Imagine that someone close to you, perhaps a small child with asthma or an elderly person, suddenly becomes unable to breathe, has a seizure, and is suffocating. How scared would we be at a time like that? So, today we are talking about a special treatment that doctors can use in hospitals in such an emergency. This is called Heliox. There are times when this can be a life-saving treatment.
Simply put, what is Heliox?
Heliox is a mixture of two gases, helium and oxygen. It is used by healthcare workers, that is, doctors, to treat patients with severe breathing difficulties, especially in emergency situations. Its main function is to reduce the effort the body has to make to breathe.
Now look, the air we normally breathe is about 21% oxygen and about 78% nitrogen. Even in a hospital, oxygen is given either as pure oxygen or mixed with nitrogen. But here, helium gas has a special ability. Helium is a much lighter gas than nitrogen.
To understand this, let's take a small example. Imagine that your airway (airway) is narrowed due to a cold, asthma, or some other reason. It's like a clogged water pipe. Now, if you try to push a thick liquid, like honey, through this clogged pipe, how difficult would it be? You have to apply a lot of pressure. Nitrogen gas is a bit heavy. But if you try to push a light liquid like water through that pipe? It flows very easily. Helium gas is just as light as water. Therefore, helium helps to carry oxygen easily through the clogged and narrowed airways into the lungs.
Helium, like nitrogen, is an ``inert gas``. That means it doesn't react with other things in the body. The body only takes the oxygen from this mixture and breathes the helium back out. That means helium is just a "vehicle" that carries the oxygen to the lungs.
When is Heliox used?
The important thing is that Heliox is not a cure for a disease. Rather, it is a support that is given to keep the patient stable until other treatments (e.g., asthma medications) are effective and the patient’s condition improves. It is like giving someone a buoy when they are drowning. It helps to save their life, while waiting for the rescue team to arrive. The table below shows some of the main situations in which Heliox is used.
| Condition | A simple explanation |
|---|---|
| Severe asthma attack (Status Asthmaticus) | When the airways become very narrow in a severe asthma condition that is not controlled by normal treatments and can be life-threatening. |
| Airway Obstruction | When the airway is blocked by a tumor or something (e.g. a piece of food) getting stuck. |
| COPD (chronic obstructive pulmonary disease) exacerbation | When COPD patients have severe difficulty breathing due to a cause such as an infection. |
| ARDS (Acute Respiratory Distress Syndrome) | A condition in which the lungs become damaged due to severe infections or accidents and fill with fluid to the point where breathing is impossible. |
| Post-extubation stridor | If a breathing tube is removed, such as after surgery, and there is a wheezing sound when breathing due to swelling in the throat. |
| Decompression Sickness ("The Bends") | When deep-sea divers surface too quickly, nitrogen accumulated in their blood turns into gas bubbles. |
How is this treatment given?
There are several ways to administer Heliox therapy. The doctor will decide based on the patient's condition.
- Via a Ventilator: This method is used when the patient is unconscious and breathing is provided by a machine if they are unable to breathe on their own.
- Through a Face Mask: It is given through a special face mask that fits over the patient's nose and mouth.
- Through a nasal cannula: It is given through a small tube placed under the nose.
A doctor or respiratory therapist will vary the percentage of helium and oxygen according to the patient's needs. Common mixtures used are 70% helium/30% oxygen or 60% helium/40% oxygen.
What are the advantages and disadvantages of this?
Advantages
The biggest advantage of this is, as I mentioned before, that it reduces the effort the body has to put in to breathe. When we have difficulty breathing, our chest and abdominal muscles work very hard. This reduces that effort and gives the body a break. It also reduces the obstruction to the passage of oxygen through the narrowed airways.
Disadvantages
The biggest disadvantage or challenge is that this treatment requires special equipment and trained staff to administer. The measurements and settings of machines normally used to administer oxygen can change when administering heliox. Therefore, doctors and staff need to be fully aware of these changes.
But as a patient, you have no reason to be afraid of this. Doctors are well aware of this, and as long as this treatment is given under their supervision, the risk to the patient is very low.
This treatment is given until the patient is able to breathe well on their own or can be transferred to regular oxygen therapy. How quickly recovery occurs depends on how quickly the underlying condition (e.g., asthma) is controlled.
Take-Home Message
- Heliox is a mixture of helium and oxygen gas. It is used in hospitals for severe breathing difficulties.
- This works by helping to carry oxygen more easily through narrowed airways to the lungs, as helium gas is lighter than nitrogen.
- This is not a cure for a disease, but a temporary supportive treatment that provides relief to the patient in an emergency, such as severe asthma or airway obstruction.
- This is provided under the supervision of a doctor, by trained staff using special equipment.
- If you or someone you know is experiencing severe difficulty breathing, the best thing to do immediately is to take them to the nearest hospital's Emergency Treatment Unit (ETU), where doctors will provide the necessary treatment.
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