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The Cochrane Database of Systematic... 2002Due to its low density properties, helium-oxygen mixtures have the potential to decrease the work of breathing and possibly avoid the need for intubation and mechanical... (Review)
Review
BACKGROUND
Due to its low density properties, helium-oxygen mixtures have the potential to decrease the work of breathing and possibly avoid the need for intubation and mechanical ventilation in patients with respiratory failure.
OBJECTIVES
To determine the effect of the addition of helium/oxygen mixtures (heliox) to standard medical care during ventilated and nonventilated acute exacerbations of COPD.
SEARCH STRATEGY
Randomized controlled trials were identified from the Cochrane Airways Review Group asthma Register. Primary authors and experts were contacted. References from included and excluded studies, known reviews and texts were also searched.
SELECTION CRITERIA
Studies were selected for inclusion if they compared treatment with heliox to placebo (oxygen or air) in randomized controlled trials in adults with an exacerbation of COPD.
DATA COLLECTION AND ANALYSIS
Data from all trials were combined using the Review Manager (version 4.1). We planned to perform: 1) random effects weighted mean difference (WMD), with 95% confidence intervals (95% CI), 2) Homogeneity of effect sizes with the Dersimonian and Laird method with p<0.1 as the cut point for significance, and 3) sensitivity analysis on different helium-oxygen mixtures (80/20 vs 70/30), and 4) methodological quality (Jadad score >2 vs. <3).
MAIN RESULTS
Four studies, all published between 1997 and 2000 met the inclusion criteria. Two studies compared heliox-oxygen vs. air-oxygen in decompensated COPD patients who were not ventilated. One study was performed in mechanical ventilated patients and one in patients undergoing noninvasive pressure support (NIPSV) ventilated patients. Data could be obtained for only two of the studies. One was a randomized crossover study of 70:30 helium-oxygen vs air-oxygen that involved nineteen patients with acute severe COPD, hospitalized in an intensive care unit for NIPSV. In the patients receiving heliox, arterial PCO2 fell more; WMD 0.8 kPa (95% CI 0.26, -1.34). The second was a randomized trial involved 47 patients with acute COPD, who presented to an Emergency Department randomized to receive updraft nebulization of albuterol and ipratropium bromide using 80% helium and 20% oxygen or compressed air as the driving gas. Treatments were administered at 0, 20, 40, and 120 minutes after randomization. There were no significant differences in the change of FEV1 and FVC between the two groups by either the 1 or 2 hours point. although a small improvement in FEF 25-75 was significantly greater in the heliox group than in the air group.
REVIEWER'S CONCLUSIONS
There is currently insufficient evidence to support the use of helium-oxygen mixtures to treat acute exacerbations of COPD in either ventilated or nonventilated patients. Suitably designed randomised controlled trials with the endpoint being the avoidance of mechanical ventilation may be justified.
Topics: Helium; Humans; Oxygen; Pulmonary Disease, Chronic Obstructive; Randomized Controlled Trials as Topic
PubMed: 12076487
DOI: 10.1002/14651858.CD003571 -
Effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in rats.Acta Cirurgica Brasileira Jul 2013To evaluate the effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in a rat model.
PURPOSE
To evaluate the effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in a rat model.
METHODS
Twenty four rats were randomized into three groups (n=8): gasless insufflation ('open', Pressure=0 mmHg), carbon dioxide pneumoperitoneum at 12 mmHg, and helium pneumoperitoneum at 12 mmHg; all lasting 90 minutes.. A cystostomy was performed and the bladder was emptied. At the end of the experiment, the urine produced, a blood sample and the left kidney of each animal were collected. The following variables were obtained: serum sodium, potassium, urea and creatinine, urine volume and creatinine. The creatinine clearance was estimated for each animal. The kidneys were stained with hematoxylin and eosin (HE) and evaluated by a pathologist blinded to the groups.
RESULTS
The CO2 and Helium groups did not differ in the variables evaluated. Both developed oliguria (p<0.001 vs. gasless). The CO2 group presented hyperkalemia compared to gasless (p=0.05), which did not attain significance in the helium group. Histopathological analysis revealed mild hydropic degeneration and congestion in the three groups, with no significant difference among them.
CONCLUSIONS
The type of gas resulted in no difference in the variables of renal function and morphology assessed. The increase in serum potassium was only observed with CO2 insufflation suggests a combined effect of elevated intra-abdominal pressure and metabolic effects of pneumoperitoneum.
Topics: Animals; Carbon Dioxide; Creatinine; Helium; Kidney; Kidney Function Tests; Male; Models, Animal; Pneumoperitoneum, Artificial; Random Allocation; Rats; Rats, Wistar; Sodium; Time Factors; Urea; Urination
PubMed: 23842929
DOI: 10.1590/s0102-86502013000700003 -
Aesthetic Surgery Journal Sep 2023Minimally invasive procedures that deliver thermal energy to subcutaneous tissue offer a solution when deciding between excisional and noninvasive options to address...
BACKGROUND
Minimally invasive procedures that deliver thermal energy to subcutaneous tissue offer a solution when deciding between excisional and noninvasive options to address face and neck aging-related changes. A minimally invasive helium plasma device, Renuvion, was first utilized for subdermal tissue heating to reduce skin laxity under an FDA general clearance for cutting, coagulation, and ablation of soft tissue.
OBJECTIVES
The purpose of this study was to demonstrate the safety and effectiveness of the helium plasma device for improving the appearance of loose skin in the neck and submental region.
METHODS
Patients undergoing the procedure with the helium plasma device in the neck and submentum were studied. They were seen for 6 months following the procedure. The primary effectiveness endpoint for improvement in lax skin in the treatment area was determined by 2 of 3 blinded photographic reviewers. The primary safety endpoint was the level of pain after treatment.
RESULTS
The primary effectiveness endpoint was met; 82.5% demonstrated improvement at Day 180. The primary safety endpoint was met; 96.9% of patients experienced no pain to moderate pain to Day 7. There were no serious adverse events reported related to the study device or procedure.
CONCLUSIONS
The data demonstrate benefit to patients by improvement of the appearance of lax skin in the neck and submental region. Outcomes resulted in US Food and Drug Administration 510(k) clearance in July 2022, expanding indications for the device to include subcutaneous dermatological and aesthetic procedures to improve the appearance of loose skin in the neck and submental region.
Topics: Humans; Treatment Outcome; Plasma Gases; Helium; Rhytidoplasty; Neck; Skin Aging
PubMed: 36883611
DOI: 10.1093/asj/sjad055 -
Anaesthesia Mar 2008The noble gases have always been an enigma. Discovered late in the history of chemistry and in seemingly small quantities in our atmosphere, they are some of the most... (Review)
Review
The noble gases have always been an enigma. Discovered late in the history of chemistry and in seemingly small quantities in our atmosphere, they are some of the most unreactive elements known. However, despite being extremely inert, the noble gases (helium, neon, argon, krypton, xenon and radon) have found diverse and ever expanding applications in medicine. Of all of them, the gases that have found the greatest number of uses in the field of anaesthesia and related specialties are helium and xenon. This review focuses on the history of the discovery of both gases, their unique physicochemical properties and describes their uses in clinical practice with particular emphasis on those applicable to anaesthesia.
Topics: Anesthesia, Inhalation; Anesthetics, Inhalation; Chemical Phenomena; Chemistry, Physical; Diagnostic Imaging; Helium; Humans; Oxygen; Respiratory Insufficiency; Xenon
PubMed: 18289236
DOI: 10.1111/j.1365-2044.2007.05253.x -
The Cochrane Database of Systematic... Oct 2006Helium and oxygen mixtures (heliox), have been used sporadically in respiratory medicine for decades. Their use in acute respiratory emergencies such as asthma has been... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Helium and oxygen mixtures (heliox), have been used sporadically in respiratory medicine for decades. Their use in acute respiratory emergencies such as asthma has been the subject of considerable debate. Despite the lapse of more than 60 years since it was first proposed, the role of heliox in treating patients with severe acute asthma remains unclear.
OBJECTIVES
To determine the effect of the addition of heliox to standard medical care on the course of acute asthma, as measured by pulmonary function testing and clinical endpoints.
SEARCH STRATEGY
Randomised controlled trials were identified from the Cochrane Airways Group Specialised Register. In addition, we contacted primary authors and experts and searched reference lists of articles. Searches are current to August 2005.
SELECTION CRITERIA
1) randomised, single or double blind, controlled trials; 2) children or adults with a clinical diagnosis of acute asthma seen in emergency departments or equivalent acute care settings; and 3) compared treatment with inhaled heliox to placebo (oxygen or air).
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed the studies for inclusion and quality assessment; disagreement was resolved by a third review author and consensus.
MAIN RESULTS
This review has been updated in 2006 to include four new trials giving atotal of ten trials involving 544 acute asthma patients. Seven studies involved adults and three studies dealt solely with children. Three were assessed as high quality (Jadad score > 3). Pulmonary function tests were recorded during heliox administration (15 to 60 min). Pooling of the eight trials contributing data to this review showed no significant group differences (standardised mean differences -0.28; 95% confidence interval (CI) -0.56 to 0.01). There was significant heterogeneity among the studies. Heliox use did improve pulmonary function only in the subgroup of patients with the most severe baseline pulmonary function impairment; however, this conclusion is based on a small number of studies. There were no significant differences between groups when adults versus children, and high versus low heliox dose studies were compared. Finally, at the end of treatment, participants treated with heliox showed no significant different risk of admission to hospital (RR 0.83 (95%CI 0.66 to 1.08, P = 0.17, I(2) = 0%).
AUTHORS' CONCLUSIONS
The existing evidence does not provide support for the administration of helium-oxygen mixtures to all ED patients with acute asthma. At this time, heliox treatment does not have a role to play in the initial treatment of patients with acute asthma. Nevertheless, new evidence suggests certain beneficial effects in patients with more severe obstruction. Since these conclusions are based upon between-group comparisons and small studies, they should be interpreted with caution.
Topics: Acute Disease; Adult; Asthma; Child; Double-Blind Method; Drug Combinations; Helium; Humans; Oxygen; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 17054154
DOI: 10.1002/14651858.CD002884.pub2 -
Respiratory Medicine May 2012Individuals with chronic obstructive pulmonary disease (COPD) are often limited in their ability to perform exercise due to a heightened sense of dyspnea and/or the... (Review)
Review
Individuals with chronic obstructive pulmonary disease (COPD) are often limited in their ability to perform exercise due to a heightened sense of dyspnea and/or the occurrence of leg fatigue associated with a reduced ventilatory capacity and peripheral skeletal muscle dysfunction, respectively. Pulmonary rehabilitation programs have been shown to improve exercise tolerance and health related quality of life. Additional therapeutic approaches such as non-invasive ventilatory support (NIVS), heliox (He-O(2)) and supplemental oxygen have been used as non-pharmacologic adjuncts to exercise to enhance the ability of patients with COPD to exercise at a higher exercise-intensity and thus improve the physiological benefits of exercise. The purpose of the current review is to examine the pathophysiology of exercise limitation in COPD and to explore the physiological mechanisms underlying the effect of the adjunct therapies on exercise in patients with COPD. This review indicates that strategies that aim to unload the respiratory muscles and enhance oxygen saturation during exercise alleviate exercise limiting factors and improve exercise performance in patients with COPD. However, available data shows significant variability in the effectiveness across patients. Further research is needed to identify the most appropriate candidates for these forms of therapies.
Topics: Cardiac Output; Combined Modality Therapy; Exercise Therapy; Helium; Humans; Muscle, Skeletal; Oxygen; Oxygen Inhalation Therapy; Pulmonary Disease, Chronic Obstructive; Respiration, Artificial; Respiratory Muscles
PubMed: 22341681
DOI: 10.1016/j.rmed.2012.01.006 -
Scientific Reports Feb 2024Recent research has highlighted the promising potential of cold atmospheric plasma (CAP) in cancer therapy. However, variations in study outcomes are attributed to...
Recent research has highlighted the promising potential of cold atmospheric plasma (CAP) in cancer therapy. However, variations in study outcomes are attributed to differences in CAP devices and plasma parameters, which lead to diverse compositions of plasma products, including electrons, charged particles, reactive species, UV light, and heat. This study aimed to evaluate and compare the optimal exposure time, duration, and direction-dependent cellular effects of two CAPs, based on argon and helium gases, on glioblastoma U-87 MG cancer cells and an animal model of GBM. Two plasma jets were used as low-temperature plasma sources in which helium or argon gas was ionized by high voltage (4.5 kV) and frequency (20 kHz). In vitro assessments on human GBM and normal astrocyte cell lines, using MTT assays, flow cytometry analysis, wound healing assays, and immunocytochemistry for Caspase3 and P53 proteins, demonstrated that all studied plasma jets, especially indirect argon CAP, selectively induced apoptosis, hindered tumor cell growth, and inhibited migration. These effects occurred concurrently with increased intracellular levels of reactive oxygen species and decreased total antioxidant capacity in the cells. In vivo results further supported these findings, indicating that single indirect argon and direct helium CAP therapy, equal to high dose Temozolomide treatment, induced tumor cell death in a rat model of GBM. This was concurrent with a reduction in tumor size observed through PET-CT scan imaging and a significant increase in the survival rate. Additionally, there was a decrease in GFAP protein levels, a significant GBM tumor marker, and an increase in P53 protein expression based on immunohistochemical analyses. Furthermore, Ledge beam test analysis revealed general motor function improvement after indirect argon CAP therapy, similar to Temozolomide treatment. Taken together, these results suggest that CAP therapy, using indirect argon and direct helium jets, holds great promise for clinical applications in GBM treatment.
Topics: Humans; Rats; Animals; Helium; Argon; Tumor Suppressor Protein p53; Plasma Gases; Glioblastoma; Temozolomide; Positron Emission Tomography Computed Tomography
PubMed: 38347045
DOI: 10.1038/s41598-024-54070-4 -
Critical Care and Resuscitation :... Mar 2006Heliox, a mix of oxygen and helium, has a number of potential medical applications resulting from its relatively lower density. This paper reviews the physics underlying... (Review)
Review
Heliox, a mix of oxygen and helium, has a number of potential medical applications resulting from its relatively lower density. This paper reviews the physics underlying its utility and considers the evidence for its use. While there are studies that support its role, particularly in patients with exacerbations of asthma and chronic obstructive pulmonary disease (COPD), the data are inconclusive.
Topics: Airway Obstruction; Asthma; Critical Illness; Croup; Helium; Humans; Hypoxia; Oxygen; Pulmonary Disease, Chronic Obstructive; Pulmonary Gas Exchange; Ventilators, Mechanical
PubMed: 16536724
DOI: No ID Found -
Emergency Medicine Journal : EMJ Mar 2004January 2002 saw the relaunch by BOC of Heliox, a gaseous mixture of helium and oxygen, for the use in a wide range of respiratory conditions. Despite a lapse of over 65... (Review)
Review
January 2002 saw the relaunch by BOC of Heliox, a gaseous mixture of helium and oxygen, for the use in a wide range of respiratory conditions. Despite a lapse of over 65 years since it was first used, and a large number of studies and case reports advocating its use, it remains an enigma, its use sporadic, and its role undefined. This paper reviews the discovery of helium and early medical use of helium oxygen mixtures and outlines areas where Heliox already has confirmed benefit as well as one or two areas that are currently under investigation. It will also look specifically at the use of Heliox in acute exacerbations of asthma and perform a thorough review of the current literature.
Topics: Airway Obstruction; Algorithms; Anti-Asthmatic Agents; Asthma; Croup; Drug Therapy, Combination; Emergencies; Helium; Humans; Hypoxia; Lung Diseases, Obstructive; Oxygen
PubMed: 14988333
DOI: 10.1136/emj.2002.003483 -
Respiratory Care May 2022
Topics: Asthma; Child; Combined Modality Therapy; Helium; Humans; Oxygen
PubMed: 35473847
DOI: 10.4187/respcare.10097