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

被引:5
|
作者
Truebel, Hubert [1 ,2 ,6 ,7 ]
Wuester, Sandra [3 ,7 ]
Boehme, Philip [6 ,7 ]
Doll, Hinnerk [7 ]
Schmied, Sven [4 ,5 ,7 ]
Szymanski, Jacek [4 ,5 ,7 ,9 ]
Langer, Thorsten [1 ,2 ,7 ,8 ]
Ostermann, Thomas [7 ]
Cysarz, Dirk [7 ]
Thuermann, Petra [4 ,5 ,7 ]
机构
[1] HELIOS Clin Wuppertal, Dept Pediat, Wuppertal, Germany
[2] Witten Herdecke Univ, Dept Pediat, Sch Med, Fac Hlth, Witten, Germany
[3] HELIOS Clin Schwelm, Dept Pediat, Schwelm, Germany
[4] HELIOS Clin Wuppertal, Philipp Klee Inst Clin Pharmacol, Wuppertal, Germany
[5] Witten Herdecke Univ, Dept Clin Pharmacol, Sch Med, Fac Hlth, Witten, Germany
[6] Bayer Pharma AG, Cardiovasc Res, Apratherweg 18, D-42096 Wuppertal, Germany
[7] Witten Herdecke Univ, Sch Med, Fac Hlth, Witten, Germany
[8] Univ Freiburg, Dept Neuropediat & Muscle Disorders, Ctr Pediat, Fac Med, Freiburg, Germany
[9] Med Ctr City Reg Aachen GmbH, Aachen, Germany
关键词
Upper airway obstruction; HELIOX; Work of breathing; Clinical proof-of-concept study; PULMONARY-DISEASE; OXYGEN; EXERCISE; PRESSURE; FLOW; MIXTURE;
D O I
10.1007/s00421-019-04116-7
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
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.
引用
收藏
页码:1253 / 1260
页数:8
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