Helium-oxygen versus air-oxygen noninvasive pressure support in decompensated chronic obstructive disease: A prospective, multicenter study.

Details

Serval ID
serval:BIB_29817
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Helium-oxygen versus air-oxygen noninvasive pressure support in decompensated chronic obstructive disease: A prospective, multicenter study.
Journal
Critical Care Medicine
Author(s)
Jolliet P., Tassaux D., Roeseler J., Burdet L., Broccard A., D'Hoore W., Borst F., Reynaert M., Schaller M.D., Chevrolet J.C.
ISSN
0090-3493 (Print)
ISSN-L
0090-3493
Publication state
Published
Issued date
2003
Volume
31
Number
3
Pages
878-884
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
OBJECTIVE: To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization costs.
DESIGN: Prospective, randomized, multicenter study.
SETTING: Intensive care units of three tertiary care university hospitals.
PATIENTS: All patients with chronic obstructive pulmonary disease admitted to the intensive care units for NIPSV during a 24-month period.
INTERVENTIONS: Patients were randomized to NIPSV with air/oxygen or He/oxygen. NIPSV settings, number of daily trials, decision to intubate, and intensive care unit and hospital discharge criteria followed standard practice guidelines.
RESULTS: A total of 123 patients (male/female ratio, 71:52; age, 71 +/- 10 yrs, Acute Physiology and Chronic Health Evaluation II, 17 +/- 4) were included. Intubation rate (air/oxygen 20% vs. He/oxygen 13%) and length of stay in the intensive care unit (air/oxygen 6.2 +/- 5.6 vs. He/oxygen 5.1 +/- 4 days) were comparable. The post-intensive care unit hospital stay was lower with He/oxygen (air/oxygen 19 +/- 12 vs. He/oxygen 13 +/- 6 days, p < .002). Cost of NIPSV gases was higher with He/oxygen, but total hospitalization costs were lower by $3,348 per patient with He/oxygen. No complications were associated with the use of He/oxygen.
CONCLUSION: He/oxygen did not significantly reduce intubation rate or intensive care unit stay, but hospital stay was shorter and total costs were lower. He/oxygen NIPSV can be safely administered and could prove to be a cost-effective strategy.
Keywords
APACHE, Aged, Blood Gas Analysis, Cost-Benefit Analysis, Dyspnea/etiology, Female, Helium/economics, Helium/therapeutic use, Hospital Costs/statistics & numerical data, Hospital Mortality, Humans, Intensive Care Units/statistics & numerical data, Intubation, Intratracheal/statistics & numerical data, Length of Stay/statistics & numerical data, Male, Middle Aged, Oxygen/economics, Oxygen/therapeutic use, Oxygen Inhalation Therapy/economics, Oxygen Inhalation Therapy/methods, Positive-Pressure Respiration/economics, Positive-Pressure Respiration/methods, Prospective Studies, Pulmonary Disease, Chronic Obstructive/complications, Pulmonary Disease, Chronic Obstructive/mortality, Safety, Switzerland/epidemiology, Treatment Outcome, Work of Breathing
Pubmed
Web of science
Create date
19/11/2007 12:27
Last modification date
20/08/2019 13:09
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