Helium-oxygen versus air-oxygen noninvasive pressure support in decompensated chronic obstructive disease: A prospective, multicenter study.

Abstract:

OBJECTIVE:To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization costs. DESIGN:Prospective, randomized, multicenter study. SETTING:Intensive care units of three tertiary care university hospitals. PATIENTS:All patients with chronic obstructive pulmonary disease admitted to the intensive care units for NIPSV during a 24-month period. INTERVENTIONS:Patients were randomized to NIPSV with air/oxygen or He/oxygen. NIPSV settings, number of daily trials, decision to intubate, and intensive care unit and hospital discharge criteria followed standard practice guidelines. RESULTS:A total of 123 patients (male/female ratio, 71:52; age, 71 +/- 10 yrs, Acute Physiology and Chronic Health Evaluation II, 17 +/- 4) were included. Intubation rate (air/oxygen 20% vs. He/oxygen 13%) and length of stay in the intensive care unit (air/oxygen 6.2 +/- 5.6 vs. He/oxygen 5.1 +/- 4 days) were comparable. The post-intensive care unit hospital stay was lower with He/oxygen (air/oxygen 19 +/- 12 vs. He/oxygen 13 +/- 6 days, p < .002). Cost of NIPSV gases was higher with He/oxygen, but total hospitalization costs were lower by $3,348 per patient with He/oxygen. No complications were associated with the use of He/oxygen. CONCLUSION:He/oxygen did not significantly reduce intubation rate or intensive care unit stay, but hospital stay was shorter and total costs were lower. He/oxygen NIPSV can be safely administered and could prove to be a cost-effective strategy.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Jolliet P,Tassaux D,Roeseler J,Burdet L,Broccard A,D'Hoore W,Borst F,Reynaert M,Schaller MD,Chevrolet JC

doi

10.1097/01.CCM.0000055369.37620.EE

subject

Has Abstract

pub_date

2003-03-01 00:00:00

pages

878-84

issue

3

eissn

0090-3493

issn

1530-0293

journal_volume

31

pub_type

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