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Media: in Russia will develop the technology of liquid breathing for divers

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Media: “It would be interesting to make a suit for diving in the Mariana trench»

A visual demonstration of the Russian development of liquid breathing stirred the Internet and social networks. Part of the audience is outraged by the inhumane” drowning ” of the Dachshund, and another part believes that the audience was deceived by issuing a short-term dive on a breath hold for a non-existent technology. But actually liquid breathing is a real development. “Attic” talked with the scientific Director of the Soviet project and the main Russian developer of the self-liquid breathing system Andrei Filippenko.

— How and when did the research in the field of liquid breathing begin?

– Historically, interest arose in the early twentieth century. Then doctors used a saline solution to understand how stretchable the human lungs are. Today, filling the lungs with saline solution is studied by students in the course of medicine. But of course it has little to do with liquid breathing. It all really started in 1962, when Johann Kilstra and his colleagues from the University of Leiden and the Dutch Navy published in the journal ASAIO (American Society of Artificial Internal Organs) Journal the famous article “Mice as fish” (of mice as fish). In their experiment, mice immersed in a buffer saline solution breathed for 18 hours, extracting oxygen from the liquid using their lungs. However, there is one important detail. Water at normal atmospheric pressure and normal temperature is able to dissolve about 3% of oxygen by volume, and this is enough for fish, but not mammals, which are accustomed to an oxygen content of about 20% (that is, the partial pressure of oxygen is 0.2 ATM). The mice were under a pressure of eight atmospheres, so they had enough oxygen (at higher pressure, you can not even fully saturate the solution with oxygen). True, the return back to breathing air was a problem-the mice died in this case, but this work gave a serious impetus to scientific research in this area.

Andrey Filipenko. Photo: Yegor Bykovsky
… those who say: “you can not Breathe salt solution — it washes away surfactants!”- in General, quite right.

— Did you find out why the animals died when they went back to breathing gas?”

— The main reason is that saline solution, even saturated with oxygen to the desired level under high pressure, is not suitable for long-term respiration of mammals. Through the lungs, the solution enters the vascular bed and into the blood, which leads to hypervolemia — an excess volume of blood and plasma, and this increases the load on the cardiovascular and many other systems of the body. In addition, the saline solution has another extremely unpleasant effect. Our lungs inside consist of a huge number of alveoli-microscopic, in fractions of a millimeter, structures in the form of bubbles, saturated with capillaries. Alveoli have a huge surface, and that they do not stick together when exhaling, they are covered with a layer of surface-active complex of proteins and phospholipids — surfactant. So, the saline solution washes away this layer! As a result, it is not enough to pump out the saline solution — you still need to restore the layer of surfactants and straighten the lungs, these are separate resuscitation measures. Therefore, those who say: “you can not Breathe salt solution — it washes away surfactants!”- in General, quite right. But here only in our system of liquid respiration saline solution is not used.

— How did you do liquid breathing?”

— I learned about this direction in the 1960s, when my father, a naval officer and a member of the research Institute of the Navy (which also dealt with the issues of the submarine fleet), offered to give a review of this idea. The topic was approved, and later in Novosibirsk Akademgorodok I saw mice that breathed salt solution. And in 1966 there was another historical article – “Survival of mammals breathing organic liquids, saturated with oxygen at atmospheric pressure” (Survival of Mammals Breathing Organic Liquids Balanced with Oxygen at Atmospheric Pressure). In the article, American biochemist and doctor Leland Clark showed that mammals-mice and cats-are able to breathe fluorocarbon liquids at atmospheric pressure for a long time. We can say that this article marked the beginning of all modern research in which perfluorocarbons are used for liquid respiration-hydrocarbons in which all hydrogen atoms are replaced by fluorine atoms. Some of these compounds have a very important property — they have an abnormally high ability to dissolve gases such as oxygen and carbon dioxide. And this is just one of the main properties that are necessary for the implementation of liquid breathing.

— That is, when using perfluorocarbons, there are no problems with liquid breathing and with returning to gas breathing?

“Of course there is. The same Clark experimented with silicone oil, which also dissolves oxygen and carbon dioxide, but all such mice and cats died after returning to gas breathing. But those who breathed perfluorocarbon survived, albeit with various lung injuries and complications such as pneumonia. With perfluorocarbons has its own problems. One of them is impurities, which can be the cause of many extremely unpleasant effects. Others are high (compared to gases) density and viscosity, which can complicate the process of self-breathing – yet the lungs are not designed for such a long-term load. In the first experiments it was generally believed that spontaneous breathing animals more than 20-30 minutes is impossible and require artificial mechanical ventilation, that is, the fluid is required to pump through the lungs some pump. I do not quite agree with this, but it certainly depends on the context: in some situations, artificial ventilation is really required, and in others, independent breathing is still possible.

For example, in any?

“For example, in the submersibles.” Rescue from a depth of hundreds of meters lasts 15-20 minutes, this time a person can breathe independently. The impetus for the beginning of these works was the incident with the submarine K-429, which sank in 1983 in the far East. 16 submariners died, and the result was the increased attention of the Central Committee and the assignment of scientists to develop methods for rescuing submariners in submarine accidents. I have worked in the 40th research Institute of rescue business, diving and deep-sea work of defense of the USSR in Lomonosov, where he studied perfluorocarbons as blood substitutes (now out of such compounds the best-known “Perftoran”, developed at the Institute of Biophysics of the USSR) to combat decompression sickness. These drugs are an emulsion of 10-20% perfluorocarbons in salt solution and increase the gas transport functions of the blood. But the progress was very small: no matter how much perfluorocarbons we poured into the blood, no matter how well they dissolved the gas bubbles, they could not significantly solve the problem. Therefore, an alternative has been proposed to completely avoid decompression sickness by using liquid respiration-perfluorocarbons are able to dissolve oxygen 20 times better than water (up to 50% by volume). This means that even at normal pressure it is theoretically already possible to breathe.

In the 40th research Institute we had a dog who lived after diving for more than 10 years.

— But after all except oxygen it is necessary to deduce still carbon dioxide?

– In perfluorocarbons, carbon dioxide dissolves even better than oxygen-150-200%. So it only remains to tie him up. This can be done with the help of chemical substances such as alkalis (or some other), as implemented in the breathing apparatus with a closed breathing cycle. So this problem is, in General, a purely technical implementation.

— So in the 1980s the idea of a liquid breathing system eventually appeared?

— Well, it’s like saying in the 1960s about the manned space program: “so Gagarin flew into space.” I was the initiator of the work on liquid breathing, well, since the initiative, as you know, is punishable, I had to become a performer. When we began to experiment with dogs, it turned out that they are able to breathe on their own up to half an hour, but not longer (abroad were about the same results). It turned out that we did not yet have a good enough idea of the process of breathing. According to the theories of respiration, which existed at the time, considering the capacity of the respiratory muscles and fatigue, it turned out that a long liquid breathing impossible. But by this time there was a principle of high-frequency ventilation of lungs, that is small volumes with high frequency — not units or tens inspirations-exhalations in a minute, and hundreds. This principle, by the way, also contradicted the theories, but it worked! In this case, high-frequency ventilation requires much less effort, but even with a very small respiratory volume can still provide the necessary gas exchange. Our ideas and our knowledge of respiration were imperfect, and the hydrodynamic models and calculations of liquid respiration did not correspond to what I had seen in animal experiments. In addition, we made serious efforts to further purify the liquid (it was mainly perfluorodecalin), and this method managed to achieve very significant results: dogs breathed independently, successfully survived after returning to gas breathing, some lived after that for many years (in the 40th research Institute we had a dog who lived after immersion for more than 10 years) and gave healthy offspring. If to adhere to our methodologies, dogs survive and live after this long and nothing not differ from other dogs. Except the fact that they exhibit the increased attention.

“What about washing off the surfactant and straightening the lungs?”

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Media: “the test of liquid breathing with a person can be carried out in three months»

The other day I spoke with Ilya Ferapontov, a journalist of N+1. Discussed many issues and all on trial. As a result, the magazine published an article open and accessible to all readers.
I am grateful to the editors of N+1 and separately to Ilya…

After a public experiment on liquid breathing with a dog, scientists expressed doubts about the usefulness of this experience and the prospects of this technology in General. The editors of N + 1 asked the doctor and scientist Andrei Filippenko, who has been developing liquid breathing systems since Soviet times, to tell about the current state of research in this area.

N + 1: We all saw a spectacular demonstration with a Dachshund, organized By the Foundation for advanced studies. You have been dealing with the subject of liquid breathing since the 1980s, do you have anything to do with this project? Are you an employee of FPI?

Andrei Filippenko: No, I work independently of FPI. In the 1980s, I was the scientific Director of research on the problems of liquid respiration (R & d “drying Oil MOH”). In 2014-15, he carried out the Terek advance project with the FPI, continued to teach liquid breathing as a social burden, went and coordinated tasks for co-executors in the continuation of the Terek-1 theme until the first half of 2016. Now I continue to work on the problem as a medical researcher and developer of liquid breathing apparatus for submariners, divers and astronauts.

Experiments with liquid breathing in 1988

Experts from the IBP doubt that in an extreme situation, you can really use the technology of liquid breathing, in particular, because to switch to it you need to quickly remove the air from the lungs, otherwise there may be “white asphyxia”. How to solve this problem?

The reason for such asphyxia is the closing of the glottis, more precisely, the vocal cords. They do not work in all mammals with immersion (full immersion under water), and the closure can be removed by anesthesia. Prevent closure is a standard problem for all bronchoscopes, and bronchoscopy is a routine event in hospitals, that is, the problem of preventing ligament closure is solved.

How to provide breathing fluid? After all, this requires constant pumping and updating of oxygen-containing liquid. How can human lungs to provide it a permanent transfer?

In 1987-88, I showed that large animals (dogs) can cope with this — due to the movement of the diaphragm and intercostal muscles to pump fluid for several hours. We first time then saw contradiction Western publications — perhaps liquid breath longer 20 minutes, i.e. inhalation oxygenated fluid and its evacuation resurfaced, under acceptable performance gases in blood. In the case of humans, it is somewhat more difficult than with animals, but there are no insurmountable obstacles to this. Yes, it is quite difficult, such experiments for healthy and strong people, for the elderly with weak lungs and heart, it is not designed. Such among submariners there is no. There is nothing impossible in switching to liquid breathing, and then to normal breathing, although it is sometimes not easy. The devil is in the details.

Are there possible negative consequences for health then? Lung damage, pneumonia? As far as I understand, the liquid should wash out the surfactant from the lungs?

Yes, the alveoli of the lungs are indeed covered from the inside with a surfactant that keeps them unfolded. In experiments with salt solutions, it was found that the surfactant was washed out and the alveoli in the lungs could subside. But we conducted experiments with perfluorocarbon liquid, and it has an extremely low wetting capacity, respectively, surfactant from the alveoli practically does not wash out. In addition, you can add a surfactant to the respiratory fluid itself (they are different in composition). In the “pure” perfluorocarbon experiments with dogs, rats, mice, we had no cases of “decline” of the alveoli of the lungs. It should be noted that the fluid is not absorbed into the walls of the alveoli and some amount of fluid in the lungs remains, but it evaporates and exhales.

But nevertheless, as a result of experiments there was a pneumonia, for example, at the same Frank Faleychik?

Faleichik, by the way, is alive and well, my doctor-friend from the Swedish Karolinska Institute saw him recently. Often it’s not just the liquid, but also the temperature. We work in the cold to simulate the rescue of submariners, initially the animal was cooled, the whole body is immersed in water at a temperature of 10 degrees, and then it is poured into the lungs — there is hypothermia. And the only way we can reduce this hypothermia is by rapidly rising to the surface.

Especially difficult situation for submariners, because below 100 meters the water temperature does not rise above 4 degrees. Even if there is no death from hypothermia in the process of surfacing, there is a possibility of death from pneumonia later. Therefore, it is pointless to make liquid breathing technology for room or laboratory conditions.

We need to solve this problem. As to exclude the possibility of aspiration into the lungs of any impurities with a liquid, for example, dogs in the experience. That is why I proposed and tested at sea three years ago to immerse the Dachshund head down in a capsule for sea trials. She breathed oxygenated liquid, then managed to wriggle out of the dog’s wetsuit and gulped down a lot of cold sea water.

The first experiments on large dogs in the laboratory of the Institute of pulmonology in 1987. Visible monitor the condition of the dog and sampling respiratory fluid in the stage of filling of the lungs.

The personal archive of Andrey Filippenko

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Another problem is related to the liquid itself. In early experiments with salt solutions, animals often died because they could not get back to breathing air. Does not give such complications with adequate technique pure perfluorocarbon liquid. By the way, even the employee of FPI trained for presentation to the first persons of the state in the video presented to the whole world misspoke and called it perfluorane, unwittingly making an advertisement for our unique drug by age. Here the purity of the liquid is critically important, it should be cleaner than for transfusions into the blood, even the slightest impurities can lead to serious consequences.
How serious a problem can high pressure nervous syndrome be?

In the hyperbaric center of the Navy of Lomonosov, where I worked since 1979, studied this effect for many years together with the institutes of the Academy of Sciences. Tried and medications, and the addition of inert gases in the breathing mixture. Helped and the, and another to lift manifestations of NSWD. What will happen at super-large depths-we will know when a person will approach them. Experiments on animals, even apes, we can not completely transfer to humans.

Why would submariners need liquid breathing technology at all? Is it not easier to make means of salvation with ordinary breathing?

It is difficult to rescue submariners — at the moment of accident on the boat there can be neither light, nor heat, almost always in an emergency compartment — water, and often the free ascent remains the only way of rescue. One of the rescue options is that submariners in special diving suits gather in one compartment, which is flooded, and then they float to the surface through a hatch. In practice, this works only at a very shallow depth, because when the pressure in the compartment increases, nitrogen begins to dissolve intensively in the blood, and then when surfacing, nitrogen bubbles are released back – in the blood vessels, in the tissues, there are many nitrogen bubbles that clog the vessels, which can lead to fatal consequences. This is called decompression sickness. It can be prevented only by maintaining a very long schedule of surfacing in the water or in the pressure chamber, which in an accident, deadly low water temperature and lack of oxygen is simply impossible.

Therefore, the period of pressure rise in the compartment should be as short as possible-tens of seconds, the instructions allow in this case even a breakthrough of the eardrums, because decompression sickness is much more dangerous. Even when submariners exercise, when they train for free ascent, people die, as reported by officers of the Dutch Navy when I was at NATO headquarters in Brussels.

And in the case of a serious deep-water accident, such as in the case of the Kursk, only one person can have a chance of salvation, the others simply will not have time. Therefore, most likely submariners will wait for rescue from the outside. Wait until demise, if the depth of more 200 meters.

In the case of liquid breathing, the situation looks completely different. The crew puts on the liquid breathing apparatus, turns them on, and then they rise, floating in a rescue wetsuit to the surface. There is no nitrogen in the respiratory fluid, there is no significant pressure difference between the lungs and the external environment, so there is no risk of decompression sickness. This does not mean that all the problems of saving people at sea will be solved, but one of them will be solved — the rise to the surface.

But such a device must be extremely complex: it must have a liquid pumping system, a system of saturating it with oxygen and removing carbon dioxide from it, there must be a liquid heating and much more. Is it even possible to use such a complex and unreliable device in an emergency? How realistic is it to build?

As for the apparatus of mechanical, forced ventilation, the Americans have made a liquid breathing apparatus the size of a Cabinet. I had to make it the size of a briefcase for papers. It was simply not possible to carry him by car on business trips. Our apparatus in experiments with liquid breathing dogs thirty years ago doubled exceeded preset labor depth-700 meters instead 350 meters. Was a success. If sensible people take it right, you can do a lot.

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