Heliox ventilation in older hypertensive ICU patients improves hemodynamics: A randomized controlled study

Abstract

Background: Conventional mechanical ventilation has adverse impacts on hemodynamics of older hypertensive ICU patients. Limited studies have addressed way to ameliorate these negative effects. This study aimed at determining if heliox ventilation mitigated the side-effects of conventional mechanical ventilation in senile hypertensive patients. Methods: Seventy-nine older adults aged 65 to 95 years with essential hypertension who underwent invasive mechanical ventilation treatment, were divided into two groups: a control group of nitrogen-oxygen ventilation (n = 40) and an experimental group of heliox ventilation (n = 39). The control group received conventional room air ventilation and the experimental group innovatively adopted the closed heliox ventilation technique. All patients had appropriate positive end-expiratory pressure (PEEP) values (5-8cmH2O) using the optimal oxygenation method under VCV mode throughout the study. Blood pressure, central venous pressure (CVP), central venous oxygen saturation (ScvO2), heart rate (HR), and airway pressure were measured every hour. Results: An increase of CVP and airway pressure coupled with a decrease of blood pressure and ScvO2 were observed in the control group as expected (p < 0.05). Comparatively, CVP and airway pressure reductions with an increased ScvO2 were observed in the experimental group (p < 0.05). In the experimental group, blood pressure and HR did not change significantly. Conclusions: Heliox ventilation improves cardiac function and blood pressure in older hypertensives as compared with nitrogen-oxygen ventilation. Trial registration This trial was registered. The Chinese trial registration number is ChiCTR2100043945. The date of registration is 6-3-2021. The registered name is that heliox ventilation improves hemodynamics in older patients with hypertention admitted to the intensive care unit.