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February 1988

Perioperative Management of Large Airway Obstruction With Helium-Oxygen Inhalation

Arch Otolaryngol Head Neck Surg. 1988;114(2):119. doi:10.1001/archotol.1988.01860140017004

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John A. Ruth, Jr, MD, and collaborators, Johns Hopkins University (Baltimore), recently reported their experience with helium-oxygen ventilation of 33 patients with respiratory distress. Their report, presented at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery, Chicago, emphasized the theoretic advantages of an 80% helium and 20% oxygen (or 70% helium and 30% oxygen) mixture compared with air or other commonly used gas mixtures. The former has less than a third of the density of air, resulting in less turbulent and laminar flow around partial airway obstructions. This mixture also has a high thermal diffusivity and is less supportive of combustion when utilized with the laser. In the series of patients these authors describe (mean age, 31 years), a helium-oxygen mixture was associated with decreased stridor and respiratory effort, as well as a stable or improved arterial oxygen saturation. Applications for helium-oxygen mixtures include partial obstruction

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