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Room air dilution of heliox given by facemask

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An Erratum to this article was published on 28 October 2008

Abstract

Objectives

To measure the extent of dilution of helium-oxygen (heliox) by room air when given via high concentration reservoir mask to spontaneously breathing subjects. Substantial dilution of heliox by room air under these circumstances might alter its physical properties sufficiently to negate any potential clinical benefit in obstructive respiratory failure.

Design

Healthy volunteers breathing different concentrations of helium in oxygen via two different masks in a randomised crossover design.

Setting

Operating theatre in a university hospital.

Patients and participants

Six healthy volunteers.

Interventions

The concentrations of helium, nitrogen and oxygen were measured in the trachea of each volunteer using a mass spectrometer during normal breathing, hyperventilation and hypoventilation.

Measurements and results

During normal breathing of Heliox21 (79% helium) via a standard non-rebreathe reservoir mask, within subject median percentage tracheal helium was 37.2% (range 29.3–52.2%) and nitrogen was 41.7% (27.4–49.4%). Air entrainment was affected by changes in breathing pattern: tracheal nitrogen concentration was greater during hyperventilation (55.4%; range 49.4–63.5%) and less during hypoventilation (33.1%; range 24.6–39.6%, p = 0.043). Tracheal nitrogen could be almost completely abolished by administering heliox via a tightly fitting cushioned facemask, even during hyperventilation (2.2%; range 0.6–6.1%, p = 0.028).

Conclusions

Heliox administration via a standard high-concentration reservoir mask leads to significant dilution by room air. For the full potential benefits of heliox to be realised in spontaneously breathing patients, it should be administered via a system that achieves a gas tight seal, with no leaks between the delivery device and the surroundings.

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Acknowledgements

The University Division of Anaesthesia was supported by an unrestricted educational grant from BOC Medical Ltd. BOC Medical Ltd did not have any role in the study design, in collection, analysis, and interpretation of data, in the writing of the paper, or in the decision to submit the paper for publication. We are grateful to J.G. Jones and to the Departments of Clinical Engineering and Lung Function at Addenbrooke’s Hospital, Cambridge, for their invaluable help and advice. The work was supported by an unrestricted educational grant from BOC Medical Ltd, UK.

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Authors and Affiliations

  1. Addenbrooke’s Hospital, Division of Anaesthesia, Box 93, University of Cambridge, Hills Road, CB2 2QQ, Cambridge, UK

    Thomas D. A. Standley, Ingrid A. Wilkins, David K. Menon & Daniel W. Wheeler

  2. Department of Anaesthesia, Box 93, Addenbrooke’s Hospital, Hills Road, CB2 2QQ, Cambridge, UK

    Helen L. Smith, Liam J. Brennan & Peter G. Bradley

  3. Department of Anaesthesia, Royal Sussex County Hospital, Eastern Road, BN2 5BE, Brighton, UK

    Casiano Barrera Groba & Andrew J. Davey

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  1. Thomas D. A. Standley
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  2. Helen L. Smith
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Correspondence to Thomas D. A. Standley.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00134-008-1341-z

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Standley, T.D.A., Smith, H.L., Brennan, L.J. et al. Room air dilution of heliox given by facemask. Intensive Care Med 34, 1469–1476 (2008). https://doi.org/10.1007/s00134-008-1064-1

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  • DOI: https://doi.org/10.1007/s00134-008-1064-1

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