Safety and efficacy of heliox as a treatment for upper airway obstruction due to radiation-induced laryngeal dysfunction

The mixture of helium and oxygen, called heliox, has been successfully used in the management of different respiratory diseases since 1935. Despite several reports on its usefulness, it is not widely available in acute care facilities and it remains somewhat controversial. In this article we present the case of a 69-year-old woman in whom bilateral vocal cord paralysis developed after radiation therapy and in whom heliox was successfully used to manage her upper airway obstruction. Although heliox offers an additional tool in the treatment of various airway and pulmonary problems, it can be used only as a temporizing agent to allow time for appropriate therapy of the underlying process. Given its beneficial physiologic and clinical effects, it seems that further studies are warranted to define a clear and concise protocol for its use in the emergency setting.