[Efficacy of heliox therapy in respiratory insufficiency in infants and children].
OBJECTIVE
To analyze response to heliox therapy in critically ill infants and children with upper and/or lower airway respiratory insufficiency.


METHODS
Sixty-five patients, aged between 12 days and 8 years old, treated with heliox through facial mask, nasal prongs or non-invasive ventilation were studied. Diagnoses were bronchiolitis (25), upper postextubation respiratory insufficiency (19), respiratory insufficiency after airway surgery (14), and croup-laryngotracheomalacia (7). Response to heliox treatment was measured by the change in clinical scores, respiratory rate, heart rate, pulse oximetry, blood gas analysis, and the need for non-invasive and invasive mechanical ventilation.


RESULTS
Fifty-four patients (83.1 %) improved after heliox therapy, with statistically significant differences in clinical score (from 8.7 to 5.5), respiratory rate (from 51.4 to 38.8 rpm), and heart rate (from 161.6 to 145.6 bpm). No changes were observed in saturation or blood gas analysis. After heliox therapy, 29.8 % of patients required non-invasive ventilation and 26.5 % required intubation. Patients with bronchiolitis and those aged less than 1 year had a lesser response to heliox therapy and more frequently required non-invasive ventilation. No significant differences were found in intubation requirements. No adverse effects were observed.


CONCLUSIONS
Heliox therapy improved clinical scores in infants and children with upper and lower airway respiratory insufficiency, but a significant percentage of patients needed non-invasive or invasive mechanical ventilation.
Iglesias Fernández
C
C
Sección de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España.
López-Herce Cid
J
J
Mencía Bartolomé
S
S
Santiago Lozano
M J
MJ
Moral Torrero
R
R
Carrillo Alvarez
A
A
D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006371:Helium / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000627:therapeutic use*; D012131:Respiratory Insufficiency / Q000188:drug therapy*
D006371:Helium; C038949:heliox; D010100:Oxygen