title: Inhaled medical gases: more to breathe than oxygen.
abstract: The mixture of oxygen and nitrogen is usually sufficient to achieve the therapeutic objective of supporting adequate gas exchange. Pediatric and neonatal patients have an assortment of physiologic conditions that may require adjunctive inhaled gases to treat the wide variety of diseases  seen in this heterogeneous population. Inhaled nitric oxide, helium oxygen mixtures, inhaled anesthetics, hypercarbic mixtures, hypoxic mixtures, inhaled carbon monoxide, and hydrogen sulfide have been used to alter physiology in an attempt to improve patient outcomes. Balancing the therapeutic  potential, possible adverse effects, and the complexity of the technical aspects of gas delivery, it is essential that clinicians thoroughly understand the application of medical gas therapy beyond the traditional nitrogen/oxygen mixture.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. michael.gentile@duke.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gentile
mesh_terms: D000280:Administration, Inhalation; D000777:Anesthetics / Q000008:administration & dosage*; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy / Q000503:physiopathology; D002648:Child; D003422:Critical Care; D016503:Drug Delivery Systems; D006371:Helium / Q000008:administration & dosage*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy; D008171:Lung Diseases / Q000188:drug therapy*; D009569:Nitric Oxide / Q000008:administration & dosage* / Q000378:metabolism; D010100:Oxygen / Q000008:administration & dosage*; D010547:Persistent Fetal Circulation Syndrome / Q000188:drug therapy; D011659:Pulmonary Gas Exchange / Q000187:drug effects / Q000502:physiology; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000777:Anesthetics; D006371:Helium; D009569:Nitric Oxide; C038949:heliox; D010100:Oxygen