Efficacy and safety of combined therapy with thermal heliox and nitric oxide during noninvasive ventilation in patients with acute chronic obstructive pulmonary disease complicated by hypoxemic, hypercapnic respiratory failure and secondary pulmonary

Aim. To study the efficacy and safety of combination therapy of thermal heliox (t-He/O2) and nitric oxide (NO) in patients with acute chronic obstructive pulmonary disease complicated by hypoxemic, hypercapnic respiratory failure and secondary pulmonary arterial hypertension (PAH) [group III PAH according to the classification of the World Health Organization]. Materials and methods. The study included 180 patients (GOLD C/D) divided into four groups: Group 1 (t-He/O₂ + non-invasive ventilation – NIV), Group 2 (NO + NIV), Group 3 (t-He/O₂ + NO + NIV), and Group 4 (control, receiving NIV alone). Clinical, gas exchange, and hemodynamic parameters were evaluated. Results. Combined therapy (Group 3) demonstrated the highest efficacy: respiratory rate decreased to 16.2±0.9 breaths/min, partial pressure of arterial carbon dioxide (PaCO₂) reduced to 41.7±2.9 mm Hg, partial pressure of arterial oxygen (PaO₂) increased to 80.8±8.9 mm Hg, and exercise tolerance improved (six-minute walk test [6MWT]: +805±156%). Minimal improvements were observed in the control group. Conclusion. The combination of t-He/O₂ and NO with NIV is safe and more effective than monotherapy or NIV alone.