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Critical Care
Published in: Critical Care 4/2001

01-08-2001 | Commentary

Helium oxygen mixtures in the intensive care unit

Author: Jean-Claude Chevrolet

Published in: Critical Care | Issue 4/2001

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Abstract

Heliox, a mixture of helium and oxygen, has a density that is less than that of air. Breathing heliox leads to a reduction in resistance to flow within the airways, and consequently to a decrease in the work of breathing (WOB), particularly in disorders that are characterized by increased airways resistance. Beneficial effects have been observed in patients with asthma, chronic obstructive pulmonary disease (COPD), bronchiolitis, bronchopulmonary dysplasia and upper airways obstruction. Until we have conclusive data that attest to the efficacy of heliox in such conditions, its use will remain controversial. Meanwhile, it appears wise not to incorporate heliox therapy into routine practice because of technical complications and high costs.
Literature
1.
O'Grady K, Doyle DJ, Irish J, Gullane P: Biophysics of airflow within the airway: a review. J Otolaryngol 1997, 26: 123-128.PubMed
2.
Pedley T, Schroter R, Sudlow M: Gas flow and mixing in the airways. In: Bioengeenering Aspects of the Lungs. Edited by West J. New York, Basel: Marcel Dekker, 1977, 2: 163-265.
3.
Olson D, Dart G, Filley G: Pressure drop and fluid flow regime of air inspired into the human lung. J Appl Physiol 1970, 28: 482-494.PubMed
4.
Otis A, Bembower W: Effect of gas density on resistance to respiratory gas flow in man. J Appl Physiol 1949, 2: 300-306.PubMed
5.
Wood LD, Engel LA, Griffin P, Despas P, Macklem PT: Effect of gas physical properties and flow on lower pulmonary resistance. J Appl Physiol 1976, 41: 234-244.PubMed
6.
Dubois A: Resistance to breathing. In: Handbook of Physiology. Edited by Macklem PT, Mead J. Bethesda: American Society of Physiology; 1986, 451-461.
7.
Radford E: The physic of gases. In: Handbook of Physiology. Edited by Macklem PT, Mead J. Bethesda: American Physiological Society; 1964, 125-151.
8.
Barnett TB: Effects of helium and oxygen mixtures on pulmonary mechanics during airway constriction. J Appl Physiol 1967, 22: 707-713.PubMed
9.
Jolliet P, Tassaux D, Chevrolet J: Beneficial effects of helium-oxygen mixtures in acute respiratory failure. In: Yearbook of Intensive Care and Emergency Medicine. Edited by Vincent J. Berlin: Springer Verlag; 1999, 244-251.
10.
Tassaux D, Jolliet P, Roeseler J, Chevrolet JC: Effects of helium-oxygen on intrinsic positive end-expiratory pressure in intubated and mechanically ventilated patients with severe chronic obstructive pulmonary disease. Crit Care Med 2000, 28: 2721-2728. 10.1097/00003246-200008000-00006CrossRefPubMed
11.
Jolliet P, Tassaux D, Thouret JM, Chevrolet JC: Beneficial effects of helium:oxygen versus air:oxygen noninvasive pressure support in patients with decompensated chronic obstructive pulmonary disease. Crit Care Med 1999, 27: 2422-2429. 10.1097/00003246-199911000-00017CrossRefPubMed
12.
Jaber S, Fodil R, Carlucci A, Boussarsar M, Pigeot J, Lemaire F, Harf A, Lofaso F, Isabey D, Brochard L: Noninvasive ventilation with helium-oxygen in acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000, 161: 1191-1200.CrossRefPubMed
13.
Manthous CA, Morgan S, Pohlman A, Hall JB: Heliox in the treatment of airflow obstruction. Respir Care 1997, 42: 1034-1042.
14.
Boorstein JM, Boorstein SM, Humphries GN, Johnston CC: Using helium-oxygen mixtures in the emergency management of acute upper airway obstruction. Ann Emerg Med 1989, 18: 688-690.CrossRefPubMed
15.
Weber JE, Chudnofsky CR, Younger JG, Larkin GL, Boczar M, Wilkerson MD, Zuriekat GY, Nolan B, Eicke DM: A randomized comparison of helium-oxygen mixture (heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics 2001, 107: E96.CrossRefPubMed
16.
Rodrigo G, Rodrigo C, Pollack C, Travers A: Helium-oxygen mixture for nonintubated acute asthma patients (Cochrane Review). Cochrane Database Syst Rev 2001, 1.
17.
Kudukis TM, Manthous CA, Schmidt GA, Hall JB, Wylam ME: Inhaled helium-oxygen revisited: effect of inhaled helium-oxygen during the treatment of status asthmaticus in children. J Pediatr 1997, 130: 217-224.CrossRefPubMed
18.
Manthous CA, Hall JB, Caputo MA, Walter J, Klocksieben JM, Schmidt GA, Wood LD: Heliox improves pulsus paradoxus and peak expiratory flow in nonintubated patients with severe asthma. Am J Respir Crit Care Med 1995, 151: 310-314.CrossRefPubMed
19.
Kass JE, Terregino CA: The effect of heliox in acute severe asthma: a randomized controlled trial. Chest 1999, 116: 296-300. 10.1378/chest.116.2.296CrossRefPubMed
20.
Darioli R, Perret C: Mechanical controlled hypoventilation in status asthmaticus. Am Rev Respir Dis 1984, 129: 385-387.PubMed
21.
Mansel JK, Stogner SW, Petrini MF, Norman JR: Mechanical ventilation in patients with acute severe asthma. Am J Med 1990, 89: 42-48.CrossRefPubMed
22.
23.
Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A: Non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 1995, 333: 17-22. 10.1056/NEJM199509283331301CrossRef
24.
Brochard L, Isabey D, Piquet A, Mancebo J, Messaadi A: Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med 1990, 323: 1523-1530.CrossRefPubMed
25.
Rossi A, Polese G, Brandi G, Conti G: Intrinsic positive end-expiratory pressure (PEEPi). Intensive Care Med 1995, 21: 522-536.CrossRefPubMed
26.
Hollman G, Shen G, Zeng L, Yngsdal-Krenz R, Perloff W, Zimmer-man J, Strayss R: Helium-oxygen improves clinical asthma scores in children with acute bronchiolitis. Crit Care Med 1998, 26: 1731-1736. 10.1097/00003246-199810000-00031CrossRefPubMed
27.
Wolfson MR, Bhutani VK, Shaffer TH, Bowen FW Jr: Mechanics and energetics of breathing helium in infants with bronchopulmonary dysplasia. J Pediatr 1984, 104: 752-757.CrossRefPubMed
28.
Pingleton SK, Bone RC, Ruth WC: Helium-oxygen mixtures during bronchoscopy. Crit Care Med 1980, 8: 50-53.CrossRefPubMed
29.
Barr J, Lushkov G, Starinsky R, Klin B, Berkovitch M, Eshel G: Heliox therapy for pneumothorax: new indication for an old remedy. Ann Emerg Med 1997, 30: 159-162.CrossRefPubMed
30.
Barr J, Eshel G, Chen-Levy Z, Lahat E: Heliox use in the treatment of acute hyperammonemia. J Child Neurol 2001, 16: 456-458.CrossRefPubMed
31.
Tassaux D, Jolliet P, Thouret JM, Roeseler J, Dorne R, Chevrolet JC: Calibration of seven ICU ventilators for mechanical ventilation with helium-oxygen mixtures. Am J Respir Crit Care Med 1999, 160: 22-32.CrossRefPubMed
32.
Chatmongkolchart S, Kacmarek RM, Hess DR: Heliox delivery with noninvasive positive pressure ventilation: a laboratory study. Respir Care 2001, 46: 248-254.PubMed
Metadata
Title
Helium oxygen mixtures in the intensive care unit
Author
Jean-Claude Chevrolet
Publication date
01-08-2001
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2001
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc1019

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