Use of helium in the management of upper airway obstruction

Inhalation therapy with the use of helium-oxygen has been advocated in the treatment of upper airway obstruction due to various causes. The therapeutic effect is secondary to a decrease in turbulent flow and airway resistance in areas of obstruction. We present a patient with acute respiratory failure secondary to upper airway obstruction caused by a tumor involving the distal trachea and proximal left mainstem bronchus. Despite assistance with a mechanical ventilator, the patient remained tachypneic and hypercarbic. Following institution of helium therapy, the patient became less short of breath and her carbon dioxide returned to a normal level. She was later weaned from mechanical ventilation and discharged from the hospital.