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Indian Pediatr 2015;52: 255-256 |
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Heliox Use in Ventilaion of Newborns: Authors’
Reply
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Xue Li and *Yuan Shi
Department of Pediatrics, Daping Hospital Third
Military Medical University, Chongqing, China.
Email: [email protected]
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Even though the distinct mechanisms of helium-induced organ protection
have not been completely unraveled, several signaling pathways have been
identified [1]. It has been shown that heliox could decrease neutrophil
infiltration, intra-alveolar edema, perivacular hemorrhage and hyaline
membrane formation of acute respiratory distress syndrome in rats [2].
Nawab, et al. [3] reported that heliox attenuated lung
inflammation and structural alterations of piglets in acute lung injury.
In our study, serum IL-6 at baseline was found be positively and
significantly correlated with the length of ventilation (LoV) [4], which
supported the speculation that helium might have anti-inflammatory
effect in humans in vivo. Thus, we speculated that there might be
other mechanisms of action of heliox, besides its physical effects in
respiratory diseases.
Heliox has been demonstrated to decrease the
threshold for surfactant and ventilation by reducing the increasing
oxygen requirement in Colnaghi’s study [5], which has important
practical application. It is very important that the utility of heliox
in reducing chronic lung disease should be expanded in more immature
infants. However, one purpose of our study was to assess the
effectiveness of heliox on lung inflammation cytokines. We tried to
explain the reason why heliox could improve the outcome of RDS from
another perspective.
Infants born before 32 weeks contribute to high
occurrence of complications of prematurity such as retinopathy of
prematurity, intraventricular hemorrhage and periventricular
leukomalacia. Nevertheless, premature infants born between 32-36 weeks
form a large proportion in NICU, and some need assisted ventilation.
Longtime ventilation will increase the risk of lung injury. Length of
ventilation should be the primary outcome as it plays an important role
leading to ventilator- associated lung injury. Further researchon the
mechanisms of heliox in respiratory diseases are still needed.
References
1. Gezina TML, Oei BS, Weber NC, Hollmann MW Preckel
B, Cellular effects of Helium in different organs. 2010;112:1503-10.
2. Yilmaz S, Daglioglu K, Yildizdas D, Bayram I,
Gumurdulu D, Polat S. The effectiveness of heliox in acute respiratory
distress syndrome. Ann Thorac Med. 2013;8:46-52.
3. Nawab US, Touch SM, Irwin-Sherman T, Blackson TJ,
Greenspan JS, Zhu G, et al. Heliox attenuates lung inflammation
and structural alterations in acute lung injury. Pediatr Pulmonol.
2005;40:524-32.
4. Li X, Shen J, Zhao J, Tang S, Shi Y. Nasal
intermittent positive pressure ventilation with heliox in premature
infants with respiratory distress syndrome: A randomized controlled
trial. Indian Pediatr. 2014;51:900-2.
5. Colnaghi M, Pierro M, Migliori C, Ciralli F,
Matassa PG, Vendettuoli V, et al. Nasal continuous positive
airway pressure with heliox in preterm infants with respiratory distress
syndrome. Pediatrics. 2012:e333-8.
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