מתוך medicontext.co.il
NEW YORK (Reuters Health) – Administration of a mixture of helium and oxygen, heliox, as adjunctive treatment for severe acute exacerbations of chronic obstructive pulmonary disease (COPD) improves prognosis, shortens hospital time, and reduces the need for intubation, French researchers report in the December issue of Critical Care Medicine.
Dr. Patrick Gerbeaux, at Hפpital de la Conception in Marseille, France, and colleagues conducted a retrospective study of 81 patients admitted with severe acute exacerbations of COPD and respiratory acidosis. Of these, 39 received heliox as adjunctive treatment. Otherwise, Dr. Gerbeaux notes, characteristics of the two groups were similar.
"When heliox was used, survival was improved, intubation requirement diminished, and the length of stay in the ICU and hospital decreased." All parameters except intubation time were significant, at p < 0.03 . The investigators caution, however, that the study is retrospective, and definite conclusions on heliox and improved survival cannot be made.
Dr. Gerbeaux and colleagues point out that "Heliox has low density and high viscosity, so it is able to reduce respiratory effort…Even if homeostasis is not completely restored, heliox may reduce the level of hypoventilation and the neurologic effects of hypercapnia, and it also may delay muscle fatigue, giving the clinician time to treat the cause of distress."
Heliox appears to be most beneficial in the most severe cases of COPD exacerbation. It is of less benefit in cases of mild to moderate COPD decompensation, the authors say.
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