoxia occurs when it is reduced below 2%. Normal oxygen pressure depends on the tissue type, although for normal tissues, the physiological range is between 4 and 8% of the atmospheric oxygen level. In general, hypoxia, or low tissue oxygen tension, can be caused by various pathologies ranging from inflammation to cancer. The SARS-CoV-2 virus directly infects the alveoli in the lungs, where oxygen is transferred from the air spaces into the blood vessels therefore, most infected patients have low blood oxygen saturation pressure (SpO 2) of <90% and impaired blood microcirculation, (1) resulting in a condition called hypoxia. The multimodal functions of oxygen-carrying NBs, including antimicrobial, antiinflammatory, drug carrying, and the promotion of wound healing are discussed, including the benefits and challenges of using NBs as a treatment for patients with acute hypoxemic respiratory failure, particularly due to COVID-19.Īt the present time, humans are faced with an ongoing pandemic outbreak of a new coronavirus responsible for a respiratory illness caused by “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), known as COVID-19. In this review, we provide a comprehensive survey of the application of oxygen-containing NBs, with a primary focus on the development of intravenous platforms. Oxygen-containing NBs can exert a range of beneficial physiologic and pharmacologic effects that include tissue oxygenation, as well as tissue repair mechanisms, antiinflammatory properties, and antibacterial activity. The present review highlights the ever-increasing application of nanobubbles (NBs), miniature gaseous vesicles, for the oxygenation of hypoxic patients. Thus, maintaining an appropriate level of oxygen in the patients’ blood by devising alternatives to ventilator systems is a top priority goal for clinicians. The coronavirus disease (COVID-19) pandemic, which has spread around the world, caused the death of many affected patients, partly because of the lack of oxygen arising from impaired respiration or blood circulation.