Clinical outcome associated with the use of different inhalation method with and without humidification in asthmatic mechanically ventilated patients

Effects of Fill Volume and Humidification on Aerosol Delivery During Single-Limb Noninvasive Ventilation

“…All of the previous in vitro studies ignored the humidity of the air exhaled by the patient and the humidity of the ventilation circuit itself, which has been shown to persist for 30 min after turning off the humidifier. 46 Based on our findings, we do not recommend interrupting humidification during aerosol delivery, especially after 2 reports found no significant effect on subjects' clinical status 22 and aerosol delivery 21 with changing humidity during aerosol administration to invasively ventilated subjects.…”

“…Although the humidity change results were far different from most of the previously published in vitro studies, which recommend switching off the humidifier when delivering aerosol to ventilated patients, 9,19,20,[42][43][44][45] the results were very close to our previous findings of the effects of humidity change on aerosol delivery in auto-CPAP ventilated subjects 16 and invasively ventilated subjects. 21,22 This finding shows that there is no need to discomfort the patient by switching off the humidifier for aerosol delivery because the dry gas could potentially be harmful to the lung and the increase in delivered aerosol was insignificant. In our study, the nebulizer was placed near the subject's mask in the single-limb ventilation circuit, similar to that of the auto-CPAP study and our in vitro study.…”

“…9,19,20,45 However, our studies on dual-limb ventilated subjects also showed an insignificant difference between humidified and non-humidified aerosol delivery. 21,22 This suggests that delivering aerosol during ventilation is not affected by the humidifier being on or off. All of the previous in vitro studies ignored the humidity of the air exhaled by the patient and the humidity of the ventilation circuit itself, which has been shown to persist for 30 min after turning off the humidifier.…”

“…9,19,20 However, we have shown that there was no significant effect on delivered aerosol associated with this practice during auto-CPAP or duallimb ventilation. 16,21,22 In addition, turning off the humidifier and delivering dry gas may be harmful to the lungs, so it is imperative that the humidifier be turned on again after aerosol delivery is complete. 4,23 Additionally, no studies were found regarding the recommended fill volume of the respiratory solutions placed in the nebulizer medication reservoir.…”

Performance of Large Spacer Versus Nebulizer T-Piece in Single-Limb Noninvasive Ventilation

“…The choice of inhaled salbutamol dosage was in accordance with previous literature. 16,18,[24][25][26][27][28][29][30][31][32][33][34][35][36] As recommended previously in studies that used single-limb NIV, 10,30 the nebulizers were placed proximal to the subject and distal to the fixed expiratory valve, as shown in Figure 1.…”