Usefulness of helium-oxygen mixtures in the treatment of mechanically ventilated patients.
The density of helium is markedly lower than that of air or any of its components, leading to a substantial decrease in airway resistance to flow when it is inhaled. In mechanically ventilated patients with obstructive airway disease, replacing the usual air-oxygen mixture with helium-oxygen has been shown to reduce dynamic hyperinflation and intrinsic positive end-expiratory pressure; to decrease lung inflation pressures, respiratory acidosis, and work of breathing; and to improve arterial blood gases. Aerosol delivery to distal airways is enhanced with helium-oxygen. Preliminary data also suggest that the use of helium-oxygen could be a valuable approach to decrease postextubation respiratory distress. However, interference with ventilator function and added costs are two major disadvantages of helium-oxygen. Hence, before its widespread use in mechanically ventilated patients can be recommended, studies are needed to determine whether these favorable short-term effects can influence patient outcome.
Jolliet
Philippe
P
Divisions of Medical Intensive Care and Anesthesiology, University Hospital, Geneva, Switzerland. jolliet@medecine.unige.ch
Tassaux
Didier
D
D006371:Helium / Q000627:therapeutic use*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D010100:Oxygen / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D012140:Respiratory Tract Diseases / Q000503:physiopathology / Q000628:therapy*; D013990:Tidal Volume
D006371:Helium; C038949:heliox; D010100:Oxygen