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Heliox Redux

Jonathan E. Kass, MD, FCCP
Author and Funding Information

Affiliations: Camden, NJ
 ,  Dr. Kass is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, The Cooper Health System, University of Medicine and Dentistry of New Jersey/Robert Wood Johnson School of Medicine at Camden.

Correspondence to: Jonathan E. Kass, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Three Cooper Plaza, Suite 312, Camden, NJ 08103; e-mail: kass-jonathan@cooperhealth.edu



Chest. 2003;123(3):673-676. doi:10.1378/chest.123.3.673
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Helium is an inert, colorless gas. It was discovered by spectroscopic methods during an eclipse of the sun in India in 1868 and, thus, was named from the Greek word helios, which means sun. It was not isolated until 1895 by Sir William Ramsey, and by Nils Langlet and P.T. Cleve. Its first major uses in the first third of the 20th century were for filling airships and balloons during World War I and for divers in a mixture with oxygen. Alvan Barach1 first used it for medical purposes in 1934 and confirmed the biological inertness of helium by exposing mice to 79% helium and 21% oxygen for 2 months without deleterious effects.2 He reported the successful usage of helium-oxygen mixtures in four cases of asthma in adults and two cases of upper airway obstruction in infants.3 Of interest, the patients were relieved of their dyspnea in 6 to 10 breaths, and when the helium was removed the dyspnea came back in 3 or 4 breaths. After the explosion of the dirigible Hindenburg in 1937, Congress regulated the sale of helium, and its availability was further reduced during World War II. After the war, with the advent of pharmacologic bronchodilators with improving side-effect profiles, helium was cast aside as a treatment for asthma. It was relegated back to filling balloons at parties, where its effect on the voice, making one sound like “Donald Duck,” was its main notoriety. There were a few reports of its respiratory usage showing the lack of significant improvement in asthmatic patients4 and in patients with emphysema.5 Helium-oxygen was shown to be an effective treatment of upper airway obstruction in 1976,6 and there were scattered reports for this usage until 1986.79

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heliox ; asthma

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