Helium-Oxygen Mixtures in Intubated Patients with Status Asthmaticus and Respiratory Acidosis

Gluck, Eric H.; Onorato, Douglas J.; Castriotta, Richard J.

doi:10.1378/chest.98.3.693

Cited by 202 publications

(106 citation statements)

References 29 publications

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“…The results from this study support previous reports of the beneficial use of Heliox28 in the treatment of obstructive lung disease (Shuie and Gluck, 1989;Gluck et al 1990;Tan et al, 1990). All of the patients in this study were current or ex-smokers and their FEV 1 /FVC all showed varying degrees of airway obstruction but we were unable to determine how much of their obstruction was due to concomitant COPD or to their cancer.…”

Section: Discussionsupporting

confidence: 92%

“…Helium/oxygen gas mixtures have been used for many years in the management of severe upper-airway obstruction associated with tumour (Hessan et al, 1988;Tan et al, 1990), asthma (Shuie and Gluck, 1989;Kass and Castriotta, 1995;Gluck et al, 1990), chronic obstructive pulmonary disease (COPD) (Grape et al, 1960;Ishikawa and Segal, 1973;Jaber et al, 2000) and a variety of other conditions (Elleau et al, 1993;Paret et al, 1996;Beckmann and Brueggemann, 2000;Khanlou and Eiger, 2001). The clinical effectiveness of this respiratory gas mixture is principally due to the lower density and higher viscosity exhibited by helium/oxygen gas mixtures compared to air or oxygen alone.…”

mentioning

confidence: 99%

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A double-blind, randomised, controlled Phase II trial of Heliox28 gas mixture in lung cancer patients with dyspnoea on exertion

et al. 2004

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Helium has a low density and the potential of reducing the work of breathing and improving alveolar ventilation when replacing nitrogen in air. A Phase II, double-blind, randomised, prospective, controlled trial was undertaken to assess whether Heliox28 (72% He/28% O 2 ) compared with oxygen-enriched air (72% N 2 /28% O 2 ) or medical air (78.9% N 2 /21.1% O 2 ) could reduce dyspnoea and improve the exercise capability of patients with primary lung cancer and dyspnoea on exertion (Borg 43). A total of 12 patients (seven male, five female patients, age 53 -78) breathed the test gases in randomised order via a facemask and inspiratory demand valve at rest and while performing 6-min walk tests. Pulse oximetry (SaO 2 ) was recorded continuously. Respiratory rate and dyspnoea ratings (Borg and VAS) were taken before and immediately post-walk. Breathing Heliox28 at rest significantly increased SaO 2 compared to oxygen-enriched air (9672 cf. 9472, Po0.01). When compared to medical air, breathing Heliox28 but not oxygen-enriched air gave a significant improvement in the exercise capability (Po0.0001), SaO 2 (Po0.05) and dyspnoea scores (VAS, Po0.05) of lung cancer patients.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

A double-blind, randomised, controlled Phase II trial of Heliox28 gas mixture in lung cancer patients with dyspnoea on exertion

et al. 2004

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“…With the administration of helium, there was a decrease in the PaCO 2 from 57.9±8.3 to 47.5±4.3 mm Hg and an increase in the pH from 7.23±0.07 to 7.32±0.04. In patients with status asthmaticus, requiring mechanical ventilation, Gluck et al 11 reported a decrease in the peak inflating pressure from a mean of 86 to 53 cm H 2 O and a decrease in the PaCO 2 from a mean of 87 to 51 Torr. The change in PIP was noted early (2.5 minutes) whereas the maximal decrease in PaCO 2 required 22.2 minutes.…”

Section: George Et Almentioning

confidence: 99%

Mechanical Ventilation During Pregnancy Using a Helium–Oxygen Mixture in a Patient With Respiratory Failure due to Status Asthmaticus

et al. 2001

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“…[5][6][7] The beneficial effects of helium have been realized in patients who have obstructive processes more distally along their tracheobronchial tree and who require mechanical ventilation for asthma and other respiratory disorders. [8][9][10] Additionally, there are anecdotal reports of helium being used successfully in the operating room to treat respiratory compromise related to an anterior mediastinal mass, bronchospasm, and tracheal stenosis. [11][12][13] During maintenance anesthesia in our patient, we noted the development of increasing upper airway obstruction and respiratory insufficiency manifested by increasing audible inspiratory stridor, decreased air movement, increased respiratory rate, suprasternal and intercostal retraction, and the development of hypercarbia with an increase of the TC-CO 2 from 46 to 68 mmHg.…”

Section: Discussionmentioning

confidence: 99%

Helium insufflation with sevoflurane general anesthesia and spontaneous ventilation during airway surgery

Tobias

2009

Can J Anesth/J Can Anesth

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Purpose The therapeutic benefits and clinical applications of helium-oxygen gas mixtures were first reported over 70 years ago. Since then, helium has been used in the treatment of obstructive processes of both the upper and lower airways. We report a unique case regarding helium insufflation with sevoflurane anesthesia and spontaneous ventilation for airway surgery. Clinical features A helium-oxygen mixture was administered during airway surgery in an 8-year-old boy with obstruction of the upper airway. Following the introduction of a helium-oxygen mixture during general anesthesia with spontaneous ventilation, a relatively rapid improvement in the patient's respiratory status was observed with a decrease in the audible inspiratory stridor, improved gas exchange, decreased respiratory rate, decreased suprasternal/intercostal retractions, and a decrease in the transcutaneous CO 2 . The physiologic basis for helium's effects on gas exchange are discussed and its use during insufflation for upper airway surgery is reviewed. Conclusions The addition of helium improves gas exchange with spontaneous ventilation during general anesthesia for airway surgery. RésuméObjectif Les bienfaits the´rapeutiques et les applications cliniques des me´langes gazeux he´lium-oxyge`ne ont e´te´r apporte´s pour la premie`re fois il y a plus de 70 ans. Depuis, l'he´lium a e´te´utilise´dans le traitement de syndromes obstructifs des voies ae´riennes supe´rieures et infe´rieures. Nous rapportons ici un cas unique en ce qui touche a`l'insufflation d'he´lium lors d'une anesthe´sie au se´voflurance en ventilation spontane´e lors d'une chirurgie des voies ae´riennes. É léments Cliniques Un me´lange he´lium-oxyge`ne a e´teá dministre´pendant une chirurgie des voies ae´riennes re´alise´e chez un enfant de huit ans manifestant une obstruction des voies ae´riennes supe´rieures. Apre`s l'introduction d'un me´lange he´lium-oxyge`ne pendant l'anesthe´sie ge´ne´rale avec ventilation spontane´e, une ame´lioration relativement rapide de l'e´tat respiratoire du patient a e´te´observe´e avec une diminution du stridor audible, un e´change gazeux ame´liore´, une fre´quence respiratoire re´duite, un tirage suprasternal/intercostal moindre et une re´duction du CO 2 transcutane´. Le fondement physiologique des effets de l'he´lium sur les e´changes gazeux est discute´et son utilisation pendant l'insufflation lors de chirurgie des voies ae´riennes supe´rieures est passe´e en revue. Conclusion L'ajout d'he´lium ame´liore les e´changes gazeux en ventilation spontane´e pendant l'anesthe´sie ge´ne´rale lors de chirurgies des voies ae´riennes.

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Helium-Oxygen Mixtures in Intubated Patients with Status Asthmaticus and Respiratory Acidosis

Cited by 202 publications

References 29 publications

A double-blind, randomised, controlled Phase II trial of Heliox28 gas mixture in lung cancer patients with dyspnoea on exertion

A double-blind, randomised, controlled Phase II trial of Heliox28 gas mixture in lung cancer patients with dyspnoea on exertion

Mechanical Ventilation During Pregnancy Using a Helium–Oxygen Mixture in a Patient With Respiratory Failure due to Status Asthmaticus

Helium insufflation with sevoflurane general anesthesia and spontaneous ventilation during airway surgery

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