Peer Reviewed| Volume 23, ISSUE 2, P33-35, March 2004

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The application of heliox in the management of croup by an air ambulance service

      Croup is an acute upper respiratory syndrome, typically viral in origin, that usually is seen in children. A subset of the condition named “spasmodic (recurrent) croup” may be an allergic reaction to viral antigens. In either case, the pathology is the same, and the clinical presentations are similar. Croup is characterized by hoarseness, a barky cough, inspiratory stridor, and varying degrees of respiratory distress.
      • Brown JC
      The management of croup.
      Clinical manifestations are a direct result of the inflammation, edema, and consequent narrowing of the tracheal walls, particularly in the subglottic area where the pediatric upper airway is the narrowest. This condition is in effect a fixed airway obstruction.
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        • Brown JC
        The management of croup.
        Br Med Bull. 2002; 61: 189-202
        • Beckman KR
        • Brueggemann WM
        Heliox treatment of severe croup.
        Am J Emerg Med. 2000; 18: 735-736
        • Weber JE
        • Chudnofsky CR
        • Younger JG
        • Larkin GL
        • Boczar M
        • Wilkerson MD
        A randomized comparison of helium-oxygen mixture (heliox) and racemic epinephrine for the treatment of moderate to severe croup.
        Pediatrics. 2001; 107 (Available at:
        • Terregino CA
        • Nairn SJ
        • Chansky ME
        • Kass JE
        The effect of heliox on croup: a pilot study.
        Acad Emerg Med. 1998; 5: 1130-1133
        • Ho AM.-H
        • Lee A
        • Karmakar MK
        • Dion PW
        • Chung DC
        • Contardi LH
        Heliox versus air-oxygen mixtures for the treatment of patients with acute asthma.
        Chest. 2003; 123: 882-890
        • Kass JE
        Heliox redux.
        Chest. 2003; 123: 673-675
        • Manthous CA
        Heliox for status asthmaticus?.
        Chest. 2003; 123: 676-677
        • Rosekrans JA
        Viral croup: current diagnosis and treatment.
        Mayo Clin Proc. 1998; 73: 1102-1107
        • Phillips SC
        Croup (laryngotracheobronchitis).
        in: Schwartz MW The 5 minute pediatric consult. 2nd ed. Williams, & Wilkins, Philadelphia: Lippincott2000: 292-293
        • Garyfallou GT
        • Costalas SK
        • Murphy CJ
        Acute pulmonary edema in a child with spasmodic croup.
        Am J Emerg Med. 1997; 15: 211-213
        • Lang SA
        • Duncan PG
        • Shephard DAE
        • Ha HC
        Pulmonary edema associated with airway obstruction.
        Can J Anaesth. 1990; 37: 210-218
        • Hurley RM
        • Kearns JR
        Pulmonary edema and croup.
        Pediatrics. 1980; 65: 860
        • Duncan PG
        Efficacy of helium-oxygen mixtures in the management of severe viral and postextubation croup.
        Can Anaesth Soc J. 1979; 26: 206-212
        • Nelson DS
        • McClellan L
        Helium-oxygen mixtures as adjunctive support for refractory viral croup.
        Ohio State Med J. 1982; 10: 729-730