Gas mixture in noninvasive ventilation

Elshazly M., Giancario G., BAYRAKCİ B., Sandoval J. L., Ahmed H. H., Esquinas A. M.

Medical Gas Research, vol.16, no.1, pp.59-65, 2026 (ESCI, Scopus) identifier identifier

  • Publication Type: Article / Review
  • Volume: 16 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.4103/mgr.medgasres-d-24-00129
  • Journal Name: Medical Gas Research
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Page Numbers: pp.59-65
  • Keywords: aerosol drug delivery, drug delivery systems, gas mixtures, heliox, helium-oxygen mixture, inhalation therapy, inhaled nitric oxide, metered-dose inhaler, nebulizer, noninvasive ventilation
  • Hacettepe University Affiliated: Yes

Abstract

Noninvasive ventilation (NIV) and high-flow nasal cannula are increasingly used to treat acute respiratory failure. Because many of these patients could also benefit from inhaled medications, combining aerosol therapy with NIV or high-flow nasal cannula is a promising approach. Effective drug delivery to the lungs is crucial for successful aerosol therapy during NIV. Prior research has identified several factors that affect aerosol delivery efficiency in NIV patients. Medical gases have a long history of use in managing various respiratory conditions. Among them, oxygen is frequently used for patients with hypoxia (e.g., hypoxemic respiratory failure and in newborns). In addition to deoxygenation, helium oxygen mixture and nitric oxide can also be administered through devices such as masks combined with NIV. This narrative review aims to provide a comprehensive overview on the application of gas mixtures (such as helium oxygen mixtures and nitric oxide) in NIV, focusing on their efficacy, safety, and optimization strategies in different clinical settings.