Effects of heliox as carrier gas on ventilation and oxygenation in an animal model of piston-type HFOV a crossover experimental study.docVIP

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Effects of heliox as carrier gas on ventilation and oxygenation in an animal model of piston-type HFOV a crossover experimental study.doc

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Effects of heliox as carrier gas on ventilation and oxygenation in an animal model of piston-type HFOV a crossover experimental study

Zeynalovetal.BioMedicalEngineeringOnLine2010,9:71 /content/9/1/71 RESEARCH OpenAccess Effectsofhelioxascarriergasonventilationand oxygenationinananimalmodelofpiston-type HFOV:acrossoverexperimentalstudy BakhtiyarZeynalov1,2,TakehikoHiroma1,TomohikoNakamura1* *Correspondence: tnakamura@naganoch.gr.jp 1DivisionofNeonatology,Nagano Children’sHospital,AzuminoCity, Nagano,Japan Abstract Objective:Thisstudyaimedtocomparegasexchangewithhelioxandoxygen- enrichedairduringpiston-typehigh-frequencyoscillatoryventilation(HFOV).We hypothesizedthatheliumgaswouldimprovebothcarbondioxideeliminationand arterialoxygenationduringpiston-typeHFOV. Method:Fiverabbitswerepreparedandventilatedbypiston-typeHFOVwithcarrier 50%helium/oxygen(heliox50)or50%oxygen/nitrogen(nitrogen50)gasmixtureina crossoverstudy.Changingthegasmixturefromnitrogen50toheliox50andback wasperformedfivetimesperanimalwithconstantventilationparameters.Arterial bloodgas,vitalfunctionandrespiratorytestindiceswererecorded. Results:Comparedwithnitrogen50,heliox50didnotchangePaCO2whenstroke volumeremainedconstant,butsignificantlyreducedPaCO2afteralignmentof amplitudepressure.NosignificantchangesinPaO2wereseendespitesignificant decreasesinmeanairwaypressurewithheliox50comparedwithnitrogen50. Conclusion:ThisstudydemonstratedthathelioxenhancesCO2eliminationand maintainsoxygenationatthesameamplitudebutwithlowerairwaypressure comparedtoair/O2mixgasduringpiston-typeHFOV. Background Helium isanoble gaswith verylowatomic weight (4g/mol) anddensity (0.18 g/L). Whenmixedwithoxygen asheliox, thelowdensity ofhelium reduces theresistance associatedwithgasdelivery.Thisincreasedmobilityhasthreeeffects:gasmorereadily reachesthealveoli,allowinggreaterdiffusion;breathingeffortissignificantly reduced withuseofaless-densegas;andcarbondioxide(CO2)iseliminatedmorerapidly[1-5]. High-frequencyoscillatoryventilation(HFOV)offersatemptingadvantageinmain- tainingoxygenationusinghighermeanairwaypressurewithminimalriskofcomplica- tions. HFOV has