title: Use of heliox in the management of neonates with meconium aspiration syndrome.
abstract: BACKGROUND
  Helium-oxygen mixture (heliox) ventilation has been known as an alternative treatment in patients with airway obstruction. Because of the physical properties of heliox, mechanical ventilation with this gas mixture may offer advantages in the management of respiratory failure associated with meconium aspiration syndrome (MAS).
  
  
  OBJECTIVE
  The purpose of this pilot study was to assess the effect of short-term mechanical ventilation with heliox in newborns with MAS on vital signs, oxygenation, acid-base balance and respiratory function parameters.
  
  
  METHODS
  The study was carried out in newborns with respiratory failure requiring mechanical ventilation due to MAS. Eight patients were ventilated using pressure-controlled synchronized intermittent mandatory ventilation. Parameters of respiratory function, oxygenation, acid-base balance and vital signs were recorded at baseline, then twice during 1 h of heliox ventilation and finally twice during 1 h after switching back to air-oxygen ventilation.
  
  
  RESULTS
  Mechanical ventilation with heliox did not affect vital signs and the infants' clinical condition remained stable during the study. Heliox ventilation was associated with a nonsignificant increase in tidal volume, minute ventilation and peak expiratory flow rate values. Mechanical ventilation with heliox allowed the use of significantly lower FiO(2), with a significant decrease in alveolar-arterial oxygen tension difference and a decrease in the oxygenation index which was not statistically significant. There was also a significant increase in the PaO(2)/FiO(2) ratio during heliox ventilation.
  
  
  CONCLUSIONS
  Ventilation with a helium and oxygen mixture had a positive effect on the selected parameters of oxygenation, while its effects on other respiratory parameters were relatively small.
authors.affiliation: Department of Neonatology, Poznań University of Medical Sciences, Poznań, Poland. tszczapa@ump.edu.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Szczapa
authors.forename: Janusz
authors.initials: J
authors.lastname: Gadzinowski
mesh_terms: D000136:Acid-Base Equilibrium / Q000187:drug effects; D000280:Administration, Inhalation; D018592:Cross-Over Studies; D005260:Female; D006371:Helium / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood; D010865:Pilot Projects; D012119:Respiration / Q000187:drug effects; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D055986:Vital Signs / Q000187:drug effects
chemical_list: D006371:Helium; C038949:heliox; D010100:Oxygen