Helium-oxygen decreases inspiratory effort and work of breathing during pressure support in intubated patients with chronic obstructive pulmonary disease.
Détails
ID Serval
serval:BIB_CF4656856BDD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Helium-oxygen decreases inspiratory effort and work of breathing during pressure support in intubated patients with chronic obstructive pulmonary disease.
Périodique
Intensive Care Medicine
ISSN
0342-4642 (Print)
ISSN-L
0342-4642
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
31
Numéro
11
Pages
1501-1507
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
OBJECTIVE: To evaluate the impact of helium-oxygen (He/O2) on inspiratory effort and work of breathing (WOB) in intubated COPD patients ventilated with pressure support.
DESIGN AND SETTING: Prospective crossover interventional study in the medical ICU of a university hospital.
PATIENTS AND PARTICIPANTS: Ten patients.
INTERVENTIONS: Sequential inhalation (30 min each) of three gas mixtures: (a) air/O2, (b) He/O2 (c) air/O2, at constant FIO2 and level of pressure support.
MEASUREMENTS AND RESULTS: Inspiratory effort and WOB were determined by esophageal and gastric pressure. Throughout the study pressure support and FIO2 were 14+/-3 cmH2O and 0.33+/-0.07 respectively. Compared to Air/O2, He/O2 reduced the number of ineffective breaths (4+/-5 vs. 9+/-5 breaths/min), intrinsic PEEP (3.1+/-2 vs. 4.8+/-2 cmH2O), the magnitude of negative esophageal pressure swings (6.7+/-2 vs. 9.1+/-4.9 cmH2O), pressure-time product (42+/-37 vs. 67+/-65 cmH2O s(-1) min(-1)), and total WOB (11+/-3 vs. 18+/-10 J/min). Elastic (6+/-1 vs. 10+/-6 J/min) and resistive (5+/-1 vs. 9+/-4 J/min) components of the WOB were decreased by He/O2.
CONCLUSIONS: In intubated COPD patients ventilated with pressure support He/O2 reduces intrinsic PEEP, the number of ineffective breaths, and the magnitude of inspiratory effort and WOB. He/O2 could prove useful in patients with high levels of PEEPi and WOB ventilated in pressure support, for example, during weaning.
DESIGN AND SETTING: Prospective crossover interventional study in the medical ICU of a university hospital.
PATIENTS AND PARTICIPANTS: Ten patients.
INTERVENTIONS: Sequential inhalation (30 min each) of three gas mixtures: (a) air/O2, (b) He/O2 (c) air/O2, at constant FIO2 and level of pressure support.
MEASUREMENTS AND RESULTS: Inspiratory effort and WOB were determined by esophageal and gastric pressure. Throughout the study pressure support and FIO2 were 14+/-3 cmH2O and 0.33+/-0.07 respectively. Compared to Air/O2, He/O2 reduced the number of ineffective breaths (4+/-5 vs. 9+/-5 breaths/min), intrinsic PEEP (3.1+/-2 vs. 4.8+/-2 cmH2O), the magnitude of negative esophageal pressure swings (6.7+/-2 vs. 9.1+/-4.9 cmH2O), pressure-time product (42+/-37 vs. 67+/-65 cmH2O s(-1) min(-1)), and total WOB (11+/-3 vs. 18+/-10 J/min). Elastic (6+/-1 vs. 10+/-6 J/min) and resistive (5+/-1 vs. 9+/-4 J/min) components of the WOB were decreased by He/O2.
CONCLUSIONS: In intubated COPD patients ventilated with pressure support He/O2 reduces intrinsic PEEP, the number of ineffective breaths, and the magnitude of inspiratory effort and WOB. He/O2 could prove useful in patients with high levels of PEEPi and WOB ventilated in pressure support, for example, during weaning.
Mots-clé
Aged, Blood Gas Analysis, Blood Pressure, Cross-Over Studies, Female, Helium/therapeutic use, Humans, Intensive Care Units, Lung Volume Measurements, Male, Middle Aged, Oxygen/therapeutic use, Positive-Pressure Respiration, Pulmonary Disease, Chronic Obstructive/therapy, Work of Breathing/drug effects
Pubmed
Web of science
Création de la notice
27/06/2013 14:30
Dernière modification de la notice
20/08/2019 15:49
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