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Critical Care
Published in: Critical Care 3/2009

Open Access 01-06-2009 | Research

Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure

Authors: Martin CJ Kneyber, Marc van Heerde, Jos WR Twisk, Frans B Plötz, Dick G Markhors

Published in: Critical Care | Issue 3/2009

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Abstract

Introduction

Respiratory syncytial virus (RSV) lower respiratory tract disease is characterised by narrowing of the airways resulting in increased airway resistance, air-trapping and respiratory acidosis. These problems might be overcome using helium-oxygen gas mixture. However, the effect of mechanical ventilation with heliox in these patients is unclear. The objective of this prospective cross-over study was to determine the effects of mechanical ventilation with heliox 60/40 versus conventional gas on respiratory system resistance, air-trapping and CO2 removal.

Methods

Mechanically ventilated, sedated and paralyzed infants with proven RSV were enrolled within 24 hours after paediatric intensive care unit (PICU)admission. At T = 0, respiratory system mechanics including respiratory system compliance and resistance, and peak expiratory flow rate were measured with the AVEA ventilator. The measurements were repeated at each interval (after 30 minutes of ventilation with heliox, after 30 minutes of ventilation with nitrox and again after 30 minutes of ventilation with heliox). Indices of gas exchange (ventilation and oxygenation index) were calculated at each interval. Air-trapping (defined by relative change in end-expiratory lung volume) was determined by electrical impedance tomography (EIT) at each interval.

Results

Thirteen infants were enrolled. In nine, EIT measurements were performed. Mechanical ventilation with heliox significantly decreased respiratory system resistance. This was not accompanied by an improved CO2 elimination, decreased peak expiratory flow rate or decreased end-expiratory lung volume. Importantly, oxygenation remained unaltered throughout the experimental protocol.

Conclusions

Respiratory system resistance is significantly decreased by mechanical ventilation with heliox (ISCRTN98152468).
Appendix
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Metadata
Title
Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure
Authors
Martin CJ Kneyber
Marc van Heerde
Jos WR Twisk
Frans B Plötz
Dick G Markhors
Publication date
01-06-2009
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2009
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7880

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