Long-abandoned treatment revived for severe asthma attacks
March 12, 1997
Breathing a mixture of 80 percent helium and 20 percent oxygen (HELIOX), in combination with standard therapy, can ease the work of breathing in children with severe asthma attacks and may prevent the need for mechanical ventilation, according to a study by researchers at the University of Chicago Medical Center, published in the February 1997 issue of the Journal of Pediatrics.
"This is a life-saving, risk-free therapy that could save thousands of patients each year," said Mark Wylam, MD, assistant professor of pediatrics and medicine, at the University of Chicago and director of the study.
Although the beneficial effects of HELIOX were studied more than 60 years ago, this is the first report of its use in treating children with asthma. Even today, medical textbooks fail to mention the use of HELIOX for treating severe and prolonged asthma attacks.
The therapeutic use of helium was first described by Alvan L. Barach, MD, in the October 17, 1936, issue of the Journal of the American Medical Association. Dr. Barach reported immediate relief in severe asthmatic patients near death, but the therapy was abandoned for nearly 40 years.
In the past 20 years several studies have revived interest in the beneficial effects of HELIOX. In the last five years, researchers at the University of Chicago Hospitals have refined the technology for administering the gas to patients with asthma and other respiratory problems.
In a double-blind, randomized, controlled trial at the University of Chicago Children's Hospital, researchers studied 18 patients, ages 16 months to 16 years, suffering severe asthma attacks. All patients were treated with common bronchodilator drugs and steroids. Then patients received either HELIOX or room air.
The 10 patients who received HELIOX experienced a significant increase in air flow and less difficulty breathing. Three patients avoided intubation and mechanical ventilation after receiving HELIOX. None of the eight control group patients experienced a significant difference in air flow or work of breathing during the study period.
Because HELIOX is about one-third as dense as air, it is thought to reduce the effort required to breathe through a narrowed airway. By making it easier for the asthmatic patient to breathe, HELIOX may prevent respiratory muscle fatigue that leads to the need for mechanical ventilator support.
"Fatigue of the breathing muscles during a severe asthma attack is generally what kills people," said Dr. Wylam. "HELIOX is an effective and little-known therapy to buy these patients enough time for the conventional drugs to take effect."
HELIOX has been standard therapy for severe asthmatics in the pediatric and adult emergency rooms at the University of Chicago for nearly five years. Respiratory therapists and physicians at the University of Chicago have successfully modified and calibrated respiratory therapy equipment to dispense HELIOX and currently disseminate their methods to hospitals across the country. The University of Chicago is also pioneering the use of HELIOX in the management of mechanically ventilated asthma patients. This news release is available online at the, an Internet resource provided by the American Association for the Advancement of Science.
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