Introduction Heliox21 reduces the work of breathing in patients with extra-thoracic airway obstruction, is not curative or intended to replace other treatments. In our specialist service we have significant numbers of patients whom have history of regular hospitalisations, relating to poorly controlled vocal cord dysfunction (VCD). The gold standard for treatment is respiratory speech and language therapy (rSLT). We increasingly value Heliox21 as an early adjunct to rSLT in severe patients who are establishing management strategies.
Aims To assess the impact of Heliox21 on patient admission rate and self-reported experience, for patients with severe VCD.
Methods We retrospectively reviewed the rSLT caseload from June–December 2014. All patients with endoscopically confirmed VCD, greater than five VCD related hospitalisations prior to the commencement of VCD treatment and who were prescribed Heliox21 for use in the community were included. We requested hospital admission data (from patient’s GP and secondary care physicians) between June 2013–June 2015, and reviewed medical and rSLT notes for demographic information/co-morbidity data/opinions of Heliox21.
Results Five patients met the inclusion criteria, three were available for analysis; one male and two female (aged 23,43,57 years). All had treated co-morbidities of asthma (BTS step 5) and reflux. One patient had treated nasal disease. Six-months prior to community Heliox21 administration the mean (range) number of hospital admissions was 11 (8–13); after instigation, during the same follow-up period, this reduced by 81% (2 admissions) and two patients had no hospitalisations. In all patients rSLT occurred simultaneously. Patient opinions included, ‘heliox gives me time to start my therapy and means I don’t ring 999 straight away,’ and, ‘heliox stops me from going to A&E all the time.’ Two patients, who had completed rSLT, had Heliox21 removed as it was no longer needed.
Conclusions Heliox21 has a positive impact on reducing VCD hospital admissions and is a low cost short-term solution (£160 set-up, £8.50 month). This retrospective review has limitations; the impact of rSLT alone on admission rates needs to be compared. Further investigation is needed to examine the worth of Heliox21 as an initial adjunct to rSLT, with consideration of how to prevent reliance.
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