The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

HELIUM-OXYGEN (HELIOX) VIA THE SERVO 900C TO MECHANICALLY VENTILATE THE STATUS ASTHMATICUS PATIENT.

Linda Dean RRT & Dwayne Smith RRT RPFT. Fairfax Hospital, Falls Church, Virginia.

OBJECTIVE: To examine the effects of heliox to mechanically ventilate the acute status asthmaticus patient who fails conventional ventilation. DESIGN: Retrospective case series of 6 status asthma patients who failed the first hr. of conventional ventilation, then placed on heliox via Servo 900C. Methods: Conventional settings were placed on the Servo. 50 psi O_{2} hose was connected to the O_{2} outlet, 50 psi air hose connected to the 50 psi port on the 8/20 Heliox mixture H cylinder, giving the blender its 2 gas sources. A 70/30 mixture was our goal. An O_{2} analyzer on the insp. limb confirmed FiO_{2}, and a Wright's respirometer (calibrated for heliox) confirmed exhaled Vt. Results: Our findings reveal positive outcomes. Overall, within the first 30 minutes, the PIP decrease was clinically significant, but our sample was too small for adequate statistical power. PaCO_{2} decreased significantly [mean (±SD)] from 62.2 (7.6) mm Hg to 39.6(8.5) mm Hg, p=0.02. pH increased from 7.17 (0.01) units to 7.33 (0.07) units, p=0.01. FiO_{2} was decreased from 66(21)% to 24(12)%, p=0.01. Auto-PEEP recorded in 1 patient decreased from 16 cm H_{2}O to 8 cm H_{2}O. No patients required chest tubes secondary to barotrauma, and all patients were weaned from the ventilator upon reversal of bronchospasm. There were no untoward effects. CONCLUSION: Heliox mixtures may be implemented immediately to mechanically ventilate the status asthma patient to facilitate PaCO_{2} reduction, reverse resp. acidosis, lower PIP, lower FiO_{2}, and decrease risk of barotrauma.

OF-97-020

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