Abstract
Late Breaking Abstract - Efficacy and safety of hydrogen-oxygen mixture in the emergency management of tracheal stenosis
Background:
A medical hydrogen generator has been developed which allows for production of high concentration hydrogen gas to reduce airway resistance in the emergency management of acute severe tracheal stenosis, but evidences for clinical practice is insufficient.
Aims:
To evaluate the efficacy and safety of breathing a hydrogen-oxygen mixture (H2-O2) in the emergency management of tracheal stenosis.
Methods:
35 patients with acute severe tracheal stenosis were studied in four consecutive periods: breathing Air (O2: 21%) 15 min, H2-O2 (H2: 66%) 15 min, N2O2 (O2: 33%) 15 min, and H2-O2 120 min. Effort to breathe, assessed by the diaphragm electromyography (EMGdi) was the main end point. Transdiaphragmatic pressure (Pdi), Borg score, vital signs, and impulse oscillometry (IOS) parameters were the secondary end points. The concentration of H2 in the environment was obtained by a sensor. The adverse inhalation reaction was recorded.
Results:
All the patients presented a decrease in EMGdi under H2-O2. The mean reduction of the EMGdi was 10.53±6.83%, ranging from 1.34-25.89%. EMGdi differed significantly between H2-O2 and N2O2 (52.95±15.00 versus 42.46±13.90 versus 53.20±14.74 versus 42.50±14.12% for the four consecutive periods; F=3.41, P<0.05); The mean reduction of the Pdi under H2-O2 was 4.77±3.51cmH2O, ranging from 0.18-14.22 cmH2O. Breathing H2-O2 significant improved Borg score and resistant parameters of IOS, whereas vital signs ware not modified. No adverse reaction occured in any patients. H2 were undetectable in the environment during the whole procedure.
Conclusions:
Breathing H2-O2 improves inspiratory effort in patient with acute severe tracheal stenosis, and the process is safe.