Heliox Therapy for Bronchiolitis: Delivery Method Matters

Heliox delivered via face mask, but not nasal cannula, reduced duration of treatment in infants hospitalized for bronchiolitis.

Researchers assessed the optimal delivery system for heliox to alleviate respiratory distress in infants hospitalized for bronchiolitis. In a prospective, randomized, controlled trial at 4 centers in the United Kingdom and Australia, 281 infants (median age, 11 weeks) received either heliox (21% oxygen + 79% helium) or airox (21% oxygen + 79% nitrogen), with additional oxygen as needed. Gas was delivered via tight-fitting nonrebreathing facemask or via nasal cannula to the 87 infants who could not tolerate the facemask. Patients receiving bronchodilator, epinephrine, or steroid therapy were excluded.
Median length of stay did not differ between the heliox and airox groups overall (1.9 days in both groups) or among infants treated via nasal cannula (2.5 and 2.8 days). However, children who received heliox via facemask had shorter stays than those who received airox via facemask (1.5 vs. 2.0 days). The reduction in stay associated with heliox delivered via facemask was even greater in children who were positive for respiratory syncytial virus (1.3 days). Overall, need for continuous positive airway pressure (CPAP) did not differ between groups (17% and 19%). Among 21 children requiring CPAP at enrollment, heliox shortened stay compared to airox (1.6 vs. 2.3 days).

CITATION(S):

Chowdhury MM et al. Heliox therapy in bronchiolitis: Phase III multicenter double-blind randomized controlled trial. Pediatrics 2013 Apr; 131:661.