Efectos de la ventilación mecánica con heliox en niños y adolescentes con patología bronquial obstructiva

Abstract

Objective: To evaluate if the Heliox reduces the resistance in the airway in children and adolescents with obstructive bronchial pathology and mechanical ventilation. Materials and Methods: An observational prospective descriptive study was made in children and adolescents with obstructive bronchial pathology and mechanical ventilation with Fi02 ≤ 0,5. Different variables were measured: resistance, pressure peak, mean airway pressure, pressure plateau, tidal volume, AutoPEEP, compliance, PetCO2, dead space ventilation, before heliox and after 30 minutes, 2, 4, 6, 12, 18 and 24 hours, and daily until heliox suspension by extubation or FiO2 > 0,5. Results: This study with partial results included 9 patients finding significant reduction of expiratory resistance to 30 minutes (51.2 versus 32,3; p=0,0008), 2 hours (51.2 versus 33,4; p=0,0019) and 4 hours (51.2 versus 30,7; p=0,0012) as well as of the inspiratory resistance to hour 2 (48.6 versus 36,2; p = 0.013) and hour 4 (48.6 versus 30; p=0,004). PetCO2 no significant decreasing tendency was observed (52.3 versus 34,3: p=0,06). No changes in variables; autoPEEP, pressure peak, mean airway pressure, compliance, dead space, pressure plateau and tidal volume, before or after the Heliox were observed. Conclusion: Mechanical ventilation with Heliox in Children with bronchial obstructive pathology appears to be that it reduce in a significant way the resistance of the airway, with tendency to the reduction of the PetC02. Prospective studies are needed at least observational analytic that corroborate these findings.