Laude Elizabeth A, Ahmedzai Sam H
Biomedical Science, University of Sheffield, UK.
Curr Opin Support Palliat Care. 2007 Aug;1(2):91-5. doi: 10.1097/SPC.0b013e3282e1c6f5.
Recent reports of the benefits of helium/oxygen gas mixtures (heliox) use for the relief of dyspnoea and exercise limitation have stimulated interest in the use of heliox in the palliation of dyspnoea especially in chronic obstructive pulmonary disease patients. With better understanding of the mechanistic causes of dyspnoea in these patients theoretical benefits of heliox have been suggested. This report considers the evidence to support this role and reviews the current position on heliox administration and use as a carrier gas for nebulization therapies.
Heliox can effectively improve exercise limitations, decrease the work of breathing and reduce dyspnoea in lung cancer and chronic obstructive pulmonary disease patients; in the latter it works by reducing dynamic hyperinflation. The evidence comes from short-term assessments of single exercise tests and additional benefits are seen when used in conjunction with other current therapies such as supplemental oxygen and nebulization. Dedicated devices with better comprehensive guidelines for administration have been developed to alleviate some of the reluctance of use.
Heliox use could prove beneficial either administered alone or as an addition to current therapies for the palliation of dyspnoea and give significant improvement in outcomes of rehabilitation programmes. There is still an urgent need to identify which patients are the best candidates for heliox use and translate the significant short-term benefits into long-term improvements in functioning and quality of life.
近期有关使用氦氧混合气体（氦氧混合气）缓解呼吸困难和运动受限的益处的报道，激发了人们对将氦氧混合气用于缓解呼吸困难（尤其是慢性阻塞性肺疾病患者）的兴趣。随着对这些患者呼吸困难机制原因的更好理解，有人提出了氦氧混合气的理论益处。本报告考量了支持这一作用的证据，并综述了氦氧混合气给药以及作为雾化治疗载气使用的现状。
氦氧混合气可有效改善肺癌和慢性阻塞性肺疾病患者的运动受限，减少呼吸功并减轻呼吸困难；对于后者，其作用机制是减少动态肺过度充气。证据来自单次运动测试的短期评估，并且与补充氧气和雾化等其他现有疗法联合使用时，可观察到额外益处。已开发出具有更好综合给药指南的专用设备，以减轻一些使用顾虑。
使用氦氧混合气单独给药或作为现有疗法的补充来缓解呼吸困难可能有益，并能显著改善康复计划的效果。仍迫切需要确定哪些患者是使用氦氧混合气的最佳人选，并将显著的短期益处转化为功能和生活质量的长期改善。
