[Use of helium-oxygen gas mixtures in acute obstructive respiratory insufficiencies].
ABSTRACT Therapeutic use of helium has been described since 1930. Its main action is to reduce bronchial resistances and consequently overall respiratory work. Helium is substituted for nitrogen. The effects of inhaling a helium-oxygen mixture result exclusively from the physicochemical properties of helium: very low density, high kinetic viscosity. With the advent of selective bronchodilators, use of helium was rapidly abandoned until recently with new interest for the treatment of severe acute asthma. We review the literature on the physical properties of helium-oxygen mixtures and propose an analysis of their therapeutic use in severe acute asthma as well as other indications such as acute episodes of obstructive bronchopneumonia and obstruction of the upper airways. Due to the non-invasive nature of this technique, its easy use with spontaneous ventilation and the large body of theoretical data emphasizing its adaptation for therapeutic use, helium-oxygen gas mixtures offer an important therapeutic option for treating severe diseases with poor prognosis. A multicentric national study is under way to validate its use early by emergency ambulatory units for the treatment of severe acute asthma.
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ABSTRACT: This book integrates chapters on a variety of topics ranging from airway physiology to scenarios of a difficult airway, and reviews and management options in patients who are known to have a difficult airway such as the difficult pediatric airway, the difficult airway in obstetrics, and those suffering from obstructive sleep apnea. All the chapters are written by renowned contributors from all over the world with tremendous experience and expertise in the various fields. The probable overspill of the secretions into the lungs is a tangible fear and this aspect has been fully addressed in the chapters. The reviews presented herein describe difficult airway scenarios in a plethora of clinical settings that would help the anesthesiologists, emergency medicine specialists and the intensivists in taking steps in the right direction when posed with a challenging airway, thus ensuring safe anesthesia practice and patient care, which is our most cherished goal.First edited by Zahid Hussain Khan, 09/2014; Springer International Publishing Switzerland., ISBN: 978-3-319-08577-7