In which of the following forms of asthma is heliox likely to be ...

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In which of the following forms of asthma is heliox likely to be most beneficial?
 
  A. intermittent asthma
  B. mild persistent asthma
  C. moderate persistent asthma
  D. severe persistent asthma

Question 2

Which of the following lung pathologies may demonstrate at least a modest degree of improvement from the use of heliox? I. croup II. bronchiolitis III. COPD IV. pulmonary edema
 
  A. I, II only
  B. II, III only
  C. I, II, III only
  D. I, III, IV only

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Answer to Question 1

ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: The evidence for the use of heliox in patients with asthma is conflicting. First line therapy with heliox is not warranted. Heliox appears to benefit patients with the most severe exacerbations and airflow obstruction. Early use of heliox may decrease the work of breathing and dyspnea, improve gas exchange, and prevent intubation in some patients.

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Studies have demonstrated that children with severe croup treated with heliox experience a significant decrease in croup score and improvement in gas exchange. Other studies have shown a decrease in respiratory distress with the use of heliox. Heliox seems to decrease the work of breathing and improve gas exchange in nonintubated infants who have bronchiolitis. However, it may not confer benefit in those who are intubated.
The evidence for the use of heliox in patients with COPD exacerbation is not robust or mature. Most of the peer-reviewed literature consists of case reports, case series, and physiologic studies in small samples of carefully selected patients. Some patients with COPD exacerbation have a favorable physiologic response to heliox therapy, whereas others do not. Determining who as a COPD patient will be a responder and who will not is difficult.
D. Incorrect response: See explanation C.