Document Detail


Helium/oxygen mixture reduces the work of breathing at the end of the weaning process in patients with severe chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  12771612     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that helium/oxygen mixture can reduce the work of breathing at the end of the weaning process in patients with chronic obstructive pulmonary disease. DESIGN: Prospective, randomized, crossover study. SETTING: Two medical intensive care units at two university tertiary care centers. PATIENTS: Thirteen patients with chronic obstructive pulmonary disease evaluated just before and after extubation. INTERVENTIONS: Helium/oxygen and air/oxygen mixtures were administered sequentially, for 20 mins each, in a randomized order, just before extubation. It was possible to repeat the study after extubation in five patients. MEASUREMENTS AND MAIN RESULTS: Before extubation, the helium/oxygen mixture induced no significant variation in the breathing pattern. By contrast, it reduced the work of breathing from 1.442 +/- 0.718 J/L (mean +/- sd) to 1.133 +/- 0.500 J/L (p <.05). This reduction was explained mainly by a reduction in the resistive component of the work of breathing from 0.662 +/- 0.376 to 0.459 +/- 0.256 J/L (p <.01). We also observed a slight reduction in the intrinsic positive end-expiratory pressure from 2.9 +/- 2.1 cm H(2)O to 2.1 +/- 1.8 cm H(2)O (p <.05). Similar results were also observed after extubation in five patients in whom the repetition of the study was possible. CONCLUSIONS: In spontaneously breathing intubated patients with chronic obstructive pulmonary disease recovering from an acute exacerbation, helium/oxygen mixture reduces the work of breathing as well as intrinsic positive end-expiratory pressure without modifying the breathing pattern.
Authors:
Jean-Luc Diehl; Alain Mercat; Emmanuel Guérot; Fethi Aïssa; Jean-Louis Teboul; Christian Richard; Jacques Labrousse
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-28     Completed Date:  2003-06-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1415-20     Citation Subset:  AIM; IM    
Affiliation:
Services de Réanimation Médicale, Hôpitaux Européen Georges Pompidou, France.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Blood Gas Analysis
Cross-Over Studies
Female
Forced Expiratory Volume / drug effects
Helium / economics,  pharmacology,  therapeutic use*
Humans
Male
Middle Aged
Oxygen / economics,  pharmacology,  therapeutic use*
Oxygen Inhalation Therapy / economics,  methods*
Positive-Pressure Respiration, Intrinsic / etiology,  prevention & control
Prospective Studies
Pulmonary Disease, Chronic Obstructive / metabolism,  physiopathology,  therapy*
Pulmonary Gas Exchange / drug effects
Respiratory Mechanics / drug effects
Tidal Volume / drug effects
Treatment Outcome
Ventilator Weaning / adverse effects,  methods*
Vital Capacity / drug effects
Work of Breathing*
Chemical
Reg. No./Substance:
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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