Helium Administration During Mechanical Ventilation in Children with Respiratory Failure

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Helium is an inert gas and does not interact with living tissues. Although it possesses no inherent therapeutic effects, its unique characteristics including decreased density result in an improvement in gas flow through narrowed airways While the majority of experience pertains to its use during spontaneous ventilation inpatients with upper airway obstruction, its unique properties suggest its utility during mechanical ventilation as a means of improving gas flow to areas with low compliance and high resistance, improving ventilation-perfusion matching, and allowing for the delivery of a larger tidal breath with a lower peak inspiratory pressure. The authors present three cases in which helium was delivered during mechanical ventilation, review the literature concerning the use of helium during mechanical ventilation in children, and discuss the technology needed for the safe and effective delivery of helium through conventional ventilators.

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