TY - JOUR
T1 - A multicenter, randomized trial of noninvasive ventilation with helium-oxygen mixture in exacerbations of chronic obstructive lung disease
AU - Maggiore, Salvatore Maurizio
AU - Richard, J. C
AU - Abroug, Fekri
AU - Diehl, Jl
AU - Antonelli, Massimo
AU - Sauder, P
AU - Mancebo, J
AU - Ferrer, M
AU - Lellouche, F
AU - Lecourt, L
AU - Beduneau, G
AU - Brochard, L.
PY - 2010
Y1 - 2010
N2 - OBJECTIVE: To assess the effect of a helium-oxygen mixture on intubation rate and clinical outcomes during noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease.
DESIGN: Multicenter, prospective, randomized, controlled trial.
SETTING: Seven intensive care units.
PATIENTS: A total of 204 patients with known or suspected chronic obstructive pulmonary disease and acute dyspnea, Paco2> 45 mm Hg and two among the following factors: pH <7.35, Paco2 <50 mm Hg, respiratory rate >25/min.
INTERVENTIONS: Noninvasive ventilation randomly applied with or without helium (inspired oxygen fraction 0.35) via a face mask.
MEASUREMENTS AND MAIN RESULTS: Duration and complications of NIV and mechanical ventilation, endotracheal intubation, discharge from intensive care unit and hospital, mortality at day 28, adverse and serious adverse events were recorded. Follow-up lasted until 28 days since enrollment. Intubation rate did not significantly differ between groups (24.5% vs. 30.4% with or without helium, p = .35). No difference was observed in terms of improvement of arterial blood gases, dyspnea, and respiratory rate between groups. Duration of noninvasive ventilation, length of stay, 28-day mortality, complications and adverse events were similar, although serious adverse events tended to be lower with helium (10.8% vs. 19.6%, p = .08).
CONCLUSIONS: Despite small trends favoring helium, this study did not show a statistical superiority of using helium during NIV to decrease the intubation rate in acute exacerbation of chronic obstructive pulmonary disease.
AB - OBJECTIVE: To assess the effect of a helium-oxygen mixture on intubation rate and clinical outcomes during noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease.
DESIGN: Multicenter, prospective, randomized, controlled trial.
SETTING: Seven intensive care units.
PATIENTS: A total of 204 patients with known or suspected chronic obstructive pulmonary disease and acute dyspnea, Paco2> 45 mm Hg and two among the following factors: pH <7.35, Paco2 <50 mm Hg, respiratory rate >25/min.
INTERVENTIONS: Noninvasive ventilation randomly applied with or without helium (inspired oxygen fraction 0.35) via a face mask.
MEASUREMENTS AND MAIN RESULTS: Duration and complications of NIV and mechanical ventilation, endotracheal intubation, discharge from intensive care unit and hospital, mortality at day 28, adverse and serious adverse events were recorded. Follow-up lasted until 28 days since enrollment. Intubation rate did not significantly differ between groups (24.5% vs. 30.4% with or without helium, p = .35). No difference was observed in terms of improvement of arterial blood gases, dyspnea, and respiratory rate between groups. Duration of noninvasive ventilation, length of stay, 28-day mortality, complications and adverse events were similar, although serious adverse events tended to be lower with helium (10.8% vs. 19.6%, p = .08).
CONCLUSIONS: Despite small trends favoring helium, this study did not show a statistical superiority of using helium during NIV to decrease the intubation rate in acute exacerbation of chronic obstructive pulmonary disease.
KW - acute respiratory failure
KW - chronic obstructive pulmonary disease
KW - endotracheal intubation
KW - heliox
KW - mechanical ventilation
KW - acute respiratory failure
KW - chronic obstructive pulmonary disease
KW - endotracheal intubation
KW - heliox
KW - mechanical ventilation
UR - http://hdl.handle.net/10807/63301
M3 - Article
SN - 0090-3493
VL - 2010
SP - 145
EP - 151
JO - Critical Care Medicine
JF - Critical Care Medicine
ER -