title: Patterns of helium-oxygen (heliox) usage in the critical care environment.
abstract: The objective of this study was to describe the patterns of heliox use in critical care units of an academic medical center. The design was a prospective case series involving 7 critical care units of an academic medical center. All patients receiving heliox therapy over a 4-year period were studied, with prospective recording of patient demographics and the location, mode, indication for, and duration of heliox use. Use pattern comparisons based on anatomic location (upper vs lower airway) and age group (pediatric vs adult) were performed by alpha(2) analysis and unpaired Student t test. Eighty-nine patients, aged 17.4 +/- 20.9 years, received heliox for 30.5 +/- 44.6 hours on 92 occasions. Pediatric (</= 18 years) applications accounted for 72.8% of heliox use. Use was greater in frequency and scope during the final 2 study years, particularly in adults. Applications were split between upper airway (47%) and lower airway (53%) disorders. Airway manipulation was required in more adults (7/16) than in children (3/27) with upper airway obstruction (P < .05). The use patterns mirrored current literature emphases on postextubation stridor and asthma. This is the first description of heliox use patterns in the tertiary care critical care environment. Heliox use may be as dependent on practitioner experience as on published data. As a benign and relatively inexpensive therapy, heliox use should continue to be attractive, although ongoing study regarding efficacy in a number of settings is indicated.
authors.affiliation: Department of Child Health, University of Missouri-Columbia, USA. john.berkenbosch@louisville.edu
authors.forename: John W
authors.initials: JW
authors.lastname: Berkenbosch
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Grueber
authors.forename: Gavin R
authors.initials: GR
authors.lastname: Graff
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000046:Academic Medical Centers; D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods / Q000706:statistics & numerical data*; D004363:Drug Utilization; D006371:Helium / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008875:Middle Aged; D010100:Oxygen / Q000009:adverse effects / Q000627:therapeutic use*; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D012449:Safety; D016896:Treatment Outcome
chemical_list: D006371:Helium; C038949:heliox; D010100:Oxygen