Heliox Allows for Lower Minute Volume Ventilation in an Animal Model of Ventilator-Induced Lung Injury

Beurskens, Charlotte J. P.; Arazi, Hamid; Beer, Friso M. de; Vroom, Margreeth B.; Preckel, Benedikt; Horn, Janneke; Juffermans, Nicole P.

doi:10.1371/journal.pone.0078159

Cited by 10 publications

(11 citation statements)

References 23 publications

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“…Moreover, heliox ventilation showed no effect on neither gas exchange or on lung inflammation. Thereby, our results are somewhat in contrast to studies investigating heliox ventilation in pediatric models as well as to findings in our own animal model of ventilator-induced lung injury, where heliox improved CO 2 removal [ 13 – 17 ].…”

Section: Discussioncontrasting

confidence: 96%

“…We set a pressure controlled ventilation mode and started with an inspiratory pressure of 15 cm H 2 O. The tidal volume was targeted by adjusting the inspiratory pressure [ 17 , 19 – 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…The use of heliox has been evaluated in pediatric animal models of ARDS induced by oleic acid or saline [ 13 – 15 ], showing that heliox ventilation improved gas exchange during high-frequency oscillatory ventilation. We recently showed that heliox improves CO 2 removal and decreases driving pressures in patients who are mechanically ventilated according to the recommended protective strategy, as well as in an animal model of lung injury inflicted by high tidal volume ventilation [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Mechanical ventilation with heliox in an animal model of acute respiratory distress syndrome

Beurskens

Arazi

Beer

et al. 2014

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BackgroundHeliox has a lower density and higher diffusion capacity compared to oxygen-in-air. We hypothesized that heliox ventilation allows for a reduction in minute volume ventilation and inspiratory pressures needed for adequate gas exchange in an animal model of an acute lung injury.MethodsAfter intratracheal instillation of lipopolysaccharide (10 mg/kg), adult rats were randomized to ventilation with either a gas mixture of helium/oxygen (50:50%) or oxygen/air (50:50%). They were mechanically ventilated according to the ARDSnet recommendations with tidal volumes of 6 ml/kg and monitored with a pneumotachometer. Bronchoalveolar lavage fluid was analyzed for markers of lung injury, and embedded lung sections were histologically scored for lung injury.ResultsHeliox limited the increase in driving pressures needed to achieve preset tidal volumes, with a concomitant decrease in loss of compliance. Heliox did neither allow for reduced minute volume ventilation in this model nor improve gas exchange. Also, heliox did not reduce lung injury.ConclusionsHeliox modestly improved respiratory mechanics but did not improve lung injury in this rat model of acute respiratory distress syndrome.

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Section: Discussioncontrasting

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mechanical ventilation with heliox in an animal model of acute respiratory distress syndrome

Beurskens

Arazi

Beer

et al. 2014

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“…The effect of heliox on lung mechanics was studied in an adult rat model in which lung injury was provoked by injurious ventilator settings [33]. With tidal volumes of 15 ml/kg, rats were ventilated with either heliox (50% helium, 50% oxygen) or a standard gas mixture (50% oxygen, 50% air) for 4 h, while adjusting the respiratory rate to maintain normocapnia.…”

Section: Resultsmentioning

confidence: 99%

The Potential of Heliox as a Therapy for Acute Respiratory Distress Syndrome in Adults and Children: A Descriptive Review

et al. 2015

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Background: In neonatal respiratory distress syndrome (RDS) and acute RDS (ARDS) mechanical ventilation is often necessary to manage hypoxia, whilst protecting the lungs through lower volume ventilation and permissive hypercapnia. Mechanical ventilation can, however, induce or aggravate the lung injury caused by the respiratory distress. Helium, in a gas mixture with oxygen (heliox), has a low density and can reduce the flow in narrow airways and allow for lower driving pressures. Objectives: The aim of this study was to review preclinical and clinical studies of the use of heliox ventilation in acute lung injury associated with respiratory failure. Methods: A systematic search was executed in the PubMed and EMBASE databases, with search terms referring to ARDS or an acute lung injury condition associated with respiratory failure and the corresponding intervention. Results: A total of 576 papers were retrieved. After the majority had been excluded 20 papers remained, of which 6 articles described animal models (3 paediatric; 3 adult animal models) and 14 were clinical studies, of which 12 described paediatric patient populations and 2 adult patient populations. In both paediatric and adult animal models, heliox improved gas exchange while allowing for less invasive ventilation in a wide variety of models using different ventilation modes. Clinical studies show a reduction in the work of breathing during heliox ventilation, with a concomitant increase in pH and decrease in PaCO₂ levels compared to oxygen ventilation. Conclusions: Although evidence so far is limited, there may be a rationale for heliox ventilation in ARDS as an intervention to improve ventilation and reduce the work of breathing.

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“…No adverse events related to the helium ventilation occurred during 3 h of ventilation with the noble gas. In animals, heliox improved CO 2 removal during lung protective mechanical ventilation [92] and allowed for lower minute volume ventilation in subjects with ventilator-induced lung injury [93]. Helium inhalation after inducing adult respiratory distress syndrome in rats decreased neutrophil infiltration, interstitial/intraalveolar oedema, perivascular and/or intraalveolar haemorrhage and hyaline membrane formation [94].…”

Section: Ventilation Improvement and Lung-protective Effects Of Heliummentioning

confidence: 99%

Gaseous mediators: an updated review on the effects of helium beyond blowing up balloons

Weber

Preckel

2019

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Noble gases, although supposed to be chemically inert, mediate numerous physiological and cellular effects, leading to protection against ischaemia-reperfusion injury in different organs. Clinically, the noble gas helium is used in treatment of airway obstruction and ventilation disorders in children and adults. In addition, studies from recent years in cells, isolated tissues, animals and finally humans show that helium has profound biological effects: helium applied before, during or after an ischaemic event reduced cellular damage, known as “organ conditioning”, in some tissue, e.g. the myocardium. Although extensive research has been performed, the exact molecular mechanisms behind these organ-protective effects of helium are yet not completely understood. In addition, there are significant differences of protective effects in different organs and animal models. A translation of experimental findings to the clinical situation has yet not been shown.

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Heliox Allows for Lower Minute Volume Ventilation in an Animal Model of Ventilator-Induced Lung Injury

Cited by 10 publications

References 23 publications

Mechanical ventilation with heliox in an animal model of acute respiratory distress syndrome

Mechanical ventilation with heliox in an animal model of acute respiratory distress syndrome

The Potential of Heliox as a Therapy for Acute Respiratory Distress Syndrome in Adults and Children: A Descriptive Review

Gaseous mediators: an updated review on the effects of helium beyond blowing up balloons

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