Skip to main content
Erschienen in: European Journal of Applied Physiology 5/2019

08.03.2019 | Original Article

A proof-of-concept trial of HELIOX with different fractions of helium in a human study modeling upper airway obstruction

verfasst von: Hubert Truebel, Sandra Wuester, Philip Boehme, Hinnerk Doll, Sven Schmiedl, Jacek Szymanski, Thorsten Langer, Thomas Ostermann, Dirk Cysarz, Petra Thuermann

Erschienen in: European Journal of Applied Physiology | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Helium in oxygen (HELIOX) can relieve airway obstruction and lower the work of breathing because it increases the threshold at which turbulent gas flow is induced. Less turbulent and more laminar flow lowers the work of breathing. According to guidelines, the fraction of Helium in HELIOX should be maximized (e.g. to 79%). Here, we investigate whether HELIOX with less than 60% of Helium is able to relieve the sensation of dyspnea in healthy volunteers.

Methods

44 volunteers underwent resistive loading breathing different gases (medical air and HELIOX with a fraction of 25%, 50% or 75% helium in oxygen) in a double-blinded crossover design. Subjects rated their degree of dyspnea (primary outcome parameter) and the variability of noninvasively measured systolic blood pressure was assessed.

Results

Dyspnea was significantly reduced by HELIOX-containing mixtures with a fraction of helium of 25% or more. Similarly, blood pressure variability was reduced significantly even with helium 25% during respiratory loading with the higher load, whereas with the smaller load an effect could only be obtained with the highest helium fraction of 75%.

Conclusion

In this clinical trial, HELIOX with less than 60% of helium in oxygen decreased the sensation of dyspnea and blood pressure variability, a surrogate parameter for airway obstruction. Therefore, higher oxygen fractions might be applied without losing the helium-related benefits for the treatment of upper airway obstruction.

Trial registration

Registration with clinical trials (NCT00788788) and EMA (EudraCT number: 2006-005289-37).
Literatur
Zurück zum Zitat AL B (1934) Use of Helium as a new therapeutic gas. Proc Soc Exp Biol Med 32:462–464CrossRef AL B (1934) Use of Helium as a new therapeutic gas. Proc Soc Exp Biol Med 32:462–464CrossRef
Zurück zum Zitat AL B (1935) The therapeutic use of helium in the treatment of asthma and obstructive lesions in the larynx and trachea. Ann Intern Med 9:739–765CrossRef AL B (1935) The therapeutic use of helium in the treatment of asthma and obstructive lesions in the larynx and trachea. Ann Intern Med 9:739–765CrossRef
Zurück zum Zitat Allan PF, Thomas KV, Ward MR, Harris AD, Naworol GA, Ward JA (2009) Feasibility study of noninvasive ventilation with helium-oxygen gas flow for chronic obstructive pulmonary disease during exercise. Respira Care 54(9):1175–1182 Allan PF, Thomas KV, Ward MR, Harris AD, Naworol GA, Ward JA (2009) Feasibility study of noninvasive ventilation with helium-oxygen gas flow for chronic obstructive pulmonary disease during exercise. Respira Care 54(9):1175–1182
Zurück zum Zitat Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exer 14(5):377–381CrossRef Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exer 14(5):377–381CrossRef
Zurück zum Zitat Haussermann S, Schulze A, Katz IM, Martin AR, Herpich C, Hunger T, Texereau J (2015) Effects of a helium/oxygen mixture on individuals’ lung function and metabolic cost during submaximal exercise for participants with obstructive lung diseases. Int J Chron Obstr Pulm Dis 10:1987–1997. https://doi.org/10.2147/COPD.S88965 CrossRef Haussermann S, Schulze A, Katz IM, Martin AR, Herpich C, Hunger T, Texereau J (2015) Effects of a helium/oxygen mixture on individuals’ lung function and metabolic cost during submaximal exercise for participants with obstructive lung diseases. Int J Chron Obstr Pulm Dis 10:1987–1997. https://​doi.​org/​10.​2147/​COPD.​S88965 CrossRef
Zurück zum Zitat Haynes JM (2006) Heliox should be available in every community hospital. Respir care 51(11):1261PubMed Haynes JM (2006) Heliox should be available in every community hospital. Respir care 51(11):1261PubMed
Zurück zum Zitat Hess DR, Fink JB, Venkataraman ST, Kim IK, Myers TR, Tano BD (2006) The history and physics of heliox. Respir care 51(6):608–612PubMed Hess DR, Fink JB, Venkataraman ST, Kim IK, Myers TR, Tano BD (2006) The history and physics of heliox. Respir care 51(6):608–612PubMed
Zurück zum Zitat Ho AM, Dion PW, Karmakar MK, Chung DC, Tay BA (2002) Use of heliox in critical upper airway obstruction. Physical and physiologic considerations in choosing the optimal helium:oxygen mix. Resuscitation 52(3):297–300CrossRefPubMed Ho AM, Dion PW, Karmakar MK, Chung DC, Tay BA (2002) Use of heliox in critical upper airway obstruction. Physical and physiologic considerations in choosing the optimal helium:oxygen mix. Resuscitation 52(3):297–300CrossRefPubMed
Zurück zum Zitat Lee DL, Lee H, Chang HW, Chang AY, Lin SL, Huang YC (2005) Heliox improves hemodynamics in mechanically ventilated patients with chronic obstructive pulmonary disease with systolic pressure variations. Crit Care Med 33(5):968–973CrossRefPubMed Lee DL, Lee H, Chang HW, Chang AY, Lin SL, Huang YC (2005) Heliox improves hemodynamics in mechanically ventilated patients with chronic obstructive pulmonary disease with systolic pressure variations. Crit Care Med 33(5):968–973CrossRefPubMed
Zurück zum Zitat Siobal MS (2009) Combining heliox and inhaled nitric oxide as rescue treatment for pulmonary interstitial emphysema. Respir Care 54(7):976–977 (author reply 977–978) CrossRefPubMed Siobal MS (2009) Combining heliox and inhaled nitric oxide as rescue treatment for pulmonary interstitial emphysema. Respir Care 54(7):976–977 (author reply 977–978) CrossRefPubMed
Zurück zum Zitat Truebel H (2008) Heliox in airway obstruction and mechanical ventilatio. In: I M (ed) Core Topics in mechanical ventilation, vol 1. Cambridge University Press, Cambridge, pp 230–238CrossRef Truebel H (2008) Heliox in airway obstruction and mechanical ventilatio. In: I M (ed) Core Topics in mechanical ventilation, vol 1. Cambridge University Press, Cambridge, pp 230–238CrossRef
Zurück zum Zitat Venkataraman ST (2006) Heliox during mechanical ventilation. Respir Care 51(6):632–639PubMed Venkataraman ST (2006) Heliox during mechanical ventilation. Respir Care 51(6):632–639PubMed
Zurück zum Zitat Vogiatzis I, Habazettl H, Aliverti A, Athanasopoulos D, Louvaris Z, LoMauro A, Wagner H, Roussos C, Wagner PD, Zakynthinos S (2011) Effect of helium breathing on intercostal and quadriceps muscle blood flow during exercise in COPD patients. Am J Physiol Regul Integr Comp Physiol 300(6):R1549–R1559. https://doi.org/10.1152/ajpregu.00671.2010 CrossRefPubMed Vogiatzis I, Habazettl H, Aliverti A, Athanasopoulos D, Louvaris Z, LoMauro A, Wagner H, Roussos C, Wagner PD, Zakynthinos S (2011) Effect of helium breathing on intercostal and quadriceps muscle blood flow during exercise in COPD patients. Am J Physiol Regul Integr Comp Physiol 300(6):R1549–R1559. https://​doi.​org/​10.​1152/​ajpregu.​00671.​2010 CrossRefPubMed
Metadaten
Titel
A proof-of-concept trial of HELIOX with different fractions of helium in a human study modeling upper airway obstruction
verfasst von
Hubert Truebel
Sandra Wuester
Philip Boehme
Hinnerk Doll
Sven Schmiedl
Jacek Szymanski
Thorsten Langer
Thomas Ostermann
Dirk Cysarz
Petra Thuermann
Publikationsdatum
08.03.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Applied Physiology / Ausgabe 5/2019
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI
https://doi.org/10.1007/s00421-019-04116-7

Weitere Artikel der Ausgabe 5/2019

European Journal of Applied Physiology 5/2019 Zur Ausgabe