Solunum sinsityal virüsü ile ilişkili bronşiyolite bağlı solunum sıkıntısı gelişen trakeostomili bir çocuk olguda Heliox tedavisi kullanımı

Ökkeş Özgür Mart; Dinçer Yıldızdaş; Özden Özgür Horoz; Faruk Ekinci; Merve Mısırlıoğlu

doi:10.17826/cumj.740316

Letter to Editor

Use of Heliox therapy in a child with tracheostomy who developed respiratory distress due to bronchiolitis associated with respiratory syncytial virus

Year 2020, Volume: 45 Issue: 3, 1257 - 1260, 30.09.2020

Ökkeş Özgür Mart , Dinçer Yıldızdaş , Özden Özgür Horoz Faruk Ekinci , Merve Mısırlıoğlu

https://doi.org/10.17826/cumj.740316

Abstract

Helyum-oksijen gaz karışımı olan Heliox, obstrüktif akciğer hastalığını tedavi etmek için uzun yıllardır kullanılmaktadır. Heliox’un azot-oksijen karışımlarına göre daha düşük yoğunluğu ve daha yüksek viskozitesi nedeniyle, obstrüktif durumlarda hava yolu direncini önemli ölçüde azaltabilir. Akut bronşiyolitli bebeklerde yüksek akış nazal kanül ile birlikte kullanıldığında, heliox kullanımının gaz değişiminde iyileşmeye yol açacağı düşünülmektedir. Solunum sinsityal virüs (RSV) infant dönemindeki bronşiyolitin en önemli etkenidir. Kliniğimizde, trakeostomisi olan ve mekanik ventilatör desteği alan RSV (+) hastamıza, mekanik ventilatörde yüksek basınçlara ve bronkodilatör tedavilere rağmen, yeterli oksijenasyonu sağlayamadığımız için mekanik ventilatör ile heliox tedavisi uyguladık. Hastamıza 4 saat boyunca heliox tedavisi verildi. Heliox sonrasında hastanın mekanik ventilatör desteklerinde ve bronkodilatör ihtiyacında önemli ölçüde azalma oldu. Kan gazındaki oksijenizasyon indeksi 7.3’den 4’e, PaCO2 55 mmHg’den 40 mmHg’ye geriledi. Biz burada, RSV ile ilişkili bronşiyolite bağlı solunum sıkıntısı gelişen, diğer tedavi uygulamalarına yanıt vermeyen ve heliox tedavisi ile düzelen bir çocuk olguyu sunduk.

Keywords

respiratory distress, child, Heliox

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