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Intensive Care Medicine

, Volume 29, Issue 9, pp 1560–1566 | Cite as

Effects of helium-oxygen on respiratory mechanics, gas exchange, and ventilation-perfusion relationships in a porcine model of stable methacholine-induced bronchospasm

  • Christine Watremez
  • Giuseppe Liistro
  • Marc deKock
  • Jean Roeseler
  • Thierry Clerbaux
  • Bruno Detry
  • Marc Reynaert
  • Pierre Gianello
  • Philippe JollietEmail author
Experimental

Abstract

Objective

To explore the consequences of helium/oxygen (He/O2) inhalation on respiratory mechanics, gas exchange, and ventilation-perfusion (VA/Q) relationships in an animal model of severe induced bronchospasm during mechanical ventilation.

Design

Prospective, interventional study.

Setting

Experimental animal laboratory, university hospital.

Interventions

Seven piglets were anesthetized, paralyzed, and mechanically ventilated, with all ventilator settings remaining constant throughout the protocol. Acute stable bronchospasm was obtained through continuous aerosolization of methacholine. Once steady-state was achieved, the animals successively breathed air/O2 and He/O2 (FIO2 0.3), or inversely, in random order. Measurements were taken at baseline, during bronchospasm, and after 30 min of He/O2 inhalation.

Results

Bronchospasm increased lung peak inspiratory pressure (49±6.9 vs 18±1 cm H2O, P<0.001), lung resistance (22.7±1.5 vs 6.8±1.5 cm H2O.l−1.s, P<0.001), dynamic elastance (76±11.2 vs 22.8±4.1 cm H2O.l−1, P<0.001), and work of breathing (1.51±0.26 vs 0.47±0.08, P<0.001). Arterial pH decreased (7.47±0.06 vs 7.32±0.06, P<0.001), PaCO2 increased, and PaO2 decreased. Multiple inert gas elimination showed an absence of shunt, substantial increases in perfusion to low VA/Q regions, and dispersion of VA/Q distribution. He/O2 reduced lung resistance and work of breathing, and worsened hypercapnia and respiratory acidosis.

Conclusions

In this model, while He/O2 improved respiratory mechanics and reduced work of breathing, hypercapnia and respiratory acidosis increased. Close attention should be paid to monitoring arterial blood gases when He/O2 is used in mechanically ventilated acute severe asthma.

Keywords

Asthma Methacholine Respiratory mechanics Ventilation/perfusion MIGET Helium 

Notes

Acknowledgements

This work was supported in part by the Fonds National Belge de la Recherche Scientifique, grant number 3.4506.02

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Christine Watremez
    • 2
  • Giuseppe Liistro
    • 3
  • Marc deKock
    • 2
  • Jean Roeseler
    • 4
  • Thierry Clerbaux
    • 3
  • Bruno Detry
    • 3
  • Marc Reynaert
    • 4
  • Pierre Gianello
    • 5
  • Philippe Jolliet
    • 1
    Email author
  1. 1.Division des soins intensifs de MédecineHôpital Cantonal UniversitaireGeneva 14Switzerland
  2. 2.Division of AnesthesiologyClinique Universitaire St.-LucBrusselsBelgium
  3. 3.Division of PneumologyClinique Universitaire St.-LucBrusselsBelgium
  4. 4.Department of Emergency and Intensive CareClinique Universitaire St.-LucBrusselsBelgium
  5. 5.Laboratory of Experimental SurgeryClinique Universitaire St.-LucBrusselsBelgium

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