Comparative effects of helium-oxygen and external positive end-expiratory pressure on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in mechanically ventilated patients with chronic obstructive pulmonary disease.

Jolliet, Philippe;Watremez, Christine;Roeseler, Jean;Ngengiyumva, J. C.;Liistro, Giuseppe;et.al.
(2003) Intensive care medicine — Vol. 29, n° 9, p. 1442-1450 (2003)

Files

pdfdocument.pdf
  • Restricted Access
  • Adobe PDF
  • 280.06 KB
Request a copy

Details

Authors
  • Jolliet, Philippe
    Author
  • Watremez, ChristineUCLouvain
    Author
  • Roeseler, JeanUCLouvain
    Author
  • Ngengiyumva, J. C.UCLouvain
    Author
  • De Kock, MarcUCLouvain
    Author
  • Clerbaux, ThierryUCLouvain
    Author
  • Reynaert, MarcUCLouvain
    Author
  • Detry, BrunoUCLouvain
    Author
  • Liistro, GiuseppeUCLouvain
    Author
Show more
Abstract
OBJECTIVE: To compare the effects of He/O(2) and external PEEP (PEEPe) on intrinsic PEEP (PEEPi), respiratory mechanics, gas exchange, and ventilation/perfusion (V(A)/Q) in mechanically ventilated COPD patients. DESIGN AND SETTING: Prospective, interventional study in the intensive care unit of a university hospital. INTERVENTIONS: Ten intubated, sedated, paralyzed, mechanically ventilated COPD patients studied in the following conditions: (a) baseline settings made by clinician in charge, air/O(2), ZEEP; (b) He/O(2), ZEEP; (c) air/O(2), ZEEP; (d) air/O(2), PEEPe 80% of PEEPi. Measurements at each condition included V(A)/Q by the multiple inert gas elimination technique (MIGET). RESULTS: PEEPi and trapped gas volume were comparably reduced by He/O(2) (4.2+/-4 vs. 7.7+/-4 cmH(2)O and 98+/-82 vs. 217+/-124 ml, respectively) and PEEPe (4.4+/-1.3 vs. 7.8+/-3.6 cmH(2)O and 120+/-107 vs. 216+/-115 ml, respectively). He/O(2) reduced inspiratory and expiratory respiratory system resistance (15.5+/-4.4 vs. 20.7+/-6.9 and 19+/-9 vs. 28.8+/-15 cmH(2)O l(-1)s(-1), respectively) and plateau pressure (13+/-4 vs. 17+/-6 cmH(2)O). PEEPe increased airway pressures, including total PEEP, and elastance. PaO(2)/FIO(2) was slightly reduced by He/O(2) (225+/-83 vs. 245+/-82) without significant V(A)/Q change. CONCLUSIONS: He/O(2) and PEEPe comparably reduced PEEPi and trapped gas volume. However, He/O(2) decreased airway resistance and intrathoracic pressures, at a small cost in arterial oxygenation. He/O(2) could offer an attractive option in COPD patients with PEEPi/dynamic hyperinflation.
Affiliations

Citations

  • APA
  • Chicago
  • FWB

Jolliet, P., Watremez, C., Roeseler, J., Ngengiyumva, J. C., De Kock, M., Clerbaux, T., Tassaux, D., Reynaert, M., Detry, B., & Liistro, G. (2003). Comparative effects of helium-oxygen and external positive end-expiratory pressure on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in mechanically ventilated patients with chronic obstructive pulmonary disease. Intensive care medicine, 29(9), 1442-1450. https://doi.org/10.1007/s00134-003-1864-2 (Original work published 2003)