Prospective randomized trial of heliox-driven continuous nebulizers in the treatment of asthma in the emergency department

Rose, John S.; Panacek, Edward A.; Miller, Penny

doi:10.1016/s0736-4679(01)00454-1

Cited by 41 publications

(26 citation statements)

References 16 publications

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“…Few randomized controlled trials have studied respiratory rate in emergency-department asthma patients treated with heliox-driven bronchodilator. Rose et al 16 carried out a randomized study with patients in asthma exacerbation and found no respiratoryrate difference between the 2 groups, which contradicts our results. A possible explanation may be that they used a lower helium concentration than we did, and an open breathing system that entrained room air.…”

Section: Discussioncontrasting

confidence: 95%

“…Our findings are similar to those of Henderson et al, 15 who found no difference in FEV 1 or PEF in asthma patients after helioxdriven bronchodilator, in comparison with oxygen. Similar results were reported by Rose et al 16 in patients with asthma in the emergency department.…”

Section: Discussionsupporting

confidence: 91%

“…asthma patients divided into heliox-driven and oxygendriven nebulization (of albuterol) groups. With helioxdriven nebulization Rose et al 16 found better modified Borg dyspnea score improvement after 2 hours, and a more lasting effect. We found no significant differences in Borg dyspnea score at any point.…”

Section: Discussionmentioning

confidence: 96%

“…18 The modified Borg dyspnea scale is applied while the patient is experiencing symptoms. 19 Only one previous study 16 has employed the Borg dyspnea scale in acute- Fig. 3.…”

Section: Discussionmentioning

confidence: 99%

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Heliox and Forward-Leaning Posture Improve the Efficacy of Nebulized Bronchodilator in Acute Asthma: A Randomized Trial

et al. 2011

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BACKGROUND: Heliox and forward-leaning posture (torso inclined forward at 50 -60°with the elbows resting on the thighs) are adjuncts in the administration of nebulized bronchodilator to patients with acute asthma. METHODS: We randomized 59 patients who presented to the emergency department in severe asthma crisis, into 4 treatment groups: nebulized bronchodilator ؉ oxygen; nebulized bronchodilator ؉ oxygen ؉ forward-leaning posture; nebulized bronchodilator ؉ heliox; and nebulized bronchodilator ؉ heliox ؉ forward-leaning posture. Before and after the bronchodilator treatments the subjects were seated with torso erect, breathing room air. Each subject received 2 doses, 20 min apart, of nebulized fenoterol (2.5 mg) plus ipratropium bromide (0.25 mg) in 3 mL of 0.9% saline, delivered with a semi-closed valved aerosol reservoir. The nebulizer was run with oxygen or 80:20 heliox. The post-treatment pulmonary function tests were performed 15 min after the second nebulization. The group's mean age was 35.1 ؎ 13.6 y, and there were 20 men and 39 women. RESULTS: The oxygen ؉ forward-leaning-posture group had a greater FEV 1 improvement than the oxygen group (59% vs 38%, P ‫؍‬ .02). The heliox ؉ forwardleaning-posture group had a greater FEV 1 improvement than the oxygen group (103% vs 38%, P ‫؍‬ .001) and the heliox group (103% vs 42%, P ‫؍‬ .03). The heliox group had greater reduction in respiratory rate than the oxygen group (P ‫؍‬ .03). The heliox ؉ forward-leaning-posture group had significantly greater peak expiratory flow improvement than any of the other groups. CON-CLUSIONS: Heliox plus forward-leaning posture during bronchodilator nebulization improves bronchodilator efficacy in patients with severe acute asthma. (ClinicalTrials.gov registration NCT00922350).

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 96%

“…18 The modified Borg dyspnea scale is applied while the patient is experiencing symptoms. 19 Only one previous study 16 has employed the Borg dyspnea scale in acute- Fig. 3.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Heliox and Forward-Leaning Posture Improve the Efficacy of Nebulized Bronchodilator in Acute Asthma: A Randomized Trial

et al. 2011

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“…While some reported benefits from heliox, [3][4][5][6][7][8] others found no clinical benefits. [9][10][11][12][13] Upon analysis, it appears that the differences between these findings may be attributed to differences in research methods, patient characteristics, as well as aerosol and gas administration techniques. However, none of those studies considered the impact of the patient's posture during bronchodilator therapy.…”

Section: See the Original Study On Page 947mentioning

confidence: 99%