Helium/oxygen-driven albuterol nebulization in the management of children with status asthmaticus: A randomized, placebo-controlled trial

摘要

Objectives: We investigated the effect of heliox-powered albuterol therapy on hospital length of stay and clinical status in children with moderate to severe status asthmaticus.Design: Prospective, randomized, placebo-controlled trial.Setting: Twenty-five-bed pediatric intensive care unit at an academic children's medical center.Patients: Forty-two children (2-21 yrs of age) with moderate to severe status asthmaticus.Interventions: Patients were randomized to receive either heliox-powered nebulized albuterol or air/oxygen-powered nebulized albuterol (placebo) until they were transitioned to albuterol delivered by a metered dose inhaler.Measurements and Main Results: Clinical asthma scores were recorded on enrollment and every 4 hrs thereafter. Patients in the heliox group (n = 22) and the control group (n = 20) had similar ages (mean +- sem: 88 +- 9.9 vs. 98 +- 11.1 months, respectively; p = .51), time to study enrollment (618 +- 70.4 vs. 597 +- 84.1 mins, respectively; p = .72), and clinical asthma scores at study entry (5.9 +- 0.2 vs. 5.7 +- 0.3, respectively; p = .72). There were no significant differences between groups in time to eligibility to hospital discharge (66.2 +- 8.7 vs. 63.4 +- 8.6 hrs, respectively; p = .61), time to clinical asthma score <3 (22 +- 2.8 vs. 21.2 +-5.3 hrs, respectively; p = .27), or time to eligibility for intensive care unit discharge (34.4 +- 6.8 vs. 33.3 +- 8.2 hrs, respectively; p = .64). There were no significant differences in adverse events between groups.Conclusions: Despite the previously demonstrated effects of heliox on improved aerosol particle delivery into the distal airways, heliox-powered nebulized albuterol therapy for children admitted to the hospital with moderate to severe status asthmati-cus does not shorten hospital length of stay or hasten rates of clinical improvement when compared with air/oxygen-powered nebulized albuterol.