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Efectos de la ventilación mecánica con heliox en niños y adolescentes con patología bronquial obstructiva
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- reponame:Repositorio Institucional EdocUR; instname:Universidad del Rosario; Philippe Jolliet, Christine Watremez, 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 Med (2003) 29:1442–1450; Claudio Migliori, The Effects of Helium/Oxygen Mixture (Heliox) Before and After Extubation in Long-term Mechanically Ventilated Very Low Birth Weight Infants Pediatrics 2009;123: 1524–1528; Fernández Jaime, Estrategias de ventilación mecánica y terapia coadyuvante en enfermedades pulmonares severas, El niño en estado crítico, 2 ed, 2011; 82-86; Matthew F Gross, Robert M Spear, Helium–oxygen mixture does not improve gas exchange in mechanically ventilated children with bronchiolitis, Crit Care 2000, 4:188–192; Martin CJ Kneyber, Marc van Heerde, Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure, Critical Care 2009; Abd-Allah SA, Rogers MS, Terry M, et al. Helium-oxygen therapy for pediatric acute severe asthma requiring mechanical ventilation. Pediatr Crit Care Med 2003;4(3):353-7.; Martin C. J. Kneyber Mechanical ventilation with heliox decreases respiratory system resistance and facilitates CO2 removal in obstructive airway disease Intensive Care Med (2006) 32:1676–167; Tobias JD: Heliox in children with airway obstruction. Pediatr Emerg Care 1997; 13: 29–32; Kass JE, Castriotta RJ: Heliox therapy in acute severe asthma. Chest 1995; 107: 757–760; Wolfson MR, Bhutani VK, Shaffer TH, et al: Mechanics and energetics of breathing helium in infants with bronchopulmonary dysplasia. J Pediatr 1984; 104: 752–757; Macklem PT: The physiology of the small airway. Am J Respir Crit Care Med 1998; 157: 2181–2183; Martinon F. Heliox: Teorías y Prácticas pediátricas. En Manual de Cuidados Intensivos Pediátricos 3ra Ed. Ruza. 2001: 532-557; Martinon-Torres F. Current treatment for acute viral bronchiolitis in infants. Expert Opin Pharmacother. 2003 Aug;4(8):1355-71; Barach AL: The use of helium in the treatment of asthma and obstructive lesions in the larynx and trachea. Ann Intern Med 1935; 9: 739–765; Stein R, Canny GJ, Bohn DJ, et al: Severe acute asthma in a pediatric intensive care unit: Six years’ experience. Pediatrics 1989; 83: 1023–1028; Osundwa VM, Dawod S: Four-year experience with bronchial asthma in a pediatric intensive care unit. Ann Allergy 1992; 69: 518–520; Shugg AW, Kerr S, Butt WW: Mechanical ventilation of paediatric patients with asthma: Short and long term outcome. J Paediatr Child Health 1990; 26: 343–346; DeNicola LK, Monem GF, Gayle MO, et al: Treatment of critical status asthmaticus in children. Pediatr Clin North Am 1994; 41: 1293–1324; Schnitzler, Eduardo MD; Minces, Pablo MD. Is helium a better vehicle for aerosol therapy?. Ped Crit Care 2002;3;86-87; Paret G, Kornecki A, Szeinberg A, et al: Severe acute asthma in a community hospital pediatric intensive care unit: A ten years’ experience. Ann Allergy Asthma Immunol 1998; 80: 339–344; Dworkin G, Katton M: Mechanical ventilation for status asthmaticus in children. J Pediatr 1989; 114: 545–549; Shiue ST, Gluck EH: The use of helium-oxygen mixtures in the support of patients with status asthmaticus and respiratory acidosis. J Asthma 1989; 26: 177–180; Manthous CA, Morgan S, Pohlman A, et al: Heliox in the treatment of airflow obstruction: A critical review of the literature. Respir Care 1997; 42: 1034–1042; Gluck EH, Onorato DJ, Castriotta R: Helium-oxygen mixtures in intubated patients with status asthmaticus and respiratory acidosis. Chest 1990; 98: 693–698; Austan F: Heliox inhalation in status asthmaticus anrespiratory acidemia: A brief report. Heart Lung 1996; 25: 155–157; Duncan PG: Efficacy of helium-oxygen mixtures in the management of severe viral and postintubation croup. Can Anaesth Soc J 1979; 26: 206–212; Kemper KJ, Ritz RH, Benson MS, et al: Helium-oxygen mixture in the treatment of postextubation stridor in pediatric trauma patients. Crit Care Med 1991; 19: 356; Kemper KJ, Izenberg S, Marvin JA, et al: Treatment of postextubation stridor in a pediatric patient with burns: The role of heliox. J Burn Care Rehabil 1990; 11: 337–339; Weber JE, Chudnofsky CR, Younger JG, et al: A randomized comparison of helium-oxygen mixture (heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics 2001; 107: e96; Piva JP, Menna Barreto S, Zelmanovitz F, et al: Heliox versus oxygen for nebulized aerosol therapy in children with lower airway obstruction. Pediatr Crit Care Med 2002; 3: 6–10; Polaner DM: The use of heliox and the laryngeal mask airway in a child with an anterior mediastinal mass. Anesth Analg 1996; 82: 208–210; Rodrigo G, Pollack C, Rodrigo C, Rowe B. Cochrane Database Syst Rev. 2003;4 Y Chest. 2003 Mar;123(3):891-6; Ho Anthony y cols. Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma. Meta-análysis. Chest 2003:123;882-890; Manthous CA, Hall JB, Melmed A, et al: Heliox improves pulsus paradoxus and peak expiratory flow in nonintubated patients with severe asthma. Am J Respir Crit Care Med 1995; 151: 310–314; Kass J. Heliox redux. Chest 2003;123:673-4; Paret G, Dekel B, Vardi A, et al: Heliox in respiratory failure secondary to bronchiolitis: A new therapy. Pediatr Pulmonol 1996; 22: 322–323; Hollman G, Shen G, Zeng L, et al: Helium-oxygen improves clinical asthma scores in children with acute bronchiolitis. Crit Care Med 1998; 26: 1731–1736; Martinon F y cols. Heliox therapy in infants with acute bronchiolitis. Pediatrics 2002;109:68-73; Pizov R, Oppenheim A, Eidelman LA, et al: Helium versus oxygen for tracheal gas insufflation during mechanical ventilation. Crit Care Med 1998; 26: 290–295; Tsuno K, Prato P, Kolobow T: Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol 1990; 69: 956–961; Sauder RA, Rafferty JF, Bilenki AL, et al: Helium-oxygen and conventional mechanical ventilation in the treatment of large airway obstruction and respiratory failure in an infant. South Med J 1991; 84: 646–648; Habib DM, Garner SS, Brandeburg S: Effect of helium-oxygen on delivery of albuterol in a pediatric, volume-cycled, ventilated lung model. Pharmacotherapy 1999; 19: 143–149; Fernández Jaime, Ventilación mecánica con Heliox, Acta Colombiana de Cuidado Intensivo 2009; 9(4): 355-358; Tassaux D, Jolliet P, Thouret J, et al: Calibration of seven ICU ventilators for mechanical ventilation with helium-oxygen mixtures. Am J Respir Crit Care Med 1999; 160: 22–32; Berkenbosch, John W. MD; Grueber, Ryan E. Effect of helium-oxygen (heliox) gas mixtures on the function of four pediatric ventilators. Crit Care Med 2003;31:2052-58; Anderson M, Svartengren M, Gunnar B, et al: Deposition in asthmatics of particles inhaled in air or in helium-oxygen. Am Rev Respir Dis 1993; 147: 524–528; Michael JG, Blockage T, Tobias JD: Helium administration during mechanical ventilation in children with respiratory failure. J Intensive Care Med 1999; 14: 140–147; Svartengren M, Skogward P, Nerbrink O, et al: Regional deposition of inhaled Evans blue dye in mechanically ventilated rabbits with air or helium oxygen mixture. Exp Lung Res 1998; 24: 159–172; Ruben A, Harris A. Heliox for asthma in the emergency departament: a review of the literature. Emerg Med J 2004:21;131-135
- Publication Year :
- 2012
-
Abstract
- Evaluar si el Heliox reduce la resistencia en la vía aérea en niños y adolescentes con patología bronquial obstructiva que requieren ventilación mecánica. Materiales y Métodos: Estudio prospectivo observacional descriptivo en niños y adolescentes con patología bronquial obstructiva y ventilación mecánica con Fi02 ≤ 0,5. Medición de variables: resistencia, presión pico, presión media de la vía aérea, presión meseta, volumen corriente, autoPEEP, distensibilidad, PetCO2, ventilación de espacio muerto antes de inicio de heliox y a los 30 minutos, 2, 4, 6, 12, 18 y 24 horas y diariamente hasta suspenderlo por extubación o FiO2 > 0,5. Resultados: Resultados parciales, incluyó 9 pacientes encontrando descenso significativo de resistencia espiratoria a los 30 minutos (51,2 vs 32,3; p=0,0008 ), 2 horas ( 51,2 vs 33,4; p=0,0019) y 4 horas (51,2 vs 30,7; p=0,0012) así como de la resistencia inspiratoria a la hora 2 (48,6 vs 36,2; p = 0,013) y hora 4 (48,6 vs 30 ; p=0,004). Se observó tendencia al descenso de la PetCO2 que no fue significativa (52,3 vs 34,3: p=0,06). No se evidenció cambios en las variables; autoPEEP, presión pico, presión media de la vía aérea, distensibilidad, ventilación de espacio muerto, presión meseta y volumen corriente antes y después del inicio del Heliox. Conclusión: La ventilación mecánica con Heliox en niños con patología bronquial obstructiva parece ser que reduce de manera significativa la resistencia de la vía aérea, con tendencia al descenso de la PetC02. Se necesitan estudios prospectivos al menos observacionales analíticos que corroboren estos hallazgos.<br />Objective: To evaluate if the Heliox reduces the resistance in the airway in children and adolescents with obstructive bronchial pathology and mechanical ventilation. Materials and Methods: An observational prospective descriptive study was made in children and adolescents with obstructive bronchial pathology and mechanical ventilation with Fi02 ≤ 0,5. Different variables were measured: resistance, pressure peak, mean airway pressure, pressure plateau, tidal volume, AutoPEEP, compliance, PetCO2, dead space ventilation, before heliox and after 30 minutes, 2, 4, 6, 12, 18 and 24 hours, and daily until heliox suspension by extubation or FiO2 > 0,5. Results: This study with partial results included 9 patients finding significant reduction of expiratory resistance to 30 minutes (51.2 versus 32,3; p=0,0008), 2 hours (51.2 versus 33,4; p=0,0019) and 4 hours (51.2 versus 30,7; p=0,0012) as well as of the inspiratory resistance to hour 2 (48.6 versus 36,2; p = 0.013) and hour 4 (48.6 versus 30; p=0,004). PetCO2 no significant decreasing tendency was observed (52.3 versus 34,3: p=0,06). No changes in variables; autoPEEP, pressure peak, mean airway pressure, compliance, dead space, pressure plateau and tidal volume, before or after the Heliox were observed. Conclusion: Mechanical ventilation with Heliox in Children with bronchial obstructive pathology appears to be that it reduce in a significant way the resistance of the airway, with tendency to the reduction of the PetC02. Prospective studies are needed at least observational analytic that corroborate these findings.
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- reponame:Repositorio Institucional EdocUR; instname:Universidad del Rosario; Philippe Jolliet, Christine Watremez, 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 Med (2003) 29:1442–1450; Claudio Migliori, The Effects of Helium/Oxygen Mixture (Heliox) Before and After Extubation in Long-term Mechanically Ventilated Very Low Birth Weight Infants Pediatrics 2009;123: 1524–1528; Fernández Jaime, Estrategias de ventilación mecánica y terapia coadyuvante en enfermedades pulmonares severas, El niño en estado crítico, 2 ed, 2011; 82-86; Matthew F Gross, Robert M Spear, Helium–oxygen mixture does not improve gas exchange in mechanically ventilated children with bronchiolitis, Crit Care 2000, 4:188–192; Martin CJ Kneyber, Marc van Heerde, Heliox reduces respiratory system resistance in respiratory syncytial virus induced respiratory failure, Critical Care 2009; Abd-Allah SA, Rogers MS, Terry M, et al. Helium-oxygen therapy for pediatric acute severe asthma requiring mechanical ventilation. Pediatr Crit Care Med 2003;4(3):353-7.; Martin C. J. Kneyber Mechanical ventilation with heliox decreases respiratory system resistance and facilitates CO2 removal in obstructive airway disease Intensive Care Med (2006) 32:1676–167; Tobias JD: Heliox in children with airway obstruction. Pediatr Emerg Care 1997; 13: 29–32; Kass JE, Castriotta RJ: Heliox therapy in acute severe asthma. Chest 1995; 107: 757–760; Wolfson MR, Bhutani VK, Shaffer TH, et al: Mechanics and energetics of breathing helium in infants with bronchopulmonary dysplasia. J Pediatr 1984; 104: 752–757; Macklem PT: The physiology of the small airway. Am J Respir Crit Care Med 1998; 157: 2181–2183; Martinon F. Heliox: Teorías y Prácticas pediátricas. En Manual de Cuidados Intensivos Pediátricos 3ra Ed. Ruza. 2001: 532-557; Martinon-Torres F. Current treatment for acute viral bronchiolitis in infants. Expert Opin Pharmacother. 2003 Aug;4(8):1355-71; Barach AL: The use of helium in the treatment of asthma and obstructive lesions in the larynx and trachea. Ann Intern Med 1935; 9: 739–765; Stein R, Canny GJ, Bohn DJ, et al: Severe acute asthma in a pediatric intensive care unit: Six years’ experience. Pediatrics 1989; 83: 1023–1028; Osundwa VM, Dawod S: Four-year experience with bronchial asthma in a pediatric intensive care unit. Ann Allergy 1992; 69: 518–520; Shugg AW, Kerr S, Butt WW: Mechanical ventilation of paediatric patients with asthma: Short and long term outcome. J Paediatr Child Health 1990; 26: 343–346; DeNicola LK, Monem GF, Gayle MO, et al: Treatment of critical status asthmaticus in children. Pediatr Clin North Am 1994; 41: 1293–1324; Schnitzler, Eduardo MD; Minces, Pablo MD. Is helium a better vehicle for aerosol therapy?. Ped Crit Care 2002;3;86-87; Paret G, Kornecki A, Szeinberg A, et al: Severe acute asthma in a community hospital pediatric intensive care unit: A ten years’ experience. Ann Allergy Asthma Immunol 1998; 80: 339–344; Dworkin G, Katton M: Mechanical ventilation for status asthmaticus in children. J Pediatr 1989; 114: 545–549; Shiue ST, Gluck EH: The use of helium-oxygen mixtures in the support of patients with status asthmaticus and respiratory acidosis. J Asthma 1989; 26: 177–180; Manthous CA, Morgan S, Pohlman A, et al: Heliox in the treatment of airflow obstruction: A critical review of the literature. Respir Care 1997; 42: 1034–1042; Gluck EH, Onorato DJ, Castriotta R: Helium-oxygen mixtures in intubated patients with status asthmaticus and respiratory acidosis. Chest 1990; 98: 693–698; Austan F: Heliox inhalation in status asthmaticus anrespiratory acidemia: A brief report. Heart Lung 1996; 25: 155–157; Duncan PG: Efficacy of helium-oxygen mixtures in the management of severe viral and postintubation croup. Can Anaesth Soc J 1979; 26: 206–212; Kemper KJ, Ritz RH, Benson MS, et al: Helium-oxygen mixture in the treatment of postextubation stridor in pediatric trauma patients. Crit Care Med 1991; 19: 356; Kemper KJ, Izenberg S, Marvin JA, et al: Treatment of postextubation stridor in a pediatric patient with burns: The role of heliox. J Burn Care Rehabil 1990; 11: 337–339; Weber JE, Chudnofsky CR, Younger JG, et al: A randomized comparison of helium-oxygen mixture (heliox) and racemic epinephrine for the treatment of moderate to severe croup. Pediatrics 2001; 107: e96; Piva JP, Menna Barreto S, Zelmanovitz F, et al: Heliox versus oxygen for nebulized aerosol therapy in children with lower airway obstruction. Pediatr Crit Care Med 2002; 3: 6–10; Polaner DM: The use of heliox and the laryngeal mask airway in a child with an anterior mediastinal mass. Anesth Analg 1996; 82: 208–210; Rodrigo G, Pollack C, Rodrigo C, Rowe B. Cochrane Database Syst Rev. 2003;4 Y Chest. 2003 Mar;123(3):891-6; Ho Anthony y cols. Heliox vs air-oxygen mixtures for the treatment of patients with acute asthma. Meta-análysis. Chest 2003:123;882-890; Manthous CA, Hall JB, Melmed A, et al: Heliox improves pulsus paradoxus and peak expiratory flow in nonintubated patients with severe asthma. Am J Respir Crit Care Med 1995; 151: 310–314; Kass J. Heliox redux. Chest 2003;123:673-4; Paret G, Dekel B, Vardi A, et al: Heliox in respiratory failure secondary to bronchiolitis: A new therapy. Pediatr Pulmonol 1996; 22: 322–323; Hollman G, Shen G, Zeng L, et al: Helium-oxygen improves clinical asthma scores in children with acute bronchiolitis. Crit Care Med 1998; 26: 1731–1736; Martinon F y cols. Heliox therapy in infants with acute bronchiolitis. Pediatrics 2002;109:68-73; Pizov R, Oppenheim A, Eidelman LA, et al: Helium versus oxygen for tracheal gas insufflation during mechanical ventilation. Crit Care Med 1998; 26: 290–295; Tsuno K, Prato P, Kolobow T: Acute lung injury from mechanical ventilation at moderately high airway pressures. J Appl Physiol 1990; 69: 956–961; Sauder RA, Rafferty JF, Bilenki AL, et al: Helium-oxygen and conventional mechanical ventilation in the treatment of large airway obstruction and respiratory failure in an infant. South Med J 1991; 84: 646–648; Habib DM, Garner SS, Brandeburg S: Effect of helium-oxygen on delivery of albuterol in a pediatric, volume-cycled, ventilated lung model. Pharmacotherapy 1999; 19: 143–149; Fernández Jaime, Ventilación mecánica con Heliox, Acta Colombiana de Cuidado Intensivo 2009; 9(4): 355-358; Tassaux D, Jolliet P, Thouret J, et al: Calibration of seven ICU ventilators for mechanical ventilation with helium-oxygen mixtures. Am J Respir Crit Care Med 1999; 160: 22–32; Berkenbosch, John W. MD; Grueber, Ryan E. Effect of helium-oxygen (heliox) gas mixtures on the function of four pediatric ventilators. Crit Care Med 2003;31:2052-58; Anderson M, Svartengren M, Gunnar B, et al: Deposition in asthmatics of particles inhaled in air or in helium-oxygen. Am Rev Respir Dis 1993; 147: 524–528; Michael JG, Blockage T, Tobias JD: Helium administration during mechanical ventilation in children with respiratory failure. J Intensive Care Med 1999; 14: 140–147; Svartengren M, Skogward P, Nerbrink O, et al: Regional deposition of inhaled Evans blue dye in mechanically ventilated rabbits with air or helium oxygen mixture. Exp Lung Res 1998; 24: 159–172; Ruben A, Harris A. Heliox for asthma in the emergency departament: a review of the literature. Emerg Med J 2004:21;131-135
- Notes :
- application/pdf, Spanish
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.ocn991865931
- Document Type :
- Electronic Resource