[The effect on gas mixing of a He-O2 mixture in chronic obstructive lung diseases (author's transl)]

In order to estimate the role played by gaseous diffusion in the mixing disorders of chronic obstructive lung disease (COLD), the effect of breathing a gas mixture lighter than air has been studied. Twenty four patients with severe airflow obstruction have been tested in the following way: in a random order they breathed two different mixtures with the same PO2 : air and helium-oxygen (heliox) for 20 min. Ventilation was monitored during the whole of each run; during the 2 last min arterial blood was sampled. While breathing heliox a slight, non-significant, increase in ventilation has been observed with a slight but statistically significant decrease of PaO2 (p less than 0.01), of PaCO2 (p less than 0.05) and increase of pH (p less than 0.01). These changes suggest a slight increase of distribution disorders with alveolar hyperventilation. For these results to be consistent with stratification, improvement of the diffusion due to low density should have been masked by other phenomena; the possible effects of ternary diffusion, increased viscous resistances and change of transfer factor have been looked at. No conclusive evidence has been found of such counter-effects. Therefore it looks unlikely that stratification be the major factor in distribution impairment in COLD.