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Báo cáo y học: "Heliox improves pulmonary mechanics in a pediatric porcine model of induced severe bronchospasm and independent lung mechanical ventilation"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Heliox improves pulmonary mechanics in a pediatric porcine model of induced severe bronchospasm and independent lung mechanical ventilation. | cc032.qxd 14 05 99 07 00 Page 65 Research paper 65 Heliox improves pulmonary mechanics in a pediatric porcine model of induced severe bronchospasm and independent lung mechanical ventilation Anthony J. Orsini John L. Stefano Kathleen H. Leef Melinda Jasani Andrew Ginn Lisa Tice and Vinay M. Nadkarni 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. Addresses Department of Neonatology New York University School of Medicine Albany New York USA tlefferson Medical College Philadelphia Pennsylvania USA Christiana Care Health