Application Of Helium Oxygen Mixture In COPD Patients Requiring Mechanical Ventilation

Objectives To study the effect of helium oxygen mixture in invasive mechanical ventilation for patients with Chronic Obstructive Pulmonary Disease(COPD).Methods 37 patients with COPD in ICU of our hospital from February 17 to March 19,including 26 males(70.3%)and 11 females(29.7%),all of whom required mechanical ventilation.Other treatments were similar in all 37 patients,except for other severe complications or concomitant symptoms.By using self-controlled test,all 37 patients were given 2-hour air-oxygen mixture mechanical ventilation,followed by 4-hour helium-oxygen mixture mechanical ventilation,and finally 2-hour air-oxygen mixture mechanical ventilation.The data of 1h and 2h of air-oxygen mixture mechanical ventilation were recorded as T1 h and T2 h.The data of 30 min,1h,2h and 4h after mechanical ventilation with helium-oxygen mixture were recorded as T30 min ’,T1 h ’,T2 h ’and T4h’.Application of empty oxygen mixture again after 1 h,2 h corresponding data record for T1 h,T2h ",the acquisition of patients’ the p H value,Pa CO2,Pa O2,platform of airway pressure,airway peak pressure breathe in,breathe out at the end of the positive pressure,resistance,expiratory resistance,respiratory function,pulmonary compliance values,in order to compare the helium oxygen mixed gas’ s influence on the mechanical ventilation of COPD patients with respiratory mechanics.During the complete trial,the ventilator mode and basic conditions of all patients were carried out under the condition that the disease allowed,and the conventional treatment was not affected in any way.Results 1.Patients who underwent air-oxygen mixture mechanical ventilation were relatively stable(there was no statistically significant difference in the value comparison between T1 h and T2 h,P > 0.05).After switching to helium-oxygen mixture for mechanical ventilation,the respiratory mechanics related indicators,arterial partial pressure of oxygen and partial pressure of carbon dioxide were significantly improved by P<0.05.Among them,the airway platform pressure,peak airway pressure,positive endexpiratory pressure,inspiratory resistance,expiratory resistance,breathing work,arterial blood pco2 decreased significantly,while lung compliance and arterial blood oxygen partial pressure increased significantly.The changes above basically occurred within 1 hour when the mixture of helium and oxygen was used for mechanical ventilation,that is to say,the numerical comparison between T30 min ’and T2 h,and the numerical comparison between T1h’ and T30 min ’were statistically significant(P < 0.05).2.After 2h and 4h of helium-oxygen mixture mechanical ventilation,the values of T2 h ’and T1h’ were compared with those of T4 h ’and T2h’,and the difference was not significant(P > 0.05).3.After changing to air-oxygen mixture mechanical ventilation for 1h,there was a significant difference in both respiratory mechanics related indexes,arterial partial pressure of oxygen and partial pressure of carbon dioxide compared with the previous time node(4h for helium-oxygen mixture mechanical ventilation).The airway platform pressure,peak pressure,positive end-expiratory pressure,inspiratory resistance,expiratory resistance,breathing work,arterial blood pco2 all increased significantly,while lung compliance and arterial blood oxygen partial pressure decreased significantly.The difference between T1 h "and T4 h ’was statistically significant(P < 0.05).4.There was no statistically significant difference between the values of air-oxygen mixture mechanical ventilation up to 2h,T2 h "and T1h"(P > 0.05).5.The p H value of arterial blood did not change significantly during the whole experiment,and the difference was not statistically significant(P > 0.05).Conclusions 1.Compared with mechanical ventilation with traditional air-oxygen mixture,mechanical ventilation with helium-oxygen mixture can effectively reduce work of breathing,decrease the inspiratory resistance,respiratory resistance,airway plateau pressure,peak airway pressure and positive end-expiratory pressure,and improve the lung compliance of patients with COPD.At the same time,it can reduce the arterial partial pressure of oxygen and partial pressure of carbon dioxide in COPD patients,but has no obvious effect on p H.2.The changes above occurred within 1 hour of mechanical ventilation with heliumoxygen mixture.In addition,one hour after helium-oxygen was replaced by air-oxygen mixture of mechanical ventilation,the patient’s indexes returned to the state when mechanical ventilation with air-oxygen mixture was given.3.Helium-oxygen mixed mechanical ventilation can reduce the partial pressure of carbon dioxide,increase arterial partial pressure of oxygen for patients with COPD,improve ventilation and oxygenation,help to stabilize the vital signs,and reduce work of breathing and consumption,which contributes to the recovery.Efforts to reduce airway platform pressure,peak airway pressure,positive end-expiratory pressure,and improve lung compliance can help reduce ventilator-induced lung injury.Figure 0;Table 4;Reference 67...