The use of a heated helium-oxygen mixture in patients with severe COVID-19 and ARDS against the background of standard therapy and noninvasive ventilation

Introduction. One of the insufficiently studied methods of Acute Respiratory Distress Syndrome (ARDS) therapy is therapy with a heated helium-oxygen mixture. Due to physico-chemical properties, helium demonstrates high efficiency in the treatment of various diseases of the pulmonological profile.

Aim. To study the effect of a heated helium-oxygen mixture on the course of a severe form of COVID-19 occurring with the development of ARDS.

Materials and methods. The study involved 58 patients with severe and extremely severe coronavirus infection and ARDS, divided into the NVL + t-He/O₂ group (n = 30) and the NVL+O₂ control group (n = 28). In addition to standard treatment, patients of the NVL + t-He/O₂ group received noninvasive ventilation (NVL) and therapy with a heated helium-oxygen mixture, according to clinical recommendations. In the main group, inhalations took place daily for 60 minutes per day for 5 days.

Results. Against the background of therapy with a heated helium-oxygen mixture, a more intense increase in the level of lymphocytes was observed: 1.39 (1.09-1.66) x 10⁹/l in the NVL + t-He/O₂ group versus 1.02 (0.78-1.40) x 10⁹/l (p = 0.02). Also, as a result of treatment, there was a significant decrease in RR, D-dimer and CRP in the study group: the level of RR (21 (20-22)/minute versus 22.5 (21-24)/minute, p = 0.003), D-dimer (0.44 (0.29-0.60) FEU ng/ml versus 0.79 (0.42-1.34) FEU ng/ml, p = 0.02) and CRP (1.1 (0.7-3.1)mg/l versus 16.6 (8.5-29.5) mg/l, p = 0.03), respectively. Similarly to the NVL + t-He/O₂ group, an increase in the level of PaO₂ and the oxygenation index was noted. In addition, there were significantly fewer patients with grade III and IV lung damage in the NVL + t-He/O₂ group compared with the control (p = 0.05).

Conclusion. The use of a heated helium-oxygen mixture in patients with severe COVID-19, occurring with the development of ARDS, against the background of standard therapy and NIV has shown its safety and effectiveness: there was a decrease in the intensity of inflammation, improved oxygenation and a reduction in the need for respiratory support.

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