medigraphic.com
ISSN 2448-8909 (Print)

1999, Number 6

<< Back

Med Crit 1999; 13 (6)

Heliox: Treatment of a patient with refractary status asmathicus

Carrillo ER, Neil NMF

Language: Spanish
References: 45
Page: 197-202
PDF size: 105.34 Kb.


ABSTRACT

Objective: To report the use of helium-oxygen in the treatment of a patient with refractary status asmathicus.
Design: Case report and literature review.
Setting: ICU of a tertiary care hospital in Mexico City.
Patient: A 55-yrs-old patient with refractary status asmathicus complicated with pneumothorax (due to barotrauma), hypoxemia and respiratory acidosis.
Interventions: Mechanical ventilation support, insertion of a pleural tube, administration of helium oxygen mixture and bronchodilators.
Measurements and main results: Noninvasive monitoring, intrinsec PEEP and arterial blood gases were performed at 1, 12 and 24 hours after de beginning of treatment with helium-oxygen. A decrease of the maximum airway pressure, intrinsec PEEP and PaCO2, as well as an increase of mean arterial pressure and PaO2 was observed. Respiratory acidosis was corrected also.
Conclusion: The use of helium-oxygen mixture is a good therapeutic alternative in patients with status asmathicus.


REFERENCES

  1. Barach AL. The therapeutic use of helium. JAMA 1936; 107: 1273-80.

  2. Ta Shung Lu, Akito Ohmura, KC Wong. Helium-oxigen in treatment of upper airway obstruction. Radiology 1976; 45: 678-680.

  3. Hutcheon MA, Hyland RH. Helium/oxygen therapy. Chest 1987; 4: 766.

  4. Cushing IE. Helium in respiratory therapy. JAMA 1978; 17: 1744.

  5. McGee DL, Wald DA, Hinchliffe S. Helium-oxygen therapy in the emergency department. J Emerg Med 1997; 3: 291-6.

  6. Gluck EH, Onorato DJ, Castriotta R. Helium-oxigen mixtures in intubated pacientes with status asthmaticus and respiratory acidosis. Chest 1990; 98: 693-698.

  7. Curtis JL, Mahlmeister M, Fink JB, Lampe G, Matthay MA. Helium-oxygen gas therapy. Chest 1986; 90: 455-57.

  8. Papamoschou Dimitri. Theoretical validation of the respiratory benefits of helium-oxygen mixtures. Respiration Physiology 1995; 99: 183-190.

  9. Dean RB, Visocher MB. The kinetics of lung ventilation. Am J Physiol 1941: 134: 4504.

  10. Otis AB, Bembower WC. Effect of gas density on resistance to respiratory gas flow in man. J Appl Physiol 1949; 2: 300-306.

  11. Slutsky AS, Berdine G, Drazen JM. Steady flow in a model of human central airway. J Appl Physiol Respir Environ Exercise Physiol 1980; 54: 417-423.

  12. Jafrin MY, Kesic P. Airway resistance: a fluid mechanical approach. J Appl Physiol 1974; 36: 354-361.

  13. Paiva M. Gas transport in the human lung. J Appl Physiol 1973; 35: 401-10.

  14. Paiva M, Engel LA. Pulmonary interdependence of tas transport. J Appl Physiol 1979; 47: 296-305.

  15. Sikland RS, Magnussen H, Scheid P, Piiper J. Convective an diffusive gas mixting in human lung: Experiments and model analysis. J Appl Physiol 1976; 40: 362-71.

  16. Dekker E. Transition between laminar and turbulent flow in the human trachea. J Appl Physiol 1961; 16: 1060-64.

  17. Christopherson SK, Hlastala MD. Pulmonary gas exchange during altered density gas breathing. J Appl Physiol 1882; 52: 221-25.

  18. West JB, Hugh-Jones P. Patterns of gas flow in the upper bronchial tree. J Appl Physiol 1959; 14: 753-59.

  19. Benatar SR. Fatal asthma. N Engl J Med 1986: 314: 423-28.

  20. Robin DE. Death from bronchial asthma. Chest 1988; 93: 614-20.

  21. O’Rourke PP, Crone RK. Halothane in status asthmaticus. Crit Care Med 1982; 10: 341-43.

  22. Kass JE, Castriotta R. Heliox therapy in acute severe asthma. Chest 1995; 107: 757760.

  23. Kukukis TM, Manthous CA, Schmidt GA et al. Inhaled helium-oxygen revisited: Effect of inhaled helium-oxygen during the treatment of status asthmaticus in children. J Pediatr 1997; 130: 217-224.

  24. Shiue ST, Gluck EH. The use of helium-oxygen mixtures in the support of patients with estatus asthmaticus and respiratory acidosis. J Asthma 1989; 26: 177-80.

  25. Swidua DM, Montenegro DH, Goldman MD, Lutchen KR, Saidel GM. Helium-oxygen breathing in severe chronic obstructive pulmonary disease. Chest 1985; 87: 790-795.

  26. Grape B, Channin E, Tyler JM. The effect of helium and oxygen mixtures on pulmonary resistances in emphysema. Am Rev Respir Dis 1960; 81: 823-9.

  27. Hyatt RE, Shilder DP, Fry DL. Relationship between maximum expiratory flow and degree of lung inflation. J Appl Physiol 1958; 13: 331.

  28. Dosman J, Bode F, Urbanetti J, Martin R, Macklem PT. The use of helium-oxygen mixture during maximum expiratory flow to demonstrate obstruction in small airways in smokers. J Clin Invest 1975; 55: 1090-9.

  29. Stretton M, Ajizian SJ, Mitchell I et al. Intensive care course and outcome of patients infected with respiratory syncytial virus. Pediatr Pulmonol 1992; 13: 143-150.

  30. Barnes SD. Does heliox decrease the need for intubation in acute bronchiolitis? Crit Care Med 1998; 10: 1633-5.

  31. Gavin R, Anderson B, Percival T. Management of severe bronchiolitis: indications for ventilator support. NZ Med J 1996; 109: 137-139.

  32. Fleming MD, Weigelt JA, Brewer V, Mclntire D. Effect of helium and oxygen on airflow in a narrowed airway. Arch Surg 1992; 8: 956-9.

  33. Milner QJ, Abdy S, Aller JG. Management of severe obstruction with helium/oxygen and a laryngeal mask airway. Anaesthesia 1997; 11: 1087-9.

  34. Riley RH, Platt PR, Phillips MJ, Schneiner M. Helium-oxygen in laser therapy for bronchial stenosis. Anaesth Intensive Care 1990; 4: 583-4.

  35. Mizrahi S, Yaari Y, Lugassy G, Cotev S. Major airway obstruction relieved by helium/oxygen breathing. Crit Care Med 1986; 11: 986-7.

  36. Curtis JL, Mahlmeister M, Fink J et al. Helium-oxygen gas therapy: Use and availability for emergency treatment of inoperable airway obstruction. Chest 1986; 90: 455458.

  37. Skrinkas GJ, Hyland RH, Hutcheon MA. Using helium-oxygen mixtures in the management of acute upper airway obstruction. Can Med Assoc J 1983: 555-59.

  38. TenEyck LG, Colgan FJ. Methods and guidelines for mechanical ventilation with helium-oxygen for severe upper airway obstruction. Respir Care 1984; 29: 155-59.

  39. Sackner MA. Bronchofiberoscopy. Amer Rev Respir Dis 1975; 111: 261-4.

  40. Demers RR. Airflow resistences of endotracheal tubes. JAMA 1977; 237: 1362-5.

  41. Pingleton SK, Bone RC, Ruth WC. Helium-oxygen mixtures during bronchoscopy. Crit Care Med 1980; 8: 50-54.

  42. Pizov R, Oppenheim A, Eidelman LA, Weiss YG. Helium versus oxygen for tracheal gas insufflation during mechanical ventilation. Crit Care Med 1998; 26: 290-295.

  43. Barr J, Lushkov G, Starinsky R, Klin B, Berkovith M, Eshel G. Heliox therapy for pneumothorax: New indication for an old remedy. Ann Emerg Med 1997; 2: 159-62.

  44. Williams EL, Berson DM. Helium induced errors in clinical mass spectrometry. Anaesth Analg 1988; 1: 83-5.

  45. Kasik JW, Headley JG, Hyde WH. Hypoxia with helium-oxygen therapy. J Pediatr 1985; 4: 648-650.




2020     |     www.medigraphic.com