Analysis of options for using oxygen-helium mixture in complex therapy and rehabilitation of patients with various diseases of the respiratory organs (review of literature)
https://doi.org/10.20340/vmi-rvz.2025.2.PHYS.2
Abstract
Relevance. Acute infectious bacterial and viral pneumonias are among the most common acute infectious diseases. In Russia, more than 1.5 million cases of community-acquired pneumonia are registered annually, which makes this pathology one of the leading causes of death from infectious diseases. The development and implementation of innovative rehabilitation methods during treatment and at the posthospital stage is an urgent task of healthcare aimed at reducing labor losses, the level of disability and economic costs.
Materials and methods. A systematic analysis of domestic and foreign literature for 2000-2024, published in leading peer-reviewed scientific journals and indexed in the PubMed, Scopus, Web of Science and RSCI databases, was conducted. The inclusion criteria for publications in the review were: studies of the physiological and pathophysiological aspects of the use of oxygen-helium mixtures (OHM), clinical studies of the effectiveness of OHM in respiratory diseases, data on the epidemiology and contagiousness of bacterial and viral pneumonia.
Objective of the study. Systematization and critical analysis of scientific data on the physiological effects, mechanisms of action and clinical use of oxygen-helium mixtures in the complex therapy and rehabilitation of patients with respiratory diseases, including bacterial and viral pneumonia of varying severity. Development of a conceptual model of complex therapy using heated OHM in inpatient and outpatient settings, as well as an assessment of the effect of this technique on hemodynamics, respiratory function and psychoemotional status of patients.
Results. Based on the analysis of literary data, the key mechanisms of the therapeutic effect of CGS were identified: reduction of airway aerodynamic resistance due to transformation of turbulent flow into laminar flow, improvement of ventilation-perfusion relations, optimization of oxygen transport to tissues and increase in the efficiency of carbon dioxide elimination. Promising areas of clinical application of CGS in various pathologies of the respiratory system were determined: obstructive disorders of the upper and lower respiratory tract, acute respiratory distress syndrome, bronchial asthma, COPD, pneumonia of various etiologies, including those associated with COVID-19. The potential positive effect of CGS on the psychoemotional status of patients was demonstrated, which is especially significant in chronic respiratory diseases.
Conclusions. Oxygen-helium mixtures are a promising method of complex therapy and rehabilitation of patients with respiratory diseases. The unique physical properties of helium provide a multifactorial therapeutic effect, including improved pulmonary ventilation, reduced work of breathing, optimized gas exchange, and prevention of atelectasis. The safety of use, absence of toxic effects and metabolic changes make CGS the method of choice for patients with limited sensitivity to standard pharmacotherapy. The introduction of treatment methods using CGS has high socio-economic significance in the context of increasing incidence of respiratory pathologies.
About the Authors
Yu. A. KhatuntsevaRussian Federation
Yuliuya A. Khatuntseva, Therapist-pulmonologist; postgraduate student, junior research fellow
35, Aviatsionnaya str., Pushkino, 141206
Khoroshevskoe shosse, 76A, Moscow, 123007
Competing Interests:
Авторы заявляют об отсутствии конфликта интересов.
V. M. Manuylov
Russian Federation
Vladimir M. Manuylov, Dr. Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Chief Physician
35, Aviatsionnaya str., Pushkino, 141206
61/2, Shchepkina str., Moscow, 129110
Competing Interests:
Авторы заявляют об отсутствии конфликта интересов.
A. N. Shcherbyuk
Russian Federation
Aleksandr N. Shcherbyuk, Dr. Sci. (Med.), Professor, Head of the Scientific and Clinical Department; Professor of the Department of Surgical Diseases
35, Aviatsionnaya str., Pushkino, 141206
Ya. E. Nemstsveridze
Russian Federation
Yakov E. Nemstsveridze, Specialist of the scientific and innovation department; dentist, clinical resident of the department of orthopedic dentistry
61/2, Shchepkina str., Moscow, 129110
2, Krasnobogatyrskaya str., building 2, Moscow, 107564
Competing Interests:
Авторы заявляют об отсутствии конфликта интересов.
A. A. Andrushchenko
Russian Federation
Artem A. Andrushchenko, 5th year student of the medical faculty
2, Krasnobogatyrskaya str., building 2, Moscow, 107564
Competing Interests:
Авторы заявляют об отсутствии конфликта интересов.
G. I. Kurnakin
Russian Federation
Grigoriy I. Kurnakin, 6th year student of the medical faculty
1, Ostrovityanova St., Moscow, 117513
Competing Interests:
Авторы заявляют об отсутствии конфликта интересов.
References
1. 1 Визель А.А., Лысенко Г.В. Пневмония: к вопросу диагностики и лечения в современных условиях. ПМ. 2012;1(56):22-26.
2. 2 Tsareva A.Yu. Epidemiological characteristics of community-acquired pneumonia at the present stage: a literature review. Medicine. 2024;12(4):98-118. (In Russ.).
3. 3 Bobkina N.V. Use of heated oxygen-helium mixture in patients with arterial hypertension. Physiotherapy, balneology and rehabilitation. 2021;20(4):333-340. (In Russ.).
4. 4 Nikandrov V., Domashevich E., Zhuk O. Inhalations of oxygen-helium mixture. Science and Innovation. 2012;116:62-67. (In Russ.).
5. 5 Kushnir G.M., Kuntsevskaya I.V. Features of psycho-emotional status in patients with chronic obstructive pulmonary disease. Tavrichesky Journal of Psychiatry. 2015;2(71):24-28. (In Russ.).
6. 6 Douglas F., Gasiorek J.M., Swaffield J.A. Fluid Mechanics. Harlow, UK: Prentice Hall; 2001.
7. 7 Grosz A.H., Jacobs I.N., Cho C., et al. Use of helium-oxygen mixtures to relieve upper airway obstruction in a pediatric population. Laryngoscope. 2001;111:1512-1514.
8. 8 Cherkashin D.V., Tkachenko K.N., Shakhnovich P.G., Alanichev A.E., Efimov S.V., Makiev R.G. Prospects of the use of helium in some diseases of the respiratory and cardiovascular systems. Cardiology. 2018;19:984-990. (In Russ.).
9. 9 Kushnir G.M., Kuntsevskaya I.V. Features of psycho-emotional status in patients with chronic obstructive pulmonary disease. Tavrichesky Journal of Psychiatry. 2015;2(71):24-28. (In Russ.).
10. 10 McGarvey J.M., Pollack C.V. Heliox in airway management. Emerg Med Clin North Am. 2008;26(4):905-920.
11. 11 Красновский А.Л., Григорьев С.П., Лошкарева Е.О., Золкина И.В. Использование гелиокса в лечении больных с бронхолегочной патологией. Российский медицинский журнал. 2012;(5):46-51. Krasnovsky A.L., Grigoriev S.P., Loshkareva E.O., Zolkina I.V. Use of heliox in the treatment of patients with bronchopulmonary pathology. Russian Medical Journal. 2012;(5):46-51. (In Russ.).
12. 12 Elleau C., Galperine R.I., Guenard H., et al. Helium-oxygen mixture in respiratory distress syndrome: a double-blind study. J Pediatr. 1993;122:132-136.
13. 13 Hessan H., Houck J., Harvey H. Airway obstruction due to lymphoma of the larynx and trachea. Laryngoscope. 1988;98:176-180.
14. 14 Chiappa G.R., Queiroga F. Jr., Meda E., et al. Heliox improves oxygen delivery and utilization during dynamic exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009;179:1004-1010.
15. 15 Beurskens C.J., Brevoord D., Lagrand W.K., et al. Heliox improves carbon dioxide removal during lung protective mechanical ventilation. Crit Care Res Pract. 2014;2014:954814.
16. 16 Craig S.S., Dalziel S.R., Powell C.V., et al. Interventions for escalation of therapy for acute exacerbations of asthma in children: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2020;8/
17. 17 Jaber S., Carlucci A., Boussarsar M., et al. Helium-oxygen in the postextubation period decreases inspiratory effort. Am J Respir Crit Care Med. 2001;164:633-637.
18. 18 Farooq U., Riaz H.H., Munir A., Zhao M., Tariq A., Islam M.S. Application of heliox for optimized drug delivery through respiratory tract. Physics of Fluids. 2023;35(10):101301.
19. 19 Bobkina N.V., Lyadov M.V., Gerasimenko M.Yu., Zhitareva I.V. Use of heated oxygen-helium mixture in patients with chronic obstructive pulmonary disease. Physiotherapy, balneology and rehabilitation. 2021;20(1):23-29. (In Russ.).
20. 20 Smirnova M.I., Antipushina D.N., Drapkina O.M. Possible options for using helium-oxygen mixture in acute respiratory pathology and in the context of the COVID-19 pandemic. Preventive medicine. 2020;23(7):78-84. (In Russ.).
21. 21 Bobkina N.V. Use of heated oxygen-helium mixture in patients with arterial hypertension. Physiotherapy, balneology and rehabilitation. 2021;20(4):333-340. (In Russ.).
22. 22 Bova A.A. Respiratory failure syndrome: state of the problem and medical tactics. Medical news. 2011;2:15-19. (In Russ.).
23. 23 Чучалин А.Г. Пульмонология. Национальное руководство. Москва; 2009. Чучалин А.Г. Пульмонология. Национальное руководство. Москва; 2009. (In Russ.).
24. 24 Pavone M., De Sanctis F. Aerosol Therapy (Bronchodilators, Corticoids), Surfactant Therapy, Humidification, Oxygen, Nitric Oxide, and Heliox. In: Pharmacology in Noninvasive Ventilation. Cham: Springer International Publishing. 2024:251-256.
25. 25 Zhuravel S.V., Gavrilov P.V., Kuznetsova N.K., Utkina I.I., Talyzin A.M., Aleksandrova V.E. Clinical case: thermal helium in the treatment of pneumonia caused by the new coronavirus infection COVID-19 (SARS-CoV-2). Bulletin of the Medical Institute "REAVIZ". Rehabilitation, Doctor and Health. 2021; (1): 5-10. (In Russ.).
26. 26 Hallowell R. Physiology and clinical use of heliox. UpToDate. Waltham, MA; 2023.
27. 27 Chen X., Xu L., Li S., Yang C., Wu X., Feng M., et al. Efficacy of respiratory support therapies during pulmonary rehabilitation exercise training in chronic obstructive pulmonary disease patients: a systematic review and network meta-analysis. BMC Medicine. 2024;22(1):389.
28. 28 Chen X., Xu L., Li S., Yang C., Wu X., Feng M., et al. Efficacy of respiratory support therapies during pulmonary rehabilitation exercise training in chronic obstructive pulmonary disease patients: a systematic review and network meta-analysis. BMC Medicine. 2024;22(1):389.
29. 29 Abdelrahim M.E., Saeed H., Harb H.S., Madney Y.M. Aerosol Therapies During High Flow Oxygen Therapy. In: Essentials of Aerosol Therapy in Critically Ill Patients. 2021:189-194.
30. 30 Gomes N.S., da Silva W.A., Pena R., Chiappa G. Heliox improves minute-ventilation variability during incremental maximal exercise in COPD patients. Manual Therapy, Posturology & Rehabilitation Journal. 2023;21:1-7.
31. 31 Alessa A., Alanazi A., Altuwairqi F., Alqarni A., Allehyani B., Alamer M., et al. The Applications of Heliox therapy, article review. Journal of Advanced Medical Practice. 2022;3(1):45-52.
32. 32 Sutherland L.D., Pearl R.G. Non-Oxygen Therapeutic Gases in the OR and ICU. ASA Monitor. 2023;87(8):29-30. 33 Berganza C.J., Zhang J.H. The role of helium gas in medicine. Medical Gas Research. 2013;3:18.
33.
Supplementary files
Review
For citations:
Khatuntseva Yu.A., Manuylov V.M., Shcherbyuk A.N., Nemstsveridze Ya.E., Andrushchenko A.A., Kurnakin G.I. Analysis of options for using oxygen-helium mixture in complex therapy and rehabilitation of patients with various diseases of the respiratory organs (review of literature). Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2025;15(2):14-24. (In Russ.) https://doi.org/10.20340/vmi-rvz.2025.2.PHYS.2