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Heliox is a medical gas mixture composed of helium and oxygen, typically in ratios such as 79:21, 80:20, or 70:30. Its therapeutic utility stems from the physical properties of helium, which is significantly less dense than nitrogen. By replacing nitrogen in the inspired gas, heliox reduces gas density, thereby decreasing airway resistance and promoting laminar flow over turbulent flow in narrowed bronchi. This reduction in the work of breathing makes it an effective adjunctive therapy for patients with severe airflow obstruction, including acute exacerbations of asthma and chronic obstructive pulmonary disease (COPD). It is also used to improve exercise tolerance in COPD patients by reducing dynamic lung hyperinflation and accelerating heart rate kinetics. Additionally, heliox is employed as a rescue therapy in pediatric critical care for status asthmaticus and as a temporizing measure for upper airway obstructions such as post-extubation stridor and vocal cord dysfunction.
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