title: Use of heliox delivered via high-flow nasal cannula to treat an infant with coronavirus-related respiratory infection and severe acute air-flow obstruction.
abstract: Heliox, a helium-oxygen gas mixture, has been used for many decades to treat obstructive pulmonary disease. The lower density and higher viscosity of heliox relative to nitrogen-oxygen mixtures can significantly reduce airway resistance when an anatomic upper air-flow obstruction is present and gas flow is turbulent. Clinically, heliox can decrease airway resistance in acute asthma in adults and children and in COPD. Heliox may also enhance the bronchodilating effects of β-agonist administration for acute asthma. Respiratory syndromes caused by coronavirus infections in humans range in severity from the common cold to severe acute respiratory syndrome associated with human coronavirus OC43 and other viral strains. In infants, coronavirus infection can cause bronchitis, bronchiolitis, and pneumonia in variable combinations and can produce enough air-flow obstruction to cause respiratory failure. We describe a case of coronavirus OC43 infection in an infant with severe acute respiratory distress treated with heliox inhalation to avoid intubation.
authors.affiliation: Department of Pediatric Respiratory Care sherwin.morgan@uchospitals.edu.
authors.forename: Sherwin E
authors.initials: SE
authors.lastname: Morgan
authors.affiliation: Department of Pediatric Critical Care Nursing, Comer Children's Hospital.
authors.forename: Kirissa
authors.initials: K
authors.lastname: Vukin
authors.affiliation: Department of Pediatric Respiratory Care.
authors.forename: Steve
authors.initials: S
authors.lastname: Mosakowski
authors.affiliation: Department of Pediatric Respiratory Care.
authors.forename: Patti
authors.initials: P
authors.lastname: Solano
authors.affiliation: Department of Pediatric Respiratory Care.
authors.forename: Lolita
authors.initials: L
authors.lastname: Stanton
authors.affiliation: Department of Pediatric Pulmonary Medicine, Comer Children's Hospital, The University of Chicago, Chicago, Illinois.
authors.forename: Lucille
authors.initials: L
authors.lastname: Lester
authors.affiliation: Department of Pediatric Critical Care.
authors.forename: Romeen
authors.initials: R
authors.lastname: Lavani
authors.affiliation: Section of Pulmonary and Critical Care Medicine.
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Hall
authors.affiliation: Department of Anesthesia and Critical Care, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Avery
authors.initials: A
authors.lastname: Tung
mesh_terms: D000280:Administration, Inhalation; D000402:Airway Obstruction / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000914:Antibodies, Viral / Q000032:analysis; D001990:Bronchiolitis, Viral / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D017934:Coronavirus / Q000276:immunology*; D018352:Coronavirus Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006371:Helium; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology; D007223:Infant; D007440:Intubation / Q000379:methods*; D008297:Male; D009666:Nose; D010100:Oxygen
chemical_list: D000914:Antibodies, Viral; D006371:Helium; C038949:heliox; D010100:Oxygen
keywords: air-flow obstruction; coronavirus; heliox; high-flow nasal cannula; respiratory syndrome