Patients with COPD who breathe in a mixture of helium and oxygen (He-O2) may be able to fend off acute episodes of asthma, as well as symptom exacerbations in chronic obstructive pulmonary disease (COPD), say doctors, who unveiled discoveries about the potential therapy combination at a medical conference in Europe this month.1
The combination therapy works, experts contend, because the low density of helium makes the mixture easier to breathe, and allows oxygen to be widely distributed throughout the lungs. Doctors at Bel Air Hospital in Metz-Thionville, France unveiled their findings of the study that involved 203 patients at the 14th Annual Congress of the European Respiratory Society held in Scotland.
A Disease That Robs the Airways
COPD is a lung disease classified as the fourth leading cause of death in the United States. When COPD occurs, the airways become partly obstructed, making it difficult to breathe. Air sacs in the lung lose their shape and become floppy. Additionally, the walls between many of the air sacs are destroyed, the wall of the airways become thick and inflamed, and cells in the airways make more mucous than usual, which tends to cause airway obstruction.2
Smoking is one of the biggest risk factors for COPD, which is an umbrella term for emphysema and chronic bronchitis. A family history of the disease, as well as exposure to certain lung irritants like air pollution or chemical fumes, vapors and dusts in occupational environments are also linked with higher risk of the disease. There is no cure for COPD. Current treatments like bronchodilators, corticosteroids, or oxygen therapy can only ease symptoms, and possibly slow disease progression.2
Idiopathic pulmonary fibrosis and COPD (emphysema or bronchitis) have distinct characteristics, but can often occur simultaneously in some patients.3,4 Pulmonary hypertension is also a common complication in patients with COPD.5
Comparing Two Gaseous Therapies
In the 2-year study, patients with asthma attacks were given bronchodilator therapy every 20 minutes for 1 hour. Half of them were given oxygen to inhale, and the rest received the helium-oxygen mixture (65% helium and 35% oxygen) during the same period of time.
After 60 minutes, the asthma clinical score was the same for those who breathed oxygen alone compared to the helium-oxygen mixture. But the rate of peak expiratory flow—the maximum airflow measured during forced exhalation—was actually higher in those taking the combination therapy. The latter group also managed to function better; only 8 percent of patients in that group needed to stay in the ICU for more than 4 days compared to 20 percent in the group receiving oxygen therapy only, reported Phillippe Sattonnet, MD, and his fellow investigators. The findings mean that the helium-oxygen combination should be considered as first-line treatment for those with acute asthma, the research team pointed out.
Does Helium-Oxygen Work in COPD?
In a separate but similar study,1 doctors at Royal Hallamshire Hospital in Sheffield, England assessed the benefit of the helium-oxygen therapy in patients diagnosed with chronic obstructive pulmonary disease (COPD).
Eighty-two patients in that analysis were given four different therapeutic gases in random order: air with 21% oxygen, air with a slightly enriched oxygen content of 28%, and two helium-oxygen mixtures—heliox 21 and heliox 28—in which the nitrogen content of the first two gases was replaced with helium while oxygen proportion remained at 21% and 28%, respectively.
While heliox 21 therapy similarly improved the distance that COPD patients were able to walk within a certain time period, as well as breathlessness after exertion, as heliox 28, the latter treatment was found to be significantly more effective, wrote Liz Laude, MD, and her colleagues. Patients using heliox 28 were able to walk nearly two-thirds farther compared to the distance they covered prior to using therapy. And even though walking distance was farther in the group receiving heliox 28, blood oxygen concentration was also improved, Laude explained.
1. 14th Annual Congress of the European Respiratory Society. 2004 Sep 4-8. Glasgow, Scotland.
2. National Heart, Lung and Blood Institute. National Institutes of Health (NIH).
3. Hiwatari N, Shimura S, Takishima T. Pulmonary emphysema followed by pulmonary fibrosis of undetermined cause. Respiration 1993;60(6):354-8.
4. Du M, Wang C, Cao D, Weng X, Wu X, Liu Y. A pathological study on pulmonary fibrosis caused by chronic obstructive pulmonary disease [in Chinese]. Zhonghua Jie He He Hu Xi Za Zhi 1999 Jan;22(1):30-2.
5. Barbera JA, Peinado, VI, Santos S. Pulmonary hypertension in COPD: old and new concepts. Monaldi Arch Chest Dis 2000 Dec;55(6):445-9.
John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include coverage of health news for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.
