Helium-oxygen versus air-oxygen noninvasive pressure support in decompensated chronic obstructive disease: A prospective, multicenter study

Crit Care Med. 2003 Mar;31(3):878-84. doi: 10.1097/01.CCM.0000055369.37620.EE.


Objective: To study whether noninvasive pressure support ventilation (NIPSV) with helium/oxygen (He/oxygen), which can reduce dyspnea, PaCO2, and work of breathing more than NIPSV with air/oxygen in decompensated chronic obstructive pulmonary disease, could have beneficial consequences on outcome and hospitalization costs.

Design: Prospective, randomized, multicenter study.

Setting: Intensive care units of three tertiary care university hospitals.

Patients: All patients with chronic obstructive pulmonary disease admitted to the intensive care units for NIPSV during a 24-month period.

Interventions: Patients were randomized to NIPSV with air/oxygen or He/oxygen. NIPSV settings, number of daily trials, decision to intubate, and intensive care unit and hospital discharge criteria followed standard practice guidelines.

Results: A total of 123 patients (male/female ratio, 71:52; age, 71 +/- 10 yrs, Acute Physiology and Chronic Health Evaluation II, 17 +/- 4) were included. Intubation rate (air/oxygen 20% vs. He/oxygen 13%) and length of stay in the intensive care unit (air/oxygen 6.2 +/- 5.6 vs. He/oxygen 5.1 +/- 4 days) were comparable. The post-intensive care unit hospital stay was lower with He/oxygen (air/oxygen 19 +/- 12 vs. He/oxygen 13 +/- 6 days, p < .002). Cost of NIPSV gases was higher with He/oxygen, but total hospitalization costs were lower by $3,348 per patient with He/oxygen. No complications were associated with the use of He/oxygen.

Conclusion: He/oxygen did not significantly reduce intubation rate or intensive care unit stay, but hospital stay was shorter and total costs were lower. He/oxygen NIPSV can be safely administered and could prove to be a cost-effective strategy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Gas Analysis
  • Cost-Benefit Analysis
  • Dyspnea / etiology
  • Female
  • Helium / economics
  • Helium / therapeutic use*
  • Hospital Costs / statistics & numerical data
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Intubation, Intratracheal / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Oxygen / economics
  • Oxygen / therapeutic use*
  • Oxygen Inhalation Therapy / economics
  • Oxygen Inhalation Therapy / methods*
  • Positive-Pressure Respiration / economics
  • Positive-Pressure Respiration / methods*
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / mortality
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Safety
  • Switzerland / epidemiology
  • Treatment Outcome
  • Work of Breathing


  • Helium
  • heliox
  • Oxygen