Use of helium-oxygen mixtures to relieve upper airway obstruction in a pediatric population

Objectives. Helium as a component of inspired gas decreases turbulent flow and airway resistance. Helium-oxygen mixtures have been used since the 1930s in the management of patients with upper airway obstruction. The objective of this study was to evaluate the efficacy of helium-oxygen mixtures in relieving upper airway obstruction in a pediatric population. Study Design: Retrospective chart review of 42 pediatric patients who received helium-oxygen mixtures for upper airway obstruction within a 3-year period. Methods. The study protocol included 42 pediatric patients, aged 1 week to 14 years, who were admitted to the Children's Hospital of Philadelphia from June 1997 to December 2000 and who received a total of 44 treatments of helium-oxygen therapy for upper airway obstruction. Response to treatment was determined by reduction in work of breathing noted on the chart. Results: Thirty-two of 44 helium-oxygen treatments resulted in a positive response (73%). There were no significant differences in demographic characteristics between responders and nonresponders, except all of the premature infants were responders and 6 of the 9 patients with syndromes were nonresponders. Conclusions. Helium- oxygen therapy is a useful adjunct therapy for upper airway obstruction. Controlled clinical trials are necessary to better define the appropriate settings for use of helium-oxygen.