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Efficacy of helium — oxygen mixtures in the management of severe viral and post-intubation croup

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An appreciable number of children with viral or post-intubation croup progress to respiratory failure necessitating an artificial airway. We report seven such patients with critical airway narrowing in whom we reduced the work of breathing by deploying helium rather than air as a carrier gas for oxygen. Assessment of patients by a croup-scoring system and blood gas analysis suggests helium-oxygen mixtures to be a useful alternative to intervention with tracheostomy or tracheal intubation. The rationale and limitations of this treatment are discussed.


Un certain nombre ďenfants présentant un faux-croup ďorigine virale ou secondaire à une intubation, évoluent vers une insuffisance respiratoire nécessitant une réintubation ou une trachéostomie. Nous rapportons sept de ces cas avec atteinte grave où ľon a pu réduire le travail de la respiration avec ľemploi ďun mélange helium-oxygène au lieu ďun mélange airoxygène. Ľévolution de ces enfants évaluée au moyen de ľéchelle de Downes (Croup Score) et de gazométries, a démontré que le mélange hélium-oxygène est une mesure utile permettant souvent ďéviter une réintubation ou une trachéostomie. La justification et les limites de cette thérapie sont discutées.


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Correspondence to Peter G. Duncan.

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Duncan, P.G. Efficacy of helium — oxygen mixtures in the management of severe viral and post-intubation croup. Canad. Anaesth. Soc. J. 26, 206–212 (1979). https://doi.org/10.1007/BF03006983

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  • Tracheal Intubation
  • Patent Ductus Arteriosus
  • Croup
  • Airway Narrowing
  • Artificial Airway