Post-extubation stridor poses a significant challenge in critical care settings, often necessitating prompt intervention to prevent respiratory compromise and potential reintubation. This case report details the successful management of post-extubation stridor in a 55-year-old female patient with a complex medical history, using heliox therapy. Heliox, a gas mixture of helium and oxygen, has emerged as a novel therapeutic option in such scenarios, owing to its ability to reduce airway resistance and improve gas flow dynamics. Following the patient's elective intubation for MRI imaging, she developed hoarseness, loud breathing, and stridor upon extubation, indicative of subglottic edema and bilateral vocal cord paralysis. Despite initial treatment with conventional modalities yielding minimal improvement, heliox therapy (70%/30%) with supplemental oxygen was initiated, resulting in significant alleviation of symptoms. Subsequent maintenance therapy with corticosteroids and bronchodilators further facilitated the resolution of respiratory distress. This case underscores the pivotal role of heliox therapy as an effective adjunct in managing post-extubation stridor, offering rapid relief and potentially obviating the need for reintubation. Moreover, it highlights the importance of innovative therapeutic approaches in optimizing outcomes for patients with respiratory distress in critical care settings. However, further research is warranted to elucidate the optimal utilization criteria and long-term efficacy of heliox therapy in this context.
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http://dx.doi.org/10.7759/cureus.78740 | DOI Listing |
Cureus
February 2025
Pulmonary and Critical Care, BronxCare Health System, Bronx, USA.
Post-extubation stridor poses a significant challenge in critical care settings, often necessitating prompt intervention to prevent respiratory compromise and potential reintubation. This case report details the successful management of post-extubation stridor in a 55-year-old female patient with a complex medical history, using heliox therapy. Heliox, a gas mixture of helium and oxygen, has emerged as a novel therapeutic option in such scenarios, owing to its ability to reduce airway resistance and improve gas flow dynamics.
View Article and Find Full Text PDFCureus
February 2025
Anesthesiology, HCA Florida Westside Hospital, Plantation, USA.
Refractory status asthmaticus is an extreme form of asthma exacerbation characterized by hypoxemia, hypercarbia, and secondary respiratory failure and is considered a medical emergency. Mechanical ventilation and maximal medical therapy are often required for treatment, but they frequently fail to provide a resolution. Extracorporeal membrane oxygenation (ECMO), however, has increasingly been used as an unconventional treatment modality if all others fail.
View Article and Find Full Text PDFRespir Care
February 2025
Drs. Newth and Ross are affiliated with Keck School of Medicine University of Southern California, Los Angeles, California, USA.
In the United States and Canada, severe asthma requiring mechanical ventilation has declined over the past decade reflecting a rise in noninvasive therapies. When aggressive noninvasive therapies fail, endotracheal intubation and mechanical ventilation are lifesaving and should be planned for in advance. As speed is important, the most experienced practitioner should intubate and rapid correction of hypercarbia and respiratory acidosis should be avoided.
View Article and Find Full Text PDFRespir Care
January 2025
Dr. Rotta is affiliated with Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Duke University School of Medicine, Durham, North Carolina.
Laryngoscope Investig Otolaryngol
October 2024
Department of Otolaryngology-Head and Neck Surgery Feinberg School of Medicine, Northwestern University Chicago Illinois USA.
Objective: Heliox, a mixture of helium and oxygen, has been shown to improve laminar airflow and decrease airway resistance in children. This study aims to describe the outcomes of heliox use in children with respiratory compromise and to identify variables associated with a need for airway surgical intervention.
Methods: A retrospective cohort study of patients who received heliox between 2012 and 2022 at a tertiary care children's hospital.
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