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@article{Chowdhury:2013:10.1542/peds.2012-1317,
author = {Chowdhury, MMM and McKenzie, SA and Pearson, CC and Carr, S and Pao, C and Shah, A and Reus, E and Eliahoo, J and Gordon, F and Bland, H and Habibi, P},
doi = {10.1542/peds.2012-1317},
journal = {Pediatrics},
pages = {661--669},
title = {Heliox Therapy in Bronchiolitis: Phase III MulticenterDouble-Blind Randomized Controlled Trial},
url = {http://dx.doi.org/10.1542/peds.2012-1317},
volume = {131},
year = {2013}
}

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TY  - JOUR
AB  - BACKGROUND AND OBJECTIVE: Supportive care remains the mainstayof therapy in bronchiolitis. Earlier studies suggest that helium-oxygentherapy may be beneficial, but evidence is limited. We aimed to compareefficacy of 2 treatment gases, Heliox and Airox (21% oxygen 1 79%helium or nitrogen, respectively), on length of hospital treatment forbronchiolitis.METHODS: This was a multicenter randomized blinded controlled trial of319 bronchiolitic infant subjects randomly assigned to either gas; 281 subjectscompleted the study (140 Heliox, 141 Airox), whose data was analyzed.Treatment was delivered via facemask (nasal cannula, if thefacemask intolerant) 6 continuous positive airway pressure (CPAP).Severe bronchiolitics received CPAP from the start. Primary end pointwas length of treatment (LoT) required to alleviate hypoxia and respiratorydistress. Secondary end-points were proportion of subjects needingCPAP; CPAP (LoT); and change in respiratory distress score.RESULTS: Analysis by intention to treat (all subjects); median LoT (interquartilerange, days): Heliox 1.90 (1.08–3.17), Airox 1.87 (1.11–3.34), P =.41. Facemask tolerant subgroup: Heliox 1.46 (0.85–1.95), Airox 2.01 (0.93–2.86), P = .03. Nasal cannula subgroup: Heliox 2.51 (1.21–4.32), Airox 2.81(1.45–4.78), P = .53. Subgroup started on CPAP: Heliox 1.55 (1.38–2.01),Airox 2.26 (1.84–2.73), P = .02. Proportion of subjects needing CPAP:Heliox 17%, Airox 19%, O.R. 0.87 (0.47–1.60), P = .76. Heliox reduced respiratorydistress score after 8 hours (mixed models estimate, 20.1298;P , .001). The effect was greater for facemask compared with nasalcannula (mixed models estimate, 0.093; P = .04).CONCLUSIONS: Heliox therapy does not reduce LoT unless given via a tight fittingfacemask or CPAP. Nasal cannula heliox therapy is ineffective.
AU  - Chowdhury,MMM
AU  - McKenzie,SA
AU  - Pearson,CC
AU  - Carr,S
AU  - Pao,C
AU  - Shah,A
AU  - Reus,E
AU  - Eliahoo,J
AU  - Gordon,F
AU  - Bland,H
AU  - Habibi,P
DO  - 10.1542/peds.2012-1317
EP  - 669
PY  - 2013///
SP  - 661
TI  - Heliox Therapy in Bronchiolitis: Phase III MulticenterDouble-Blind Randomized Controlled Trial
T2  - Pediatrics
UR  - http://dx.doi.org/10.1542/peds.2012-1317
VL  - 131
ER  -

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