Heliox for mechanically ventilated newborns with bronchopulmonary dysplasia.
OBJECTIVE
We assessed the safety and studied the influence of short-term helium-oxygen (heliox) mechanical ventilation (MV) on respiratory function, gas exchange and oxygenation in infants with bronchopulmonary dysplasia (BPD) or at high risk for BPD.


METHODS
A pilot, time-series study.


METHODS
Neonatal intensive care unit.


METHODS
Infants with severe BPD who required MV.


METHODS
MV with helium-oxygen and air-oxygen mixtures.


METHODS
Respiratory parameters, acid-base balance, oxygenation and vital signs were recorded at five time points: initially during MV with air-oxygen, after 15 and 60 min of helium-oxygen MV, and 15 and 60 min after return to air-oxygen MV.


RESULTS
15 infants with BPD were enrolled. Helium-oxygen MV was well tolerated and was associated with a statistically significant increase in tidal volume, dynamic compliance and peak expiratory flow rate. An improvement in oxygenation and a decrease in fraction of inspired oxygen was also observed. During helium-oxygen MV there was a significant decrease in the oxygenation index and alveolar-arterial oxygen tension difference. The PaO2/fraction of inspired oxygen (FiO2) ratio increased significantly during helium-oxygen ventilation. A decrease in PaCO2 and an increase in pH were also observed during helium-oxygen administration, however this was not statistically significant. After ventilation with helium-oxygen was discontinued, the infants' respiratory function and oxygenation deteriorated and supplemental oxygen requirements increased accordingly.


CONCLUSIONS
Helium-oxygen MV is safe and resulted in improvement of respiratory function and oxygenation in infants with severe BPD requiring MV.
Department of Neonatology, Poznań University of Medical Sciences, , Poznań, Poland.
Tomasz
T
Szczapa
Janusz
J
Gadzinowski
Jerzy
J
Moczko
T Allen
TA
Merritt
D000402:Airway Obstruction / Q000150:complications* / Q000628:therapy; D001997:Bronchopulmonary Dysplasia / Q000209:etiology / Q000628:therapy*; D005260:Female; D006371:Helium / Q000627:therapeutic use*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology* / Q000628:therapy; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010100:Oxygen / Q000097:blood* / Q000627:therapeutic use; D010865:Pilot Projects; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D012129:Respiratory Function Tests; D013990:Tidal Volume
D006371:Helium; C038949:heliox; D010100:Oxygen
Intensive Care; Neonatology; Respiratory