Intended Audience 

This activity is intended for emergency department clinicians, pulmonologists, respiratory therapists, registered nurses, and other health care professionals involved in the treatment of acute respiratory distress conditions.

Statement of Need

Chronic obstructive pulmonary disease (COPD), asthma, severe airway obstruction, and bronchiolitis are conditions that are increasing worldwide and the frequent cause of admission to emergency departments. Epidemic during winter months, these diseases affect infants, children with diseased lungs, asthmatic patients, and the elderly population. Outpatient visits by children younger than the age of 2 years in the United States are estimated to number in the millions over the last decade. COPD is the fourth leading cause of death in the United States, with 24 million adults showing evidence of impaired lung function. Educating physicians about the management of these diseases is important to the overall treatment of the patient.

Pharmacologic agents, such as bronchodilators, have been demonstrated to improve airway function and reduce airway obstruction, lowering the probability of hospital admission. Noninvasive ventilatory support has resulted in a decrease in the average length of hospital stays. Novel gas mixtures, such as low-density helium and oxygen mixtures, have proved to be an effective delivery method for aerosolized drugs. By preserving laminar airflow and reducing turbulent airflow, low-density gas mixtures provide more effective aerosolized drug delivery and yet often are overlooked as a first line of defense against acute asthma exacerbations. Although helium treatment has been available since 1934, the use of helium and oxygen mixtures in the treatment of asthma was recently developed. Low-density gas mixtures enhance clinical respiratory status and are proven to be a safe, effective, noninvasive, simple delivery method for nebulized albuterol.

This CE/CME-certified activity will highlight the importance of reducing respiratory distress in patients in an emergency department setting, the use of helium and oxygen mixtures for aerosolized drug delivery, and increasing laminar airflow while decreasing turbulent airflow.

Learning Objectives

At the conclusion of this activity, clinicians should be better able to:

• Recognize the use of adjunctive therapies in the management of acute
   respiratory disorders

• Explain how therapeutic gas mixtures improve laminar airflow in mechanical
   ventilation and medication delivery

• Determine the benefits of low-density gas to reduce the work of breathing for
  patients with acute asthma

• Manage acute exacerbations of asthma and COPD through innovative gas
  delivery techniques


Michael R. Pinsky, MD, Dr hc
Department of Critical Care Medicine
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania


   2 min


Welcome and Introduction

42 min

Scientific Presentation

12 min

Q&A Session

   1 min

Closing Comments

Accreditation and Certification

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Annenberg Center for Health Sciences at Eisenhower and CogniMed Inc. The Annenberg Center is accredited by the ACCME to provide continuing medical education for physicians.

The Annenberg Center designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The Annenberg Center for Health Sciences is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

A maximum of 1 contact hour may be earned for successful completion of this activity.

This program is approved for 1.0 hour of Continuing Respiratory Care Education (CRCE) credit through the American Association of Respiratory Care.

Physician and nurse continuing education credit cannot be granted for this Web archive if you participated in the live Web conference version of this activity. CRCE credit is available for all participants.

There is no charge for this activity. Statements of Credit will be mailed 4 to 6 weeks following activity participation and upon completion and electronic submission of the evaluation form to CogniMed Inc.

Disclosure Declaration

It is the policy of the Annenberg Center to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All faculty and planners participating in sponsored programs are expected to identify and reference off-label product use and disclose any significant relationship with those supporting the activity or any others whose products or services are discussed.

In accordance with the Accreditation Council for Continuing Medical Education Standards, parallel documents from other accrediting bodies, and Annenberg Center policy, the following disclosures have been made:


Michael R. Pinsky, MD, Dr hc, is a consultant for Praxair, Inc.

The faculty for this activity has disclosed that there will be discussion about the use of products for non–FDA-approved indications.

The ideas and opinions presented in this educational activity are those of the faculty and do not necessarily reflect the views of the Annenberg Center and/or its agents. As in all educational activities, we encourage the practitioners to use their own judgment in treating and addressing the needs of each individual patient, taking into account that patient’s unique clinical situation. The Annenberg Center disclaims all liability and cannot be held responsible for any problems that may arise from participating in this activity or following treatment recommendations presented.

This activity is supported by an independent educational grant provided by      

This activity is an enduring material and consists of a Web posting. Successful completion is achieved by viewing the material, reflecting on its implications in your practice, and completing the assessment component.

The estimated time to complete the activity is 1 hour.

This activity was originally released June 6, 2008, and is eligible for credit through June 6, 2009.