The Science Journal of the American Association for Respiratory Care

2001 OPEN FORUM Abstracts

DELIVERY OF HELIOXFOR STATUS ASTHMATICUS UTILIZING PARATREND 7® CONTINUOUS BLOOD GASMONITOR .

Clifton Dennis, RRT, Dr.Lynn Coule, M.D. Medical College of Georgia, PICU

Heliox is used to treat asthma thatis unresponsive to conventional therapy (1,2). There is published data indicatingthat heliox is effective in lowering Pulsus Paradoxus and increasing peak flow(1). As well as decreasing PaCo2 and increasing pH (2). We monitor airway pressuresdue to the decreased volume of Heliox delivered when utilizing the SV300 (3).In this particular case we utilized the Paratrend 7 intra-arterial continuousblood gas monitor to continuously monitor acid-base and oxygenation status.The Paratrend 7 has been shown to be effective in the pediatric population.(4) A 9-month-old black male was referred to our institution for pediatric intensivecare management of acute status ashtmaticus that was refractory to conventionalmanagement that included continuous nebulized bronchodilators and oxygen therapy.This patient was a known asthmatic with uncontrolled asthma; he had had threeprior hospitalizations in the previous year for asthma none requiring intubation.He was placed on Pressure Regulated Volume Control, He received continuous nebulizedalbuterol, intravenous terbutaline, magnesium, systemic corticoidsteriods. Afemoral arterial catheter was placed to monitor blood pressure and provide continuousblood gases via the Paratrend 7. This patient had limited response to bronchodilatortherapy and adjunct therapy. Since this patient had increasing peak airway pressuresand a worsening respiratory acidosis. It was decided by the care team to tryheliox via a SV 300 ventilator in an attempt to decrease the peak airway pressuresas well as to decrease the respiratory acidosis. Throughout all interventionscontinuous blood the Paratrend 7 provided gas monitoring. Within 1 hour afterinitiation of heliox there was a dramatic decrease in the Pco2 and an increasein the pH.. On day five this patient was discharged to the pediatric generalcare floor where he was eventually discharged home in his normal sate of health.

1.

KudukisTM, Inhaled helium-oxygen revisited: effect of inhaled-oxygen during thetreatment of status asthmaticus in children. J Pediatr Feb 1997; 130:217-24

2.

Kass JE,Heliox therapy in acute severe asthma. Chest Mar. 1995: 107(3) 757-761

3.

DevabhaktuniVG, Effect of nitric oxide, perflurocarbon, and heliox on minute volumemeasurement nad ventilator volumes delivered. Crit Care Med 1999 Aug ;27 (8): 1603-7

4.

CouleLW, Accuracy and utility of a continuous intra-arterial blood gas monitoringsystem in pediatric patients. Crit Care Med 2001 Feb; 29(2): 420-6

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