Helium-oxygen in bronchiolitis-A systematic review and meta-analysis

Area of Science:

• Pediatrics
• Respiratory Medicine
• Critical Care

Background:

• Bronchiolitis is a frequent cause of infant hospitalization.
• Evaluating novel therapeutic interventions for bronchiolitis is crucial for improving patient outcomes and reducing healthcare burden.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of helium-oxygen (heliox) therapy in infants diagnosed with bronchiolitis.
• To assess heliox's impact on key clinical outcomes including respiratory support needs and hospitalization duration.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
• Six RCTs involving 560 infants were included after screening 463 studies.
• Primary outcomes included the need for continuous positive airway pressure (CPAP) or intubation, hospitalization duration, and symptom severity (modified Woods Clinical Asthma Scale).

Main Results:

• Low-quality evidence suggests heliox does not significantly reduce the need for CPAP (RR 0.87, CI: 0.56-1.35) or intubation (RR 1.39, CI: 0.53-3.63).
• Hospitalization duration showed a non-significant increase of 0.25 days with heliox (CI: -0.22 to 0.71).
• A significant mean decrease in M-WCAS scores of 1.90 points (CI: 1.46-2.34) was observed with heliox, indicating rapid symptom relief.

Conclusions:

• Heliox therapy demonstrates limited efficacy in reducing the need for respiratory support or shortening hospitalization for bronchiolitis.
• Heliox may offer rapid symptomatic relief of respiratory distress in infants with bronchiolitis.
• Further high-quality RCTs are needed, particularly in severe bronchiolitis cases, to definitively assess heliox's role, especially regarding intubation rates.