The utility of albuterol nebulized with heliox during acute asthma exacerbations.

Heliox improves lung deposition of inhaled particles when compared with air or oxygen inhalation. We studied the spirometric effects of albuterol nebulized with heliox during emergency room visits for asthma exacerbations. Forty-five patients were randomized to receive albuterol nebulized with oxygen (control) versus heliox (n = 22 control and 23 heliox subjects). At baseline, demographics, outpatient asthma medications, vital signs, oxygen saturation, and forced expiratory volume in one second were not different between the two groups. Three consecutive albuterol treatments were given to each group. The heliox group had a significantly higher heart rate after albuterol nebulization compared with the control group. Following albuterol Treatment 1, the median change in forced expiratory volume in one second was 14.6% in the control group and 32.4% in the heliox group (p = 0.007). After Treatment 2, the results were 22.7% versus 51.5%, respectively (p = 0.007). After Treatment 3, the results were 26.6% versus 65.1%, respectively (p = 0.016). We conclude that during acute asthma exacerbations, albuterol nebulized with heliox leads to a more significant improvement in spirometry when compared with albuterol nebulized with oxygen. This is likely due to the low-density gas improving albuterol deposition in the distal airways.

[1]  M. Tobin,et al.  Improvement in aerosol delivery with helium-oxygen mixtures during mechanical ventilation. , 2001, American journal of respiratory and critical care medicine.

[2]  W. Summer,et al.  Randomized trial of the use of heliox as a driving gas for updraft nebulization of bronchodilators in the emergent treatment of acute exacerbations of chronic obstructive pulmonary disease , 2000, Critical care medicine.

[3]  D. Habib,et al.  Effect of Helium‐Oxygen on Delivery of Albuterol in a Pediatric, Volume‐Cycled, Ventilated Lung Model , 1999, Pharmacotherapy.

[4]  L. Chan,et al.  Use of heliox-driven nebulizer therapy in the treatment of acute asthma. , 1999, Annals of emergency medicine.

[5]  C. Camargo,et al.  The Effect of Heliox on Nebulizer Function Using a β-Agonist Bronchodilator , 1999 .

[6]  P. R. Verbeek,et al.  Heliox does not improve FEV1 in acute asthma patients. , 1998, The Journal of emergency medicine.

[7]  E. R. Mcfadden,et al.  Observations on the effects of aerosolized albuterol in acute asthma. , 1997, American journal of respiratory and critical care medicine.

[8]  Jesse B. Hall,et al.  Heliox in the treatment of airflow obstruction : A critical review of the literature , 1997 .

[9]  John L. Hankinson,et al.  Standardization of Spirometry, 1994 Update. American Thoracic Society. , 1995, American journal of respiratory and critical care medicine.

[10]  J E Kass,et al.  Heliox therapy in acute severe asthma. , 1995, Chest.

[11]  C. Manthous,et al.  Heliox improves pulsus paradoxus and peak expiratory flow in nonintubated patients with severe asthma. , 1995, American journal of respiratory and critical care medicine.

[12]  P Camner,et al.  Deposition in asthmatics of particles inhaled in air or in helium-oxygen. , 1993, The American review of respiratory disease.

[13]  E. Gluck,et al.  Helium-oxygen mixtures in intubated patients with status asthmaticus and respiratory acidosis. , 1990, Chest.

[14]  P. Stillwell,et al.  Effectiveness of open-circuit and oxyhood delivery of helium-oxygen. , 1989, Chest.

[15]  M. Svartengren,et al.  Human lung deposition of particles suspended in air or in helium/oxygen mixture. , 1989, Experimental lung research.

[16]  A. Greenough,et al.  Abnormalities of lung mechanics in young asthmatic children. , 1987, Thorax.

[17]  R. Zuwallack,et al.  Density dependence of maximal expiratory air flow in asthmatics with exacerbation of their disease. , 1987, The American review of respiratory disease.

[18]  N. Zamel,et al.  Pneumotachograph calibration for inspiratory and expiratory flows during HeO2 breathing. , 1981, Journal of applied physiology: respiratory, environmental and exercise physiology.

[19]  A. Barach.  Use of Helium as a New Therapeutic Gas , 1934 .