Document Detail


Heliox and noninvasive positive-pressure ventilation: a role for heliox in exacerbations of chronic obstructive pulmonary disease?
MedLine Citation:
PMID:  16723041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Evidence-based respiratory therapy for exacerbations of chronic obstructive pulmonary disease (COPD) includes oxygen, inhaled bronchodilators, and noninvasive positive-pressure ventilation. Examining the physics of gas flow, a case can be made either for or against the use of helium-oxygen mixture (heliox) in the care of patients with COPD. The evidence for the use of heliox in patients with COPD exacerbation is not strong at present. Most of the peer-reviewed literature consists of case reports, case series, and physiologic studies in small samples of carefully selected patients. Some patients with COPD exacerbation have a favorable physiologic response to heliox therapy, but predicting who will be a responder is difficult. Moreover, the use of heliox is hampered by the lack of widespread availability of an approved heliox delivery system. Appropriately designed randomized controlled trials with patient-important outcomes, such as avoidance of intubation, decreased intensive-care-unit and hospital days, and decreased cost of therapy, are sorely needed to establish the role of heliox in patients with COPD exacerbation, including those receiving noninvasive positive-pressure ventilation. Lacking such evidence, the use of heliox in patients with COPD exacerbation cannot be considered standard therapy.
Authors:
Dean R Hess
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Respiratory care     Volume:  51     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-25     Completed Date:  2006-08-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  640-50     Citation Subset:  IM    
Affiliation:
Department of Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USA. dhess@partners.org
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MeSH Terms
Descriptor/Qualifier:
Anoxia / physiopathology
Biophysical Phenomena
Biophysics
Carbon Dioxide / metabolism
Functional Residual Capacity
Helium / administration & dosage,  pharmacology,  therapeutic use*
Humans
Oxygen / administration & dosage,  pharmacology,  therapeutic use*
Positive-Pressure Respiration*
Pulmonary Disease, Chronic Obstructive / drug therapy*,  physiopathology,  therapy
Respiratory Function Tests
Work of Breathing / drug effects
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 58933-55-4/heliox; 7440-59-7/Helium; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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