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Use of helium‐oxygen mixture in adult patients presenting with exacerbations of asthma and chronic obstructive pulmonary disease: a systematic review
Author(s) -
Colebourn C. L.,
Barber V.,
Young J. D.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2006.04897.x
Subject(s) - medicine , pulmonary disease , asthma , asthma exacerbations , intensive care medicine , respiratory disease , copd , chronic disease , disease , lung
Summary We examined systematically all controlled and cross‐over randomised trials in patients with acute exacerbations of asthma and chronic obstructive pulmonary disease comparing Heliox against air‐oxygen mixtures. Fourteen studies were identified. In asthma studies, peak expiratory flow rate (PEFR) was increased by an average of 29.6% (95% CI 16.6–42.6) by Heliox‐driven nebulisers, or by 13.3 l.min −1 (95% CI 3.71–22.81) absolute. In studies of patients with chronic obstructive pulmonary disease receiving non‐invasive ventilation the arterial carbon dioxide tension ( P a co 2 ) and respiratory rate were unchanged: weighted mean difference for P a co 2 −0.29kPa (95% CI − 0.64–0.07) favoured Heliox, and for respiratory rate 1.6 breaths.min −1 (95% CI − 0.93, 4.14) favoured control. Heliox minimally reduced the work of breathing in intubated patients, and reduced intrinsic positive end expiratory pressure (iPEEP). The use of Heliox to drive nebulisers in patients with acute asthma slightly improves airflow measures. We were unable to determine whether this improved recovery.