Heliox ventilation in elderly, hypertensive ICU patients improves microcirculation: A randomized controlled study

Conventional mechanical ventilation has adverse impacts on the hemodynamics of elderly, hypertensive ICU patients. Limited studies have addressed ways to ameliorate these negative effects. This study aimed to determine whether heliox ventilation could improve the hemodynamics, especially microcirculation, of elderly, hypertensive patients undergoing mechanical ventilation. Thirty-eight patients, over the age of 65 with essential hypertension who underwent invasive mechanical ventilation treatment, were divided into two groups: a control group of nitrogen‑oxygen ventilation ( n = 19) and an experimental group of heliox ventilation (n = 19). The control group received conventional room air ventilation and the experimental group adopted the innovative, closed heliox ventilation technique. Changes in blood pressure, heart rate (HR), peripheral oxygen saturation (SpO 2 ), central venous oxygen saturation (ScvO 2 ), regional cerebral oxygen saturation (rSO 2 ), lactic acid (Lac) and airway pressure were measured at 0,1,2,3 h under volume-controlled ventilation (VCV) mode throughout the study. Sublingual microcirculation parameters were additionally measured at 0 h and 3 h of ventilation treatment. SpO 2 in both groups increased after 1 h of ventilation compared with 0 h ( p < 0.001), subsequently remaining stable. Compared with the control group, the experimental group showed a decrease in airway pressure and Lac, while blood pressure, ScvO 2 , and rSO 2 increased ( p < 0.05). Moreover, the sublingual microcirculation indexes in the experimental group improved compared with the control group ( p < 0.05). Heliox ventilation improves blood pressure and microcirculation in elderly hypertensive patients and may resolve the limitations of traditional nitrogen‑oxygen ventilation. This trial was registered. The Chinese trial registration number is ChiCTR2100043945. The date of registration is 6-3-2021. • Adopting the innovative, closed heliox ventilation technique. • Expanding the application of heliox ventilation and providing a novel modality for the mechanical ventilation of elderly patients. • A hermetic breathing circuit was innovatively applied for heliox ventilation to recycle helium. • Heliox has a protective effect on hemodynamics in elderly hypertensive, mechanically-ventilated patients.