Use of helium-oxygen mixture (Heliox®) in the treatment of obstructive lower airway disease in a pediatric emergency department

Objective: to determine whether the use of salbutamol,in a helium-oxygen mixture (80:20),can modify outcome and risk of hospitalization of pediatric patients. methods: a controlled cohort study including patients aged 2 months to 12 years with diagnoses of asthmatic crisis or viral bronchiolitis. intensity was characterized from moderate to severe,as measured by clinical score (pulmonary index,pi) for obstructive disease. scores > 8 were considered eligible. the heliox® group was composed of 20 patients and the oxygen group of 40 patients. patients received sequentially,at 20-min intervals,until six nebulization cycles were completed (2-h period): salbutamol 0.15 mg/kg/dose (maximum 5 mg). the nebulized drug was driven either by heliox® mixture (80:20) or 100% oxygen. patients diagnosed with acute asthmatic crisis received,additionally,prednisolone (2 mg/kg) orally. results: eleven patients in the heliox® group still required treatment at 6 h,against 38 patients in the group receiving oxygen-driven nebulization (p = 0.034). at 12 h,7 patients in the heliox® group remained under observation,against 27 in the oxygen group. differences regarding the need for supplemental oxygen were observed only at 6 h of treatment (p = 0.02). conclusions: heliox® (80:20),for salbutamol administration,is effective in the treatment of pediatric obstructive disease that responds to bronchodilator therapy. compared to usual aerosol delivery technique,heliox®-driven salbutamol nebulization is associated with shorter stay in the observation room after 6 h of treatment. copyright © 2010 by sociedade brasileira de pediatria.