Related Experiment Video
Updated: Jun 12, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Outcomes of heliox use in children with respiratory compromise: A 10-year single institution experience
Ashley Young1, Eli Stein2, Matthew Rowland3,4
1Department of Otolaryngology-Head and Neck Surgery Feinberg School of Medicine, Northwestern University Chicago Illinois USA.
Insights
Heliox therapy in children with respiratory compromise may be a temporary solution. Prolonged use exceeding 47 hours, particularly with neuromuscular or intracranial conditions, increases the need for surgical airway intervention.
Area of Science:
- Pediatric Pulmonology
- Critical Care Medicine
- Respiratory Therapy
Background:
- Heliox, a helium-oxygen mixture, improves airflow and reduces airway resistance in pediatric patients.
- Understanding the long-term outcomes and predictors of surgical intervention in children receiving heliox is crucial.
Purpose of the Study:
- To evaluate the outcomes of heliox therapy in children with respiratory compromise.
- To identify factors associated with the need for airway surgical intervention.
Main Methods:
- Retrospective cohort study of 119 children treated with heliox between 2012 and 2022.
- Analysis of patient demographics, comorbidities, heliox usage duration, and need for tracheostomy or airway reconstruction.
Main Results:
- Most patients (84%) had significant comorbidities.
- Cumulative heliox use >47 hours was linked to a 6.2-fold increased risk of needing tracheostomy or airway reconstruction (p<0.0001).
- Neuromuscular disease, intracranial neuropathology, and prolonged heliox use were associated with definitive airway intervention.
Conclusions:
- Heliox can serve as a temporizing measure for pediatric upper airway obstruction.
- The effectiveness and necessity of prolonged heliox use (>47 hours), especially in children with neuromuscular disease or intracranial neuropathology, warrant reconsideration.
Objective:
Heliox, a mixture of helium and oxygen, has been shown to improve laminar airflow and decrease airway resistance in children. This study aims to describe the outcomes of heliox use in children with respiratory compromise and to identify variables associated with a need for airway surgical intervention.
Methods:
A retrospective cohort study of patients who received heliox between 2012 and 2022 at a tertiary care children's hospital.
Results:
A hundred and thirty-eight heliox treatments were recorded in 119 children. Twelve patients were excluded. Most (n = 100, 84%) patients had significant comorbidities. On average, patients spent a cumulative mean of 94 ± 187 h on heliox therapy per hospital admission. Patients with croup or asthma without known airway pathology presented at an older age than patients with other indications for heliox therapy (4.0 ± 4.7 vs. 2.2 ± 3.6 years, p = 0.04) and were significantly less likely to have background diseases (n = 14, 52% vs. n = 74, 93%, p < 0.0001). Overall, 51 (47.7%) patients were recommended tracheostomy placement, airway reconstruction, or palliative care. Cumulative use of heliox for more than 47 h was associated with an increased risk of needing tracheostomy or airway reconstruction (odds ratio 6.2, 95% confidence intervals 2.56-14.13, p < 0.0001). In multivariable regression analysis, neuromuscular disease, intracranial neuropathology, and cumulative time of heliox were associated with a need for definitive airway intervention.
Conclusions:
Heliox may be used as a temporizing agent in children with upper airway obstruction. The effectiveness of heliox use for more than 47 h in children, especially in the presence of neuromuscular disease and intracranial neuropathology should be reconsidered.Level of evidence: 4.
More Related Videos
Related Concept Videos
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
01:17Pulmonary Cycle: Exhalation
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...