Heliox tolerance in spontaneously breathing neonates with bronchopulmonary dysplasia.

The use of a gas mixture in which helium is substituted for nitrogen allows a decrease in pulmonary resistances and in resistive work of breathing. This treatment might allow a reduction in energy expenditure in infants with bronchopulmonary dysplasia (BPD) and spare calories for growth. In a preliminary study designed to assess tolerance to Heliox(R), 4 infants with BPD and 4 controls were studied firstly when breathing air and secondly when breathing Heliox(R), at 10, 20 and 30 min exposure (T10, T20, T30). The following parameters were recorded: respiratory and cardiac rates, room (RT) and skin temperatures (ST) and transcutaneous (Tc) blood gases. When breathing air, TcPO2 was normal in the two groups (mean +/- SEM: 70 +/- 4 mm Hg in BPD vs. 78 +/-4 in controls). TcPCO2 was higher in the BPD group (41 +/- 2 vs. 35 +/- 1 mm Hg in controls; p = 0.028). Spontaneously breathing Heliox had immediate consequences such as wakening, crying, decrease in ST and hypoxia. Hypoxia was more serious and more rapid in the BPD group. At the 10-min exposure, mean TcPO2 was 39 +/- 4 mm Hg in BPD vs. 69 +/- 7 in controls (p = 0.042). Hypoxia was immediately corrected when breathing room air. TcPCO2 was unchanged in both groups.