Heliox

Question 1

Indications for Heliox

Answer 1

reversible obstructive disorders such as asthma
acute upper airway obstruction
post-extubation stridor
croup
Occasionally, COPD
Tumors, foreign body aspiration

Question 2

Why use Heliox

Answer 2

The low-density of helium makes it useful when mixed with oxygen to decrease driving pressure needed in ventilation

With Heliox, gas flows thru narrowed airways with less turbulence

Heliox used to decrease WOB and increase ventilation while other therapies help

Question 3

What are the mixtures that heliox comes in?

Answer 3

80(He)/ 20(O2) (most common)
70/30
60/40 (Rare)

Question 4

How do you calculate flow with heliox?

Answer 4

You need a heliox flow meter for accurate flows
but if you use an O2 flow meter

Multiply the flow by 1.8 for 80/20
Multiply the flow by 1.6 for 70/30

Question 5

How can you deliver heliox?

Answer 5

Mask
-Non-rebreather with Wye for Heliox and oxygen delivery (if needed increased FiO2)

-Non-rebreather with cannula for increased FiO2
Tight fitting mask MUCH better

-Non-rebreather masks LEAK, try to get it to fit as best you can – if patient tolerates an anesthesia mask, GREAT!

NCPAP prongs

HFNC with Vapotherm

Question 6

What flow would you need for heliox and cool mist?

Answer 6

15-20 lpm

Question 7

What is not recommend for heliox delivery?

Answer 7

Not recommended for tents

Leaks too much
Potential for hypothermia

Question 8

What about heliox and aerosol delivery? flow and deposition

Answer 8

lower output over time but greater deposition
Increasing flow will compensate for lower output (x1.5)

Hope neb and flow mist are duel entry nebs for air and heliox

Use only nebulizers approved for heliox and monitor patient response to therapy

Question 9

What are the 3 hazards to using heliox

Answer 9

Anoxia (Wrong tank, Unmixed tank You should verify your tank)

Too much volume delivered

Hypothermia – 6 x times colder than nitrogen and cause babies lose heat and cause apnea

Question 10

What happens if patients has a Less effective cough and spontaneous secretion clearance

Answer 10

Lower density heliox inhibits expulsive phase of coughing

Wash out helium with air-oxygen mixture before directed coughing

Question 11

What devices can you use to deliver Heliox? describe the device

Answer 11

Vapotherm - High Flow nasal Canula (Best Device)

Adaptaer Heliox - machine that can deliver it with P/S

HopeNeb and Flow Mist - Nebulizer