Use of heliox in patients with severe exacerbation of chronic obstructive pulmonary disease

Objective. To assess whether patients with chronic obstructive pulmonary disease treated with heliox have a better prognosis than those treated with standard therapy. Design: Retrospective analysis over 18 months. Setting: Academic emergency department. Patients. Eighty-one patients admitted with exacerbation of chronic obstructive pulmonary disease and respiratory acidosis. Interventions. Use of helium-oxygen mixture as an adjunctive therapy. Measurements and Main Results. The following data were collected: age, gender, medical history, vital signs, arterial blood gas at admission, emergency room treatment, requirement for intubation, admission in intensive care unit, length of stay, and evolution. Patients were classified into two groups according to whether heliox was used as a therapeutic agent (heliox group) or not (standard group). Chi-square test and Student's t-test were used for statistical analysis (significant at p < .05). In both groups, the following data were similar: age, gender, medical history, vital signs, initial arterial blood gas, and emergency room treatment. Significant decreases in intubation, and mortality rate were identified in the heliox group. Significant decreases In intensive care unit stay and in-hospital stay were observed for survivors in the heliox group. Conclusion. Use of heliox seems to improve prognosis in patients with severe acute exacerbation of chronic obstructive pulmonary disease. Prospective randomized studies are needed to confirm these results.