Chest
Clinical InvestigationsAsthmaThe Effect of Heliox in Acute Severe Asthma: A Randomized Controlled Trial
Section snippets
Materials and Methods
The study was reviewed and approved by our Institutional Review Committee. We enrolled 23 adult subjects who presented with acute severe asthma to the Cooper Hospital/University Medical Center Emergency Department from 1992 to 1995. Patients between 18 and 50 years of age were eligible if they had a clinically severe exacerbation of asthma, as defined by a peak flow of < 200 L/min after treatment with 5 mg of nebulized albuterol. The diagnosis of asthma was made from the patient's history or
Results
There were no significant differences between the groups for gender, age, smoking history, years of asthma, duration of asthma exacerbation, or arterial blood gas findings (Table 1). Before the study, 20 patients were maintained on an inhaledβ -agonist, 6 patients on theophylline, 3 patients on oral corticosteroids, and 5 patients on inhaled corticosteroids, and there were no significant differences between the groups for these prestudy medications (p > 0.1). Nineteen of the 23 subjects (83%)
Discussion
This is the first study to demonstrate in a prospective, randomized, controlled fashion that heliox causes both a rapid improvement in peak flow and a decrease in dyspnea in adult patients with acute severe asthma that is maintained for at least 8 h. Similar objective improvements have been demonstrated in children.1516 All of the heliox patients had a > 20% increase in %PEF at 20 min, whereas only two patients of the oxygen group did. Helium, because of its lower density than nitrogen or
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