Helium/Oxygen-Driven Albuterol Nebulization in the Treatment of Children With Moderate to Severe Asthma Exacerbations: A Randomized, Controlled Trial
- 1 November 2005
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 116 (5), 1127-1133
- https://doi.org/10.1542/peds.2004-2136
Abstract
Background. Helium and oxygen mixtures (heliox) increase both pulmonary aerosol delivery and gas delivery relative to oxygen. We aimed to compare the effectiveness of a 70%:30% helium/oxygen (heliox)–driven continuous aerosol delivery versus 100% oxygen-driven delivery in the treatment of asthmatic children with moderate to severe exacerbations.Methods. We enrolled 30 children aged 2 to 18 years who presented to an urban, pediatric emergency department (ED) with moderate to severe asthma as defined by a pulmonary index (PI) score of ≥8. PI scores can range from 0 to 15. In this randomized, controlled, single-blind trial conducted in a convenience sample of children, all patients in the trial received an initial nebulized albuterol (5 mg) treatment driven by 100% oxygen and a dose of oral prednisone or prednisolone. Subsequently, patients were randomly assigned to receive continuously nebulized albuterol (15 mg/hour) delivered by either heliox or oxygen using a nonrebreathing face mask. The primary outcome measure was degree of improvement as assessed in blinded video-recorded PI scores over 240 minutes (at 30-minute intervals for the first 3 hours) or until ED discharge (if <240 minutes).Results. The mean change in PI score from baseline to 240 minutes or ED discharge was 6.67 for the heliox group compared with 3.33 for the oxygen group. Eleven (73%) patients in the heliox group were discharged from the hospital in <12 hours compared with 5 (33%) patients in the conventional group.Conclusion. Continuously nebulized albuterol delivered by heliox was associated with a greater degree of clinical improvement compared with that delivered by oxygen among children with moderate to severe asthma exacerbations.Keywords
This publication has 21 references indexed in Scilit:
- Development of Aerosol Drug Delivery with Helium Oxygen Gas MixturesJournal of Aerosol Medicine, 2004
- Heliox for nonintubated acute asthma patientsPublished by Wiley ,2003
- Heliox versus oxygen for nebulized aerosol therapy in children with lower airway obstructionPediatric Critical Care Medicine, 2002
- Inhaled heliox does not benefit ED patients withmoderate to severe asthmaThe American Journal of Emergency Medicine, 2000
- Continuous vs Intermittent Nebulized Albuterol for Emergency Management of AsthmaAcademic Emergency Medicine, 1996
- Theoretical validation of the respiratory benefits of helium-oxygen mixturesRespiration Physiology, 1995
- Continuous versus intermittent albuterol nebulization in the treatment of acute asthmaAnnals of Emergency Medicine, 1993
- Comparison of intermittent and continuously nebulized albuterol for treatment of asthma in an urban emergency departmentAnnals of Emergency Medicine, 1993
- A prospective, randomized study of continuous versus intermittent nebulized albuterol for severe status asthmaticus in childrenCritical Care Medicine, 1993
- Helium-Oxygen Mixtures in Intubated Patients with Status Asthmaticus and Respiratory AcidosisSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1990