Document Detail

Helium-oxygen in the postextubation period decreases inspiratory effort.
MedLine Citation:
PMID:  11520728     Owner:  NLM     Status:  MEDLINE    
After tracheal extubation, upper and total airway resistances may frequently be increased resulting in an increase in inspiratory effort to breathe. We tested whether breathing a helium-oxygen mixture (HeO(2)) would reduce inspiratory effort in the period after extubation. Eighteen consecutive patients with no chronic obstructive pulmonary disease who had received mechanical ventilation (> 48 h) were successively studied immediately after extubation (N(2)O(2)), 15 min after breathing HeO(2), and after return to N(2)O(2). Effort to breathe, assessed by the transdiaphragmatic pressure swings (DeltaPdi) and the pressure-time index of the diaphragm (PTI), comfort, and gas exchange, were the main end points. The mean reduction of the transdiaphragmatic pressure under HeO(2) was 19 +/- 5%. All but three patients presented a decrease in transdiaphragmatic pressure under HeO(2), ranging from - 4 to - 55%, and a significant reduction in DeltaPdi was observed between HeO(2) and N(2)O(2) (10.2 +/- 0.7 versus 8.6 +/- 1.1 versus 10.0 +/- 0.8 cm H(2)O for the three consecutive periods; p < 0.05). PTI also differed significantly between HeO(2) and N(2)O(2) (197 +/- 19 versus 166 +/- 22 versus 201 +/- 23 cm H(2)O/s/min for the three periods; p < 0.05). Breathing HeO(2) significantly improved comfort, whereas gas exchange was not modified. We conclude that the use of HeO(2) in the immediate postextubation period decreases inspiratory effort and improves comfort.
S Jaber; A Carlucci; M Boussarsar; R Fodil; J Pigeot; S Maggiore; A Harf; D Isabey; L Brochard
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  164     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-24     Completed Date:  2001-10-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-7     Citation Subset:  AIM; IM    
Service de Réanimation Médicale, Hôpital Henri Mondor, AP-HP, Université Paris, France.
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MeSH Terms
Administration, Inhalation
Aged, 80 and over
Analysis of Variance
Blood Gas Analysis
Diaphragm / drug effects,  physiopathology
Drug Therapy, Combination
Helium / pharmacology,  therapeutic use*
Hemodynamics / drug effects
Inspiratory Capacity* / drug effects*
Intubation, Intratracheal* / adverse effects
Middle Aged
Oxygen Inhalation Therapy / methods*
Pulmonary Gas Exchange
Respiratory Insufficiency / metabolism,  physiopathology*,  therapy*
Time Factors
Treatment Outcome
Ventilator Weaning / adverse effects,  methods*
Work of Breathing
Reg. No./Substance:

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