Abstract:

Objective To investigate the curative effect of inhaling heliox and air oxygen mixture in meconium aspiration syndrome under the support of synchronized intermittent mandatory ventilation (SIMV). Methods Sixty-four children with MAS in NICU of the DaPing Hospital, Third Military Medical University from March 1st, 2014 to May 30th, 2015 were taken as samples. The children, who were treated with SIMV as respiratory support mode, were divided into Helio group (n=33) and control group (n=31) in accordance with the random number table. Heliox group inhaled Heliox 70 (He 70% O-2 30%) for 6 h after replacement of inhaling air oxygen mixture (30% O-2 ); Control group inhaled air oxygen mixed gas. Main outcome measures: oxygenation index (OI) during treatment and extubation time; Secondary outcome measures: incidence of the complications of mechanical ventilation, hospital stays in NICU, bood gas analysis, inflammation index and myocardial injury markers, amplitude integrated electroencephalography (aEEG) results. Results OI in the heliox group was significantly higher than that in the control group; the difference was statistically significant (P=0.022), and the extubation time, incidence of the complications of mechanical ventilation and hospital stays in NICU of heliox group were significantly lower than those of control group; the differences were statistically significant (P=0.037, 0.013 and 0.010). Blood gas analysis index (pH, HCO-3-, BE, PaO-2 , PaCO-2 ) in two groups (2, 6, 12, 24, 48 h) presented some discrepancy; the differences were statistically significant (P<0.05). The inflammation index (IL-6, IL-8, TNF-a CRP) at 6 h and myocardial injury markers (CK, CK-MB) at 24 h of the two groups were decreased compared with those at 0 h, and heliox group decreased more significantly compared with the control group; the differences were statistically significant (P<0.05). The aEEG abnormal checking rate of children born after 28 and 100 days of heliox group was 9.1% and 3.0%, significantly lower than 25.8% and 9.6% of the control group (P< 0.05). Conclusion Inhaling heliox has better curative effect and high security than inhaling air oxygen mixture for MAS under the support of SIMV, and it is worthy of further study.