• Tomasz Szczapa, Janusz Gadzinowski, Jerzy Moczko, and T Allen Merritt.
• Department of Neonatology, Poznań University of Medical Sciences, , Poznań, Poland.
• Arch. Dis. Child. Fetal Neonatal Ed. 2014 Mar 1;99(2):F128-33.

ObjectiveWe assessed the safety and studied the influence of short-term helium-oxygen (heliox) mechanical ventilation (MV) on respiratory function, gas exchange and oxygenation in infants with bronchopulmonary dysplasia (BPD) or at high risk for BPD.DesignA pilot, time-series study.SettingNeonatal intensive care unit.PatientsInfants with severe BPD who required MV.InterventionsMV with helium-oxygen and air-oxygen mixtures.Main Outcome MeasuresRespiratory parameters, acid-base balance, oxygenation and vital signs were recorded at five time points: initially during MV with air-oxygen, after 15 and 60 min of helium-oxygen MV, and 15 and 60 min after return to air-oxygen MV.Results15 infants with BPD were enrolled. Helium-oxygen MV was well tolerated and was associated with a statistically significant increase in tidal volume, dynamic compliance and peak expiratory flow rate. An improvement in oxygenation and a decrease in fraction of inspired oxygen was also observed. During helium-oxygen MV there was a significant decrease in the oxygenation index and alveolar-arterial oxygen tension difference. The PaO2/fraction of inspired oxygen (FiO2) ratio increased significantly during helium-oxygen ventilation. A decrease in PaCO2 and an increase in pH were also observed during helium-oxygen administration, however this was not statistically significant. After ventilation with helium-oxygen was discontinued, the infants' respiratory function and oxygenation deteriorated and supplemental oxygen requirements increased accordingly.ConclusionsHelium-oxygen MV is safe and resulted in improvement of respiratory function and oxygenation in infants with severe BPD requiring MV.

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