{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:23:05Z","timestamp":1777638185230,"version":"3.51.4"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2014,2,5]],"date-time":"2014-02-05T00:00:00Z","timestamp":1391558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH COBRE","award":["8 P20 GM103464"],"award-info":[{"award-number":["8 P20 GM103464"]}]},{"name":"NIH","award":["5T32 GM008562-17"],"award-info":[{"award-number":["5T32 GM008562-17"]}]},{"name":"NICHD Under the Best Pharmaceuticals for Children Act"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High flow nasal cannula (HFNC) improves ventilation by washing out nasopharyngeal dead space while delivering oxygen. Heliox (helium\u2013oxygen gas mixture), a low\u2010density gas mixture, decreases resistance to airflow, reduces the work of breathing, and facilitates distribution of inspired gas. Excessive lung work and potential injury increases the workload on the immature diaphragm predisposing the muscle to fatigue, and can lead to inflammatory and oxidative stress, thereby contributing to impaired diaphragmatic function. We tested the hypothesis that HFNC with Heliox will decrease the work of breathing thereby unloading the neonatal diaphragm, and potentially reducing diaphragmatic injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Spontaneously breathing neonatal pigs were randomized to Nitrox (nitrogen\u2013oxygen gas mixture) or Heliox, and studied over 4\u2009hr following oleic acid injury. Gas exchange, pulmonary mechanics indices, and systemic markers of inflammation were measured serially. Diaphragm inflammation biomarkers and histology for muscle injury were assessed at termination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Heliox breathing animals demonstrated decreased respiratory load and work of breathing with lower pressure\u2010rate product, lower labored breathing index, and lower levels of diaphragmatic inflammatory markers, and muscle injury score as compared to Nitrox.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results suggest that HFNC with Heliox is a useful adjunct to attenuate diaphragmatic fatigue in the presence of lung injury by unloading the diaphragm, resulting in a more efficient breathing pattern, and decreased diaphragm injury. <jats:bold>Pediatr Pulmonol. 2014; 49:1214\u20131222.<\/jats:bold> \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.23000","type":"journal-article","created":{"date-parts":[[2014,2,5]],"date-time":"2014-02-05T15:51:38Z","timestamp":1391615498000},"page":"1214-1222","source":"Crossref","is-referenced-by-count":7,"title":["High flow nasal cannula (HFNC) with Heliox decreases diaphragmatic injury in a newborn porcine lung injury model"],"prefix":"10.1002","volume":"49","author":[{"given":"Romal K.","family":"Jassar","sequence":"first","affiliation":[{"name":"Neonatology Alfred I. duPont Hospital for Children Wilmington Delaware"},{"name":"Neonatology Thomas Jefferson University Hospital Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haritha","family":"Vellanki","sequence":"additional","affiliation":[{"name":"Neonatology Alfred I. duPont Hospital for Children Wilmington Delaware"},{"name":"Neonatology Thomas Jefferson University Hospital Philadelphia 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