Skip to main content

Helium..in Birthday balloons and in Medicine

Helium is the second most abundant element in the universe (that’s cool)! It is an inert gas that is odorless and tasteless. It has a lower molecular weight and is less dense than Oxygen. It has been used in medicine since the 1930’s.It is used as integral part of HELIOX and for  inflation of Intra aortic Ballon  Pumps(IABs)..

 
In Heliox :





Heliox is a mixture of oxygen and Helium resulting in a gas less dense than air (essentially Helium replaces Nitrogen in the air). In conditions where there is increased airway resistance (asthma, croup, upper airway masses, etc) there is turbulent airflow, which increases the work of breathing. Heliox can reduce airway resistance by increasing laminar airflow and decrease work of breathing.   

 
It is generally administered in mixtures of 70:30 or 80:20 (Helium:Oxygen).
 
Potential Benefits: 
Better lung mechanics
Improved delivery of albuterol or other nebulized medications
Few known side-effects/complications (it is inert after all)
 
Drawbacks:
Expensive
Contraindicated in hypoxemic patients (if your patient needs 50% oxygen, you can’t use Heliox)
Paucity of large prospective randomized trials to support its use
It doesn’t treat the causative issue

 
Currently systematic reviews and guidelines state that Heliox should NOT be used in ALL patients with acute asthma  and that it doesn’t play a role in the initial treatment.
FORTUNATELY, those are not the patients that we would likely use Heliox in.  There are studies that point toward its benefit in selected patients with severe obstructive disease.

 
In IABPs:

Intra Aortic Balloon Pump (IABP) Counterpulsation utilizes helium gas to inflate its balloon. As Helium is a low density as well as an inert gas, in case of balloon rupture it is easily absorbed into the bloodstream. this may be heralded by high balloon inflation pressures.The key indicator of balloon rupture is the presence of blood in the connecting tubing.

 
Management involves
  • immediate cessation of counterpulsation
  • placement of the patient head down and IAB removal
  • Consider giving broad spectrum antibiotics as the gas chamber of the balloon is not sterile
Labels:

Comments

Post a Comment

Popular posts from this blog

Things to Avoid in Anesthesia for Pregnant with Pulmonary hypertension

Anesthesia for Pregnant woman with Pulmonary Hypertension is a real challenge for anesthesiologist. It is very crucial to remember the pathophysiology of pulmonary hypertension in pregnant women and to avoid some practices that will worsen the cardiac status. 1-Avoid single shot spinal anesthesia. Some authorities consider pulmonary hypertension as absolute contraindication for single shot spinal anesthesia specially in patients with NYHA III ,IV. Spinal anesthesia causes major hemodynamic instability(decrease SVR, decrease VR, decrease in CO) The preferred neuroaxial techniques are (epidural anesthesia and CSE with minimal spinal dose) 2-Avoid PAC. Pulmonary Artery catheters insertion may lead to pulmonary artery rupture or thrombosis. TEE is better cardiac monitor/Arteial line is mandatory. 3-Avoid Nitrous oxide in gas mixture.N2O increase the PVR 4-If MV to be started, avoid High TV and PEEP 5-Avoid Oxytocin Boluses, or rapid administration of Pitocin. Oxytocin causes ...
Post a Comment
Read more

power injectable peripherally inserted central catheters

Clinical experience with power injectable peripherally inserted central catheters in intensive care patients     Introduction In intensive care units (ICU), peripherally inserted central catheters (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome by the use of power-injectable catheters . Method We have retrospectively reviewed all the power injectable PICCs inserted in adult and pediatric patients in the ICU during a 12-month period, focusing on the rate of complications at insertion and during maintenance. Results We have collected 89 power injectable PICCs (in adults and in children), both multiple and single lumen. All insertions were successful. There were no major complications at insertion and no episodes of catheter-related blood stream infection. Non-infective complications ...
1 comment
Read more

Lumbar and thoracic epidural in Pediatrics-Technical aspect

The midline approach is most commonly used. The ligamentum   flavum is considerably thinner and less dense in infants than in older children and adults. This makes recognition of engagement in the ligament more difficult and requires both extra care and slower, more deliberate passage of the needle to avoid subarachnoid puncture. The angle of approach to the epidural space is slightly more perpendicular to the plane of the back than in older children and adults, owing to the orientation of the spinous   processes in infants and small children. The loss of resistance technique should be used, but only with saline, not air. There are several reports of venous air embolism in infants and children when air was used to test for loss of resistance Use a short (5 cm) 18-gauge Tuohy needle and a 20- or 21-gauge catheter in infants and children. Epidural kits specifically for infants and children are available Maximum of 0.4 mg/kg/hr of bupivacaine after the initial block is estab...
Post a Comment
Read more