From the Guidelines
Heliox therapy should be administered through a non-rebreather mask or tight-fitting face mask at a typical mixture of 70-80% helium and 20-30% oxygen, adjusted based on the patient's oxygenation needs. The gas mixture should be delivered from premixed tanks via a helium-compatible flowmeter, as standard oxygen flowmeters will provide inaccurate readings due to helium's lower density 1. Initial flow rates should be set at 10-15 L/min to prevent rebreathing of exhaled carbon dioxide, with continuous monitoring of oxygen saturation, respiratory rate, and work of breathing. The mask must maintain a tight seal to prevent entrainment of room air, which would dilute the therapeutic effect.
Key Considerations
- Duration of therapy varies based on clinical response, typically continuing until respiratory distress improves.
- Heliox works by reducing airway resistance through its lower density compared to nitrogen-oxygen mixtures, allowing improved laminar flow through narrowed airways and reducing the work of breathing.
- This makes it particularly effective for conditions with upper airway obstruction or severe asthma.
- Patients should be closely monitored for clinical improvement, with therapy discontinued gradually once the underlying condition resolves or alternative treatments take effect 1.
Monitoring and Maintenance
- Oxygen saturation and delivery system (including flow rate) should be recorded on the patient’s monitoring chart 1.
- Oxygen delivery devices and flow rates should be adjusted to keep the oxygen saturation in the target range, which is typically 94–98% for most acutely ill patients or 88–92% for those at risk of hypercapnic respiratory failure 1.
- Oxygen should be prescribed and a signature should be entered on the drug chart on each drug round 1.
From the Research
Administration Protocol for Heliox Therapy
The administration of Heliox, a helium-oxygen mixture, is used in various medical settings, particularly for patients with severe airway obstruction. The proper administration protocol involves:
- Using a mixture of helium and oxygen, with the optimal ratio depending on the patient's condition 2
- Administering Heliox with vigilance and continuous monitoring to avoid technical complications 3
- Considering the patient's individual risk/benefit ratio, as the clinical application of Heliox is not definitively studied 3
Heliox Mixture Ratios
The choice of helium:oxygen ratio depends on the patient's condition:
- For patients with hypercarbia, an 80% helium mixture is recommended 2
- For patients with hypoxia, a higher oxygen concentration is appropriate 2
- A mixture of 70% heliox and 30% oxygen has been used in some studies 4
Clinical Applications
Heliox therapy has been used in various clinical settings, including:
- Severe asthma attacks and chronic obstructive pulmonary disease (COPD) 5
- Upper airway obstruction, bronchiolitis, and bronchopulmonary dysplasia 5, 6
- Croup in children, with some studies suggesting its effectiveness in relieving respiratory distress 4
Safety and Monitoring
Heliox therapy is considered extremely safe, with no adverse effects reported in most studies 3. However, it is essential to administer Heliox with continuous monitoring to avoid technical complications 3. The evidence for the effectiveness and safety of Heliox is limited, and more research is needed to fully assess its role in various medical conditions 6, 4