title: Helium/oxygen-driven albuterol nebulization in the management of children with status asthmaticus: a randomized, placebo-controlled trial.
abstract: OBJECTIVE
  We investigated the effect of heliox-powered albuterol therapy on hospital length of stay and clinical status in children with moderate to severe status asthmaticus.
  
  
  METHODS
  Prospective, randomized, placebo-controlled trial.
  
  
  METHODS
  Twenty-five-bed pediatric intensive care unit at an academic children's medical center.
  
  
  METHODS
  Forty-two children (2-21 yrs of age) with moderate to severe status asthmaticus.
  
  
  METHODS
  Patients were randomized to receive either heliox-powered nebulized albuterol or air/oxygen-powered nebulized albuterol (placebo) until they were transitioned to albuterol delivered by a metered dose inhaler.
  
  
  RESULTS
  Clinical asthma scores were recorded on enrollment and every 4 hrs thereafter. Patients in the heliox group (n = 22) and the control group (n = 20) had similar ages (mean +/- sem: 88 +/- 9.9 vs. 98 +/- 11.1 months, respectively; p = .51), time to study enrollment (618 +/- 70.4 vs. 597 +/- 84.1 mins, respectively; p = .72), and clinical asthma scores at study entry (5.9 +/- 0.2 vs. 5.7 +/- 0.3, respectively; p = .72). There were no significant differences between groups in time to eligibility to hospital discharge (66.2 +/- 8.7 vs. 63.4 +/- 8.6 hrs, respectively; p = .61), time to clinical asthma score <3 (22 +/- 2.8 vs. 21.2 +/- 5.3 hrs, respectively; p = .27), or time to eligibility for intensive care unit discharge (34.4 +/- 6.8 vs. 33.3 +/- 8.2 hrs, respectively; p = .64). There were no significant differences in adverse events between groups.
  
  
  CONCLUSIONS
  Despite the previously demonstrated effects of heliox on improved aerosol particle delivery into the distal airways, heliox-powered nebulized albuterol therapy for children admitted to the hospital with moderate to severe status asthmaticus does not shorten hospital length of stay or hasten rates of clinical improvement when compared with air/oxygen-powered nebulized albuterol.
authors.affiliation: Division of Critical Care Medicine, Akron Children's Hospital, Akron, OH, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Bigham
authors.forename: Brian R
authors.initials: BR
authors.lastname: Jacobs
authors.forename: Marie A
authors.initials: MA
authors.lastname: Monaco
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Brilli
authors.forename: Dan
authors.initials: D
authors.lastname: Wells
authors.forename: Edward M
authors.initials: EM
authors.lastname: Conway
authors.forename: Scott
authors.initials: S
authors.lastname: Pettinichi
authors.forename: Derek S
authors.initials: DS
authors.lastname: Wheeler
mesh_terms: D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006371:Helium / Q000009:adverse effects; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000592:standards*; D009820:Ohio; D010100:Oxygen / Q000009:adverse effects; D010919:Placebos; D012720:Severity of Illness Index; D013224:Status Asthmaticus / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001993:Bronchodilator Agents; D010919:Placebos; D006371:Helium; C038949:heliox; D000420:Albuterol; D010100:Oxygen