Heliox with inhaled nitric oxide: a novel strategy for severe localized interstitial pulmonary emphysema in preterm neonatal ventilation.
We describe the combined use of inhaled nitric oxide and heliox (79% helium and 21% oxygen) as a rescue therapy for a critically ill infant with localized interstitial pulmonary emphysema and pulmonary hypertension. Conventional interventions were ineffective, not feasible, or unlikely to take effect in time, during this infant's acute critical illness. We added heliox based on its known pulmonary effects, and inhaled nitric oxide to improve oxygenation, after echocardiographic evidence of high right-ventricular pressure. The infant made a full recovery. To our knowledge this is the first case report of heliox and inhaled nitric oxide used simultaneously in localized interstitial pulmonary emphysema.
Phatak
Rajesh S
RS
Hull Royal Infirmary, East Yorkshire, United Kingdom.
Pairaudeau
Charles F
CF
Smith
Christopher J
CJ
Pairaudeau
Peter W
PW
Klonin
Hilary
H
D000280:Administration, Inhalation; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D006371:Helium / Q000008:administration & dosage*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy*; D017563:Lung Diseases, Interstitial / Q000628:therapy*; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage*; D010100:Oxygen / Q000008:administration & dosage*; D011656:Pulmonary Emphysema / Q000628:therapy*; D012121:Respiration, Artificial
D001993:Bronchodilator Agents; D006371:Helium; D009569:Nitric Oxide; C038949:heliox; D010100:Oxygen