Gas mixture in noninvasive ventilation

Elshazly, Mostafa1; Giancario, Garuti2; Bayrakci, Benan3; Sandoval, Jose Luis4; Ahmed, Hebatallah Hesham1,*; Esquinas, Antonio M.5

Author Information

1Faculty of Medicine, Cairo University, Giza, Egypt

2Pneumologo Unit, Santa Maria Bianca Hospital, Modena, Italy

3Department of Pediatric Intensive Care Medicine, Life Support Center, Hacettepe University, Ankara, Turkey

4Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico

5Intensive Care Unit, Hospital Meseguer, NIV-ICM, Instituto Murciano de Investigación Biosanitaria, Murcia, Spain

*Correspondence to: Hebatallah Hesham Ahmed, MSc, hebahesham922018@gmail.com.

Abstract

Noninvasive ventilation (NIV) and high-flow nasal cannula are increasingly used to treat acute respiratory failure. Because many of these patients could also benefit from inhaled medications, combining aerosol therapy with NIV or high-flow nasal cannula is a promising approach. Effective drug delivery to the lungs is crucial for successful aerosol therapy during NIV. Prior research has identified several factors that affect aerosol delivery efficiency in NIV patients. Medical gases have a long history of use in managing various respiratory conditions. Among them, oxygen is frequently used for patients with hypoxia (e.g., hypoxemic respiratory failure and in newborns). In addition to deoxygenation, helium oxygen mixture and nitric oxide can also be administered through devices such as masks combined with NIV. This narrative review aims to provide a comprehensive overview on the application of gas mixtures (such as helium oxygen mixtures and nitric oxide) in NIV, focusing on their efficacy, safety, and optimization strategies in different clinical settings.

摘要

无创通气（NIV）和经鼻高流量氧疗越来越多地用于治疗急性呼吸衰竭。由于许多这类患者也可能受益于吸入性药物，因此将气溶胶治疗与NIV或经鼻高流量氧疗相结合是一种前景广阔的方法。有效的肺部药物递送对于NIV期间气溶胶治疗的成功至关重要。先前的研究已经确定了影响NIV患者气溶胶递送效率的几个因素。医用气体在管理各种呼吸系统疾病方面有着悠久的使用历史。其中，氧气常用于缺氧患者（例如，低氧性呼吸衰竭患者和新生儿）。除了纠正低氧血症外，氦氧混合气和一氧化氮也可以通过面罩等装置与NIV联合使用。本叙述性综述旨在全面概述气体混合物（如氦氧混合气和一氧化氮）在NIV中的应用，重点关注其在不同临床环境下的疗效、安全性和优化策略。