title: High flow nasal heliox improves work of breathing and attenuates lung injury in a newborn porcine lung injury model.
abstract: BACKGROUND
  High flow nasal cannula (HFNC) has been shown to improve ventilation and oxygenation and reduce work of breathing in newborns with respiratory distress. Heliox, decreases resistance to airflow, reduces the work of breathing, facilitates the distribution of inspired gas, and has been shown to attenuate lung inflammation during the treatment of acute lung injury.
  
  
  OBJECTIVE
  Heliox delivered by HFNC will decrease resistive load, decrease work of breathing, improve ventilation and attenuate lung inflammation during spontaneous breathing following acute lung injury in the newborn pig.
  
  
  METHODS
  Spontaneously breathing neonatal pigs received Nitrox or Heliox by HFNC and studied over 4 hrs following oleic acid injury. Gas exchange, pulmonary mechanics and systemic inflammation were measured serially. Lung inflammation biomarkers were assessed at termination.
  
  
  RESULTS
  Heliox breathing animals demonstrated lower work of breathing reflected by lower tracheal pressure, phase angle and phase relationship. Ventilation efficiency index was greater compared to Nitrox. Heliox group showed less lung inflammation reflected by lower tissue interleukin-6 and 8.
  
  
  CONCLUSIONS
  High flow nasal Heliox decreased respiratory load, reduced resistive work of breathing indices and attenuated lung inflammatory profile while ventilation was supported at less pressure effort in the presence of acute lung injury.
authors.affiliation: Neonatology, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.|Neonatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: R K
authors.initials: RK
authors.lastname: Jassar
authors.affiliation: Neonatology, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.|Neonatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Vellanki
authors.affiliation: Alfred I. duPont Hospital for Children, Center for Pediatric Lung Research, Wilmington, DE, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Alfred I. duPont Hospital for Children, Center for Pediatric Lung Research, Wilmington, DE, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Hesek
authors.affiliation: Alfred I. duPont Hospital for Children, Center for Pediatric Lung Research, Wilmington, DE, USA.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: Alfred I. duPont Hospital for Children, Center for Pediatric Lung Research, Wilmington, DE, USA.|Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
authors.forename: E
authors.initials: E
authors.lastname: Rodriguez
authors.affiliation: Temple University School of Medicine, Departments of Physiology, Pediatrics, and Medicine, Center for Inflammation, Translational and Clinical Lung Research, Philadelphia, PA, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Wolfson
authors.affiliation: Alfred I. duPont Hospital for Children, Center for Pediatric Lung Research, Wilmington, DE, USA.|Temple University School of Medicine, Department of Physiology and Pediatrics, Philadelphia, PA, USA.
authors.forename: T H
authors.initials: TH
authors.lastname: Shaffer
mesh_terms: D055371:Acute Lung Injury / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy*; D000818:Animals; D004195:Disease Models, Animal; D006371:Helium / Q000008:administration & dosage*; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D010100:Oxygen / Q000008:administration & dosage*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011014:Pneumonia / Q000378:metabolism; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012123:Pulmonary Ventilation / Q000187:drug effects; D013552:Swine; D014939:Work of Breathing / Q000187:drug effects*
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8; D006371:Helium; C038949:heliox; D010100:Oxygen
keywords: Helium-oxygen (Heliox); High flow nasal cannula (HFNC); lung injury