The need for using different medical gases in hospitals depends on the patient condition, the underlying disease and the role of the medical gas in treating the disease. Oxygen, nitric oxide, and heliox (the combination of helium and oxygen) are examples of various types of gases that are being uses in the hospital.

 

Oxygen therapy is the number one drug that is used in hospitals to treat patients with hypoxemia, myocardial infarction, or short-term use for surgeries. It could be implemented on the patient through various delivery devices, which are classified as low and high flow oxygen therapy devices depending on whether the total flow generated by the device is enough to meet the patient inspiratory flow demands. A continuous evaluation of the patient’s condition and response to gas administration is crucially required throughout the treatment. That will give the therapist crucial information about the patient’s improvement or deterioration. In some cases adding oxygen to adjacent therapy will be beneficial. For example, hyperbaric oxygen therapy that is the use of oxygen at a pressure above atmospheric pressure to promote the effect of oxygen. Air embolism as a result of deep diving, and carbon monoxide poisoning from smoke inhalation are indications for hyperbaric therapy.

 

Mixing helium that has low gas density with the oxygen is effective in treating respiratory conditions associated with high airways resistance such as asthma, bronchitis and chronic obstructive pulmonary disease2. The use of heliox is not limited to the aforementioned diseases; it has been demonstrated in a few studies that it may have a beneficial effect in treating patients with acute respiratory distress syndrome3, in addition to patients with croup. Because of the low density of helium, it decreases turbulent flow in the airways thereby decreasing the work of breathing.2 It is important to know that heliox can be used with both intubated and non-intubated patients. During heliox therapy, it is imperative that the respiratory therapist monitor the patient very closely to prevent hypoxemia and any unwanted complications since the oxygen concentration delivered with heliox therapy may be lower than that required by the patient. Heliox mixtures usually contain either 80% helium and 20% oxygen or 70% helium and 30% oxygen.

 

It is vital for respiratory therapists to know the concentration of each gas in the different gas mixtures, and their effect, since that will aid in choosing the optimal therapy for the patient. Moreover, respiratory therapists should be able to select the appropriate delivery device that is suitable for the gas mixture, and to to meet the patient’s inspiratory flow demand.

 

Reference:

1- Mosby’s Respiratory care Equipment book

2- Chevrolet, J C. “Helium oxygen mixtures in the intensive care unit.” Critical care 5.4 (2001):179-81. Web.

3- Yilmaz, Sema, et al. “The effectiveness of heliox in acute respiratory distress syndrome.” Annals of thoracic medicine 8.1 (2013):46-52. Web.