Uso da mistura gasosa de hélio e oxigênio (Heliox®) no tratamento da doença respiratória obstrutiva da via aérea inferior em serviço de emergência pediátrica / Use of helium-oxygen mixture (Heliox®) in the treatment of obstructive lower airway disease in a pediatric emergency department

OBJETIVO: Determinar se a utilização de salbutamol, em uma mistura de hélio-oxigênio (80:20), modifica a evolução e o risco de internação em pacientes pediátricos. MÉTODOS: Delineado estudo de coorte controlada que incluiu pacientes de 2 meses a 12 anos de idade, com diagnósticos de crise de asma ou bronquiolite viral. Intensidades caracterizadas de moderada a grave, aferidas através de escore clínico (pulmonary index, PI) para doença obstrutiva. Foram considerados elegíveis escores > 8. Vinte pacientes constituíram o grupo Heliox® e 40 o grupo Oxigênio. Os pacientes receberam sequencialmente, em intervalos de 20 min, até completar seis nebulizações (período de 2 h): salbutamol 0,15 mg/kg/dose (máximo 5 mg). A droga utilizou como veículo gerador do aerossol a mistura de Heliox® (80:20) ou oxigênio a 100 por cento. Os pacientes com diagnóstico de crise aguda de asma receberam, adicionalmente, prednisolona (2 mg/kg) via oral. RESULTADOS: Onze pacientes do grupo Heliox® permaneceram necessitando de tratamento na 6ª h de atendimento, enquanto que no grupo que recebia nebulização veiculada em oxigênio, esse número foi de 38 (p = 0,034). Na 12ª h, 7 pacientes do grupo Heliox® permaneciam em observação, enquanto no grupo Oxigênio foram 27 (p = 0,02). Diferenças quanto à necessidade de suplementação de oxigênio foram observadas apenas na 6ª h de tratamento (p = 0,02). CONCLUSÕES: Heliox® (80:20), para administração de salbutamol, é efetivo no tratamento da doença obstrutiva infantil que apresente resposta à terapêutica broncodilatadora. Comparado à técnica usual de nebulização, está associado à menor permanência em sala de observação após 6 h de tratamento.

OBJECTIVE: To determine whether the use of salbutamol, in a helium-oxygen mixture (80:20), can modify outcome and risk of hospitalization of pediatric patients. METHODS: A controlled cohort study including patients aged 2 months to 12 years with diagnoses of asthmatic crisis or viral bronchiolitis. Intensity was characterized from moderate to severe, as measured by clinical score (pulmonary index, PI) for obstructive disease. Scores > 8 were considered eligible. The Heliox® group was composed of 20 patients and the Oxygen group of 40 patients. Patients received sequentially, at 20-min intervals, until six nebulization cycles were completed (2-h period): salbutamol 0.15 mg/kg/dose (maximum 5 mg). The nebulized drug was driven either by Heliox® mixture (80:20) or 100 percent oxygen. Patients diagnosed with acute asthmatic crisis received, additionally, prednisolone (2 mg/kg) orally. RESULTS: Eleven patients in the Heliox® group still required treatment at 6 h, against 38 patients in the group receiving oxygen-driven nebulization (p = 0.034). At 12 h, 7 patients in the Heliox® group remained under observation, against 27 in the Oxygen group. Differences regarding the need for supplemental oxygen were observed only at 6 h of treatment (p = 0.02). CONCLUSIONS: Heliox® (80:20), for salbutamol administration, is effective in the treatment of pediatric obstructive disease that responds to bronchodilator therapy. Compared to usual aerosol delivery technique, Heliox®-driven salbutamol nebulization is associated with shorter stay in the observation room after 6 h of treatment.

Effects of Helium-oxygen Mechanical Ventilation on Respiratory Mechanics and Oxygenation in ALI Animal Models / 医学研究杂志

Objective To investigate the effects of Helium-oxygen mechanical ventilation on respiratory mechanics and oxygenation in ALI animal models.Methods To investigate the changes of respiratory mechanics and oxygenated indexs in acute lung injury rat models caused by sepsis at different PEEP by comparing air-oxygen mixture mechanical ventilation with helium-oxygen mixture mechanical ventilation.Results 1.Helium-oxygen mechanical ventilation could not improve respiratory mechanical indexs in ALI animal models(airway peak pressure、mean airway pressure、platform pressure、dynamic compliance、airway resistance、flow rate of peak value).On the contrary,in the condition of high level of PEEP,some indexs became worse,such as depress of dynamic compliance(P

Effects of Helium-oxygen Mechanical Ventilation on Histomorphology in ALI Animal Models / 医学研究杂志

Objective To investigate the effect of Helium-oxygen mechanical ventilation on histomorphology in acute lung injury(ALI)animal models.Methods To investigate the changes of histomorphology in ALI rat models caused by sepsis by comparing air-oxygen mixture mechanical ventilation with helium-oxygen mixture mechanical ventilation.Results Helium-oxygen mechanical ventilation has no influence on the change of lung histomorphology.Conclusion Helium-oxygen mixture mechanical ventilation could not improve lung histomorphology.Helium-oxygen mixture mechanical ventilation has no protective effect on ALI animal models.

NUTRITION STUDIES OF HUMANS DURING A HELIUM-OXYGEN DIVE TO A SIMULATED DEPTH OF 200M / 营养学报

Nutrition studies were made on four divers performing a helium-oxygen saturation dive to a simulated depth of 200m in a hyperbaric chamber for about seven days. Daily intake of food was surveyed by regular weighing method and its calories and nutrients were calculated from Chinese food composition table. Fasting blood and 24h urine samples were collected on several occasions before, during and after the dive for estimation of free amino acid, nitrogen and minerals. Vitamin load test was conducted for evaluation of vitamin status. The results showed that during the dive intakes of cereal, meat and oil of divers were decreased, but vegetable, fruit and beverage intakes increased. An average body weight loss of 1.75 kg was found after a 7-day period, but little changes in the body fat. Free amino acid levels of serum and urinary output were reduced, especially the essential amino acids. The urinary excretion of minerals was in an acceptable range, but thiamin decreased markedly and not returned to an acceptable range until 10 days after leaving the hyperbaric chamber.