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Therapeutic benefits of helium-oxygen delivery to infants via nasal cannula
Judee Williams1, Kara Stewart, Joseph D Tobias
1Department of Child Health, University of Missouri-Columbia, 65212, USA.
Insights
Helium-oxygen (heliox) therapy delivered via nasal cannula is a well-tolerated and effective treatment for infants with respiratory distress who cannot use a facemask. This method rapidly improves breathing and oxygenation in neonates.
Area of Science:
- Pediatric Pulmonology
- Neonatal Respiratory Care
- Helium-Oxygen Therapy
Background:
- Helium-oxygen (heliox) therapy is beneficial for pediatric respiratory disorders.
- Traditional heliox delivery via facemask may be poorly tolerated by infants.
- Alternative delivery methods are needed for heliox administration in neonates.
Observation:
- This study evaluated heliox delivery via nasal cannula in 5 infants with respiratory distress.
- Infants received a heliox mixture at 2-3 L/min via nasal cannula.
- Treatment efficacy was assessed by changes in respiratory rate, work of breathing, and oxygenation.
Findings:
- All 5 infants tolerated nasal cannula heliox delivery.
- Nasal cannulae were used successfully in 2 infants after facemask intolerance.
- Significant improvements were observed in work of breathing, respiratory rate, CO2 levels, and stridor.
Implications:
- Nasal cannula administration is a viable and effective alternative for heliox delivery in infants.
- This method can be used for neonates who do not tolerate facemask systems.
- Facilitates improved respiratory support and outcomes in critically ill infants.
Objective:
The benefits of helium-oxygen (heliox) administration for pediatric upper and lower respiratory disorders have been well described. However, while most studies advocate delivery via a sealed or semisealed facemask system, such systems may not be tolerated in the young child. This report describes the successful and efficacious delivery of heliox via nasal cannula to 5 infants.
Methods:
A mixture of 80% helium/20% oxygen was blended with 100% oxygen from a wall source and delivered via nasal cannula to 5 spontaneously breathing infants with respiratory distress at flow rates of 2 to 3 liters per minute. Treatment efficacy was retrospectively extracted from nursing, respiratory therapist, and physician entries in the medical record, specifically focusing on changes in respiratory rate, work of breathing, and oxygenation and/or ventilation parameters.
Results:
All 5 infants tolerated the nasal cannula well. In 2, nasal cannulae were used after attempts to use a facemask system were not tolerated. All patients demonstrated rapid improvements in respiratory parameters including a decreased work of breathing (n = 5), respiratory rate (n = 4), transcutaneous CO2 (n = 2), and stridor (n = 2), or improved oxygenation (n = 1). In 1 patient, the recurrence of distress shortly after discontinuing heliox was rapidly reversed with heliox reinstitution.
Conclusions:
In infants with respiratory distress who do not tolerate a facemask, the use of nasal cannula represents a viable and efficacious alternative for heliox delivery.
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