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
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
Auteur(s)
Tassaux D., Gainnier M., Battisti A., Jolliet P.
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.
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 15:30
Dernière modification de la notice
20/08/2019 16:49
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