Noninvasive ventilation with helium-oxygen in children

Most existing literature on noninvasive ventilation (NIV) in combination with helium-oxygen (HELIOX) mixtures focuses on its use in adults, basically for treatment of acute exacerbations of chronic obstructive pulmonary disease. This article reviews and summarizes the theoretical basis, existing clinical evidence, and practical aspects of the use of NIV with HELIOX in children. There is only a small body of literature on HELIOX in pediatric NIV but with positive results. The reported experience focuses on treatment for patients with severe acute bronchiolitis who cannot be treated with standard therapies. The inert nature of helium adds no biological risk to NIV performance. Noninvasive ventilation with HELIOX is a promising therapeutic option for children with various respiratory pathologies who do not respond to conventional treatment. Further controlled studies should be warranted.