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24 - Asthma
from Section 5 - Respiratory Emergencies
- By Imikomobong Ibia
Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
Book:

Practical Emergency Resuscitation and Critical Care

Published online:

02 November 2023

Print publication:

23 November 2023, pp 218-225
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Summary

Asthma is a chronic inflammatory disorder of the airways characterized by increased sensitivity to irritating stimuli. Inflammatory episodes obstruct airflow due to bronchospasm, airway edema, bronchial smooth muscle contraction, and mucus plugs, leading to recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. The inflammatory episodes also lead to lung hyperinflation, increased work of breathing, and ventilation–perfusion mismatch. A hallmark of asthma is that the inflammatory episodes are reversible.

Chapter 17 - Anesthesia for thyroid and parathyroid surgery
from Section 3 - Anesthesia for head and neck surgery
- By Twain Russell, Richard M. Cooper
Edited by Basem Abdelmalak, John Doyle
Book:

Anesthesia for Otolaryngologic Surgery

Published online:

05 November 2012

Print publication:

18 October 2012, pp 163-174
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Summary

Stridor is noisy inspiration from turbulent gas flow in the upper airway. This chapter discusses the use of Heliox for temporarily treating stridor in the setting of ENT pathology. Stridor has many potential causes. It may occur as a result of foreign bodies, tumor formation, infections, subglottic stenosis, and airway edema, as well as a result of laryngomalacia, subglottic hemangioma, and vascular rings compressing the trachea. Stridor is usually diagnosed on the basis of symptoms and physical examination, with a view to revealing the underlying problem or condition. Chest and neck X-rays, CT scans, and/or MRIs may reveal structural pathology. Flexible fiberoptic bronchoscopy can also be very helpful, especially in assessing vocal cord function or in looking for signs of compression or infection. Heliox administered with a nonrebreathing face mask should be readily available in every operating room suite to assist in the treatment of stridor.

13 - Heliox in airway obstruction and mechanical ventilation
- By Hubert Trübel
Edited by Iain Mackenzie
Book:

Core Topics in Mechanical Ventilation

Published online:

14 October 2009

Print publication:

30 October 2008, pp 230-238
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Summary

Heliox, a mixture of helium and oxygen, was used by Barach in New York for the first time in the treatment of asthma and upper airway obstruction after its introduction to deep sea diving. Since then it has been used not only as a rescue medication in emergency situations for spontaneously breathing patients with airway obstruction but also as the driving gas for mechanical ventilators. The increasing interest in heliox is indicated by the rising number of publications in recent years. This chapter outlines the theoretical considerations, the application of heliox in non-intubated (e.g. with upper and lower airway obstruction) as well as in ventilated patients followed by a brief overview of potential risks and cost considerations. Future developments focus on ways to routinely apply heliox during mechanical ventilation, for example, as a commercially available add-on feature to conventional ventilators.