tailieunhanh - báo cáo hóa học: " Helium in the adult critical care setting"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Helium in the adult critical care setting | Diehl et al. Annals of Intensive Care 2011 1 24 http content 1 1 24 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Helium in the adult critical care setting 1 2 3 1 3 1 3 1 3 4 5 J L Dieni V Peigne E Guéiot C Faisy L Lecouit dill A Mieicat Abstract Helium is a low-density inert gas whose physical properties are very different from those of nitrogen and oxygen. Such properties could be clinically useful in the adult critical care setting especially in patients with upper to more distal airway obstruction requiring moderate to intermediate levels of FiO2. However despite decades of utilization and reporting it is still difficult to give any firm clinical recommendation in this setting. Numerous case reports are available in the context of upper airway obstruction of different origins but there is a lack of controlled studies for this indication. One study reported a helium-induced beneficial effect on surrogates of work of breathing after extubation in non-COPD patients possibly in relation to laryngeal consequences of tracheal intubation. Physiological benefits of helium-oxygen breathing have been demonstrated in the context of acute severe asthma but there is a lack of large controlled studies demonstrating an effect on pertinent clinical endpoints except for a study reported only as an abstract which mentioned a reduction in the intubation rate in helium-treated patients. Finally there are a number of physiological studies in the context of COLD-COPD patients demonstrating a beneficial effect mainly by a reduction in the resistive inspiratory work of breathing but also by a reduction in hyperinflation. Reduction of hypercapnia was mainly observed in spontaneously breathing and noninvasively ventilated helium-treated patients but not in intubated patients during controlled ventilation suggesting that the decrease in PaCO2 was mainly in relation to a diminution in CO2 production related to the diminution in work of

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