• Lili Zhou, Jing Lin, Mingkai Zhuang, Yue Wang, Qinyong Weng, and Hui Zhang.
• Department of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, PR China; Department of Critical Care Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, PR China. Electronic address: zhoulili@fjmu.edu.cn.
• J Crit Care. 2024 Dec 1; 84: 154897154897.

BackgroundConventional mechanical ventilation has adverse impacts on the hemodynamics of elderly, hypertensive ICU patients. Limited studies have addressed ways to ameliorate these negative effects. This study aimed to determine whether heliox ventilation could improve the hemodynamics, especially microcirculation, of elderly, hypertensive patients undergoing mechanical ventilation.MethodsThirty-eight patients, over the age of 65 with essential hypertension who underwent invasive mechanical ventilation treatment, were divided into two groups: a control group of nitrogen‑oxygen ventilation (n = 19) and an experimental group of heliox ventilation (n = 19). The control group received conventional room air ventilation and the experimental group adopted the innovative, closed heliox ventilation technique. Changes in blood pressure, heart rate (HR), peripheral oxygen saturation (SpO2), central venous oxygen saturation (ScvO2), regional cerebral oxygen saturation (rSO2), lactic acid (Lac) and airway pressure were measured at 0,1,2,3 h under volume-controlled ventilation (VCV) mode throughout the study. Sublingual microcirculation parameters were additionally measured at 0 h and 3 h of ventilation treatment.ResultsSpO2 in both groups increased after 1 h of ventilation compared with 0 h (p < 0.001), subsequently remaining stable. Compared with the control group, the experimental group showed a decrease in airway pressure and Lac, while blood pressure, ScvO2, and rSO2 increased (p < 0.05). Moreover, the sublingual microcirculation indexes in the experimental group improved compared with the control group (p < 0.05).ConclusionsHeliox ventilation improves blood pressure and microcirculation in elderly hypertensive patients and may resolve the limitations of traditional nitrogen‑oxygen ventilation.Trial RegistrationThis trial was registered. The Chinese trial registration number is ChiCTR2100043945. The date of registration is 6-3-2021.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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