Research

Heliox improves pulmonary mechanics in a pediatric porcine model of induced severe bronchospasm and independent lung mechanical ventilation

Anthony J Orsini¹, John L Stefano^2,3, Kathleen H Leef³, Melinda Jasani⁴, Andrew Ginn³, Lisa Tice⁵ and Vinay M Nadkarni^2,6

¹Department of Neonatology, New York University School of Medicine, Albany, New York, USA

²Jefferson Medical College, Philadelphia, Pennsylvania, USA

³Christiana Care Health Center, Newark, Delaware, USA

⁴Department of Emergency Medicine, St. Christopher's Hospital For Children, Philadelphia, Pennsylvania, USA

⁵Department of Research, duPont Hospital For Children, Wilmington, Delaware, USA

⁶Department of Anesthesia and Critical Care, duPont Hospital For Children, Wilmington, Delaware, USA

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Critical Care 1999, 3:65-70doi:10.1186/cc311

Published:	18 May 1999

Abstract

Background

A helium-oxygen gas mixture (heliox) has low gas density and low turbulence and resistance through narrowed airways. The effects of heliox on pulmonary mechanics following severe methacholine-induced bronchospasm were investigated and compared to those of a nitrogen-oxygen gas mixture (nitrox) in an innovative pediatric porcine, independent lung, mechanical ventilation model.

Results

All of the lungs showed evidence of severe bronchospasm after methacholine challenge. Prospective definition of 'heliox response' was a 15% or greater improvement in lung function in the lung receiving heliox compared with the matched lung receiving nitrox. Seven out of 10 pigs responded to heliox therapy with respect to resistance and eight out of 10 pigs responded to heliox therapy with respect to compliance and tidal volume (P < 0.03). After crossover from nitrox to heliox, eight out of eight lungs significantly improved with respect to tidal volume, resistance and compliance (P < 0.001). After crossover from heliox to nitrox all eight lungs showed a significant increase in resistance and a significant decrease in tidal volume (P < 0.001).

Conclusions

In a pediatric porcine model of acute, severe methacholine-induced bronchospasm and independent lung mechanical ventilation, administration of heliox improves pulmonary mechanics, gas flow, and ventilation. Administration of heliox should be considered for support of pediatric patients with acute, severe bronchospasm requiring mechanical ventilation through small artificial airways.