Book contents
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introductory Notes
- 1 Physiology of ventilation and gas exchange
- 2 Assessing the need for ventilatory support
- 3 Oxygen therapy, continuous positive airway pressure and non-invasive ventilation
- 4 Management of the artificial airway
- 5 Modes of mechanical ventilation
- 6 Oxygenation
- 7 Carbon dioxide balance
- 8 Sedation, paralysis and analgesia
- 9 Nutrition in the mechanically ventilated patient
- 10 Mechanical ventilation in asthma and chronic obstructive pulmonary disease
- 11 Mechanical ventilation in patients with blast, burn and chest trauma injuries
- 12 Ventilatory support: extreme solutions
- 13 Heliox in airway obstruction and mechanical ventilation
- 14 Adverse effects and complications of mechanical ventilation
- 15 Mechanical ventilation for transport
- 16 Special considerations in infants and children
- 17 Tracheostomy
- 18 Weaning, extubation and de-cannulation
- 19 Long-term ventilatory support
- 20 The history of mechanical ventilation
- Glossary
- Index
13 - Heliox in airway obstruction and mechanical ventilation
Published online by Cambridge University Press: 14 October 2009
- Frontmatter
- Contents
- Contributors
- Foreword
- Preface
- Introductory Notes
- 1 Physiology of ventilation and gas exchange
- 2 Assessing the need for ventilatory support
- 3 Oxygen therapy, continuous positive airway pressure and non-invasive ventilation
- 4 Management of the artificial airway
- 5 Modes of mechanical ventilation
- 6 Oxygenation
- 7 Carbon dioxide balance
- 8 Sedation, paralysis and analgesia
- 9 Nutrition in the mechanically ventilated patient
- 10 Mechanical ventilation in asthma and chronic obstructive pulmonary disease
- 11 Mechanical ventilation in patients with blast, burn and chest trauma injuries
- 12 Ventilatory support: extreme solutions
- 13 Heliox in airway obstruction and mechanical ventilation
- 14 Adverse effects and complications of mechanical ventilation
- 15 Mechanical ventilation for transport
- 16 Special considerations in infants and children
- 17 Tracheostomy
- 18 Weaning, extubation and de-cannulation
- 19 Long-term ventilatory support
- 20 The history of mechanical ventilation
- Glossary
- Index
Summary
Heliox, a mixture of helium and oxygen, was used by Barach in New York for the first time in the treatment of asthma and upper airway obstruction after its introduction to deep sea diving. Since then it has been used not only as a rescue medication in emergency situations for spontaneously breathing patients with airway obstruction but also as the driving gas for mechanical ventilators. The increasing interest in heliox is indicated by the rising number of publications in recent years (Figure 13.1). In this chapter, theoretical considerations, the application of heliox in non-intubated (e.g. with upper and lower airway obstruction) as well as in ventilated patients will be outlined, followed by a brief overview of potential risks, costs and future applications.
Theoretical considerations
In a medical setting, the inhaled gas mixture usually consists of air with a variable oxygen content up to a fractional inspired oxygen concentration (FIO2) of 1.0 and in some cases with the addition of nitric oxide (NO) or other medications in small amounts. Heliox is a commercially prepared mixture of helium and oxygen. Helium is a non-toxic, tasteless and odourless gas with a low solubility in fatty tissue. It can be used up to a fractional inspired helium concentration (FiHe) of 0.79 with an FiO2 of 0.21.
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- Core Topics in Mechanical Ventilation , pp. 230 - 238Publisher: Cambridge University PressPrint publication year: 2008
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