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

Saeed, Haitham; Mohsen, Marwa; Eldin, Abeer Salah; Elberry, Ahmed A.; Hussein, Raghda R. S.; Rabea, Hoda; Abdelrahim, Mohamed

doi:10.4187/respcare.06022

Cited by 46 publications

(40 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4 [25]. We verified our finding by studies using automatic continuous positive airway pressure (auto-CPAP) [26] and non-invasive single-limb [31,32] and invasive dual-limb [30] ventilations and still found no significance between delivering aerosol in humid or dry circuits. Furthermore, we found no significant effect of switching off or on the humidifier on the clinical status of ventilated patients [24].…”

Section: Effect Of Fill Volume and Humidity On Aerosol Deliverysupporting

confidence: 78%

“…An example of the need of such important guidelines is our last finding regarding the effect of fill volume of respiratory solution, placed in the nebulizer reservoir chamber, on delivered aerosol [25,31,32].…”

Section: Effect Of Fill Volume and Humidity On Aerosol Deliverymentioning

confidence: 99%

“…3. It even increased the nebulization time with no significant benefit [25,31,32]. So increasing the fill volume with saline is not beneficial for all types of nebulizers.…”

Section: Effect Of Fill Volume and Humidity On Aerosol Deliverymentioning

confidence: 99%

See 2 more Smart Citations

Aerosol Delivery to a Critically Ill Patient: A Big Issue Easily Solved by Developing Guidelines

Abdelrahim

2018

Pulm Ther

View full text Add to dashboard Cite

Nowadays, therapeutic aerosols are commonly delivered to mechanically ventilated patients by nebulizers and pressurized metered dose inhaler attached to an adapter or a spacer. Studies with asthmatics and chronic obstructive pulmonary disease patients have confirmed that aerosol delivery during mechanical ventilation is feasible. They have also reported that the inhaled drugs administered during mechanical ventilation provide greater and faster clinical outcomes than when delivering during spontaneous unassisted breathing. Researchers studied factors that would affect aerosol delivery during mechanical ventilation. Even with the tremendous amount of publications in this area, there have still been no recommendations or guidelines released to help respiratory therapists in their decision as to when to deliver aerosol to ventilated patients. Mostly, respiratory therapists read the literature and decide accordingly what to do and which device to use for their patients. This puts the patients at risk of receiving a sub-therapeutic or toxic dose of the inhaled aerosol. Some studies raise an alarm of physician decision upon reading any released publication related to aerosol delivery in mechanical ventilation without a trusted recommendation and guidelines. This increases the need for the development of recommendations and guidelines, by a trusted board or society, for aerosol delivery to such critically ill patients. To summarize, inhaled drugs administered to critically ill patients is of benefit compared to taking the patient off the ventilator and delivering during spontaneous unassisted breathing. However, dependable guidelines are needed to optimize aerosol delivery.

show abstract

Section: Effect Of Fill Volume and Humidity On Aerosol Deliverysupporting

confidence: 78%

Section: Effect Of Fill Volume and Humidity On Aerosol Deliverymentioning

confidence: 99%

See 1 more Smart Citation

Aerosol Delivery to a Critically Ill Patient: A Big Issue Easily Solved by Developing Guidelines

Abdelrahim

2018

Pulm Ther

View full text Add to dashboard Cite

show abstract

“…Aerosol producing devices that could be used during mechanical ventilation are nebulisers and pressurised metreddose inhaler (pMDI) but should be used with caution to avoid the infection of the surrounding personals by fugitive aerosol. 87 Several factors that could control the aerosol delivery during mechanical ventilation are summarised in Table 2 with recommended settings. 42,88,89 5.4 | Symptomatic treatment…”

Section: Aerosol Therapy During Mechanical Ventilationmentioning

confidence: 99%

COVID‐19; current situation and recommended interventions

Saeed

Osama

Madney

et al. 2021

Int. J. Clin. Pract.

Self Cite

View full text Add to dashboard Cite

Background The new coronavirus (SARS‐COV‐2) that emerged at the end of 2019 was stated in China and infected millions of people around the world, with the highest spread rate amongst humans compared with other coronaviruses. This paper aimed to review and analyse the published studies about COVID‐19 diagnosis, prevention, and treatment. Method The reviewed studies were clinical trials, in‐vivo, in‐vitro, guidelines, reports from the world health organization (WHO), and the centre for disease control and prevention (CDC) in addition to systemic reviews. All data extracted and analysed to stand on the latest updates and recommendations for fighting this severe attack of COVID‐19. Results Most important antiviral therapy of COVID‐19 clinical trials is still running without clear results, but a few trials have indicated the role of numerous drugs in the treatment of COVID‐19. Specific recommendations for aerosol therapy should be followed for the management of COVID‐19. Conclusion Nature of COVID‐19 is still not very clear, however, management of the condition is similar to the previous attacks of coronaviruses.

show abstract

“…However, many previous studies have reported that a vibrating mesh nebulizer without oxygen is more effective than a jet nebulizer. 1,[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Given that the manufacturer's maximum recommended flow is 6 L/min and the tested flow was 2 L/min, there is disagreement about the real effect of the introduction of oxygen to the holding chamber. In addition, no previous study has compared the use of a vibrating mesh nebulizer with a holding chamber with and without oxygen.…”

Section: Introductionmentioning

confidence: 99%

Effect of Oxygen Flow on Aerosol Delivery From a Nebulizer With a Holding Chamber

et al. 2019

Self Cite

View full text Add to dashboard Cite

BACKGROUND: A new holding chamber was designed to be used with a vibrating mesh nebulizer to increase the total inhalable dose for patients. It facilitates intermittent and continuous nebulization as well as the optional supply of supplemental oxygen via a T-piece with a mouthpiece adapter. This study aimed to evaluate the effect of oxygen introduction in the new holding chamber on aerosol delivery using a vibrating mesh nebulizer. METHODS: The study was divided into 2 parts. First, the total inhalable dose of 1 mL of a respirable solution (nominal dose of 5,000 gsalbutamol) was determined using a breathing simulator set to provide a tidal volume of 500 mL, a breathing frequency of 15 breaths/min, and an inspiratory:expiratory ratio of 1:1 for adults as a quiet-breathing pattern. Three experimental nebulizer setups were used: a vibrating mesh nebulizer with the holding chamber and oxygen set at 6 L/min, a vibrating mesh nebulizer with the holding chamber and no oxygen, and a vibrating mesh nebulizer with the T-piece. Aerodynamic particle size characterizations were determined using cooled Andersen cascade impaction at an inhalation flow of 15 L/min. Second, we performed an in vivo study involving 12 healthy nonsmoking subjects (6 female) who were > 18 y old with an average FEV 1 > 90% of predicted. Using normal tidal breathing, subjects inhaled 1 mL of nebulized salbutamol (5,000 g) through the vibrating mesh nebulizer with the holding chamber with and without oxygen and through the vibrating mesh nebulizer with a T-piece. To analyze salbutamol content, urine samples were obtained 30 min after dosing as an index of lung deposition, and their urine was cumulatively collected for 24 h as an index of systemic absorption. RESULTS: The holding chamber significantly increased the total inhalable dose or amount of salbutamol excreted in the first 30 min, as well as the amount of salbutamol excreted over a 24-h period compared to the dose received with the vibrating mesh nebulizer with a T-piece (P ‫؍‬ .005, P ‫؍‬ .034, and P ‫؍‬ .02, respectively), and relatively decreased the mass median aerodynamic diameter, although the difference was not significant. However, when oxygen was introduced in the holding chamber, the total inhalable dose, or amount of salbutamol excreted in the first 30 min, significantly decreased compared to use without oxygen (P ‫؍‬ .003, P ‫؍‬ .03 respectively). No significant difference was found between the vibrating mesh nebulizer with the holding chamber with oxygen and the vibrating mesh nebulizer with a T-piece. CONCLUSIONS: The vibrating mesh nebulizer with a holding chamber and without oxygen resulted in much better aerosol delivery compared to vibrating mesh nebulizer with a holding chamber and with oxygen delivery and to the vibrating mesh nebulizer with a T-piece. The use of oxygen with the holding chamber significantly decreased aerosol delivery and its benefit, and recommended flow should be reevaluated.

show abstract

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

Cited by 46 publications

References 45 publications

Aerosol Delivery to a Critically Ill Patient: A Big Issue Easily Solved by Developing Guidelines

Aerosol Delivery to a Critically Ill Patient: A Big Issue Easily Solved by Developing Guidelines

COVID‐19; current situation and recommended interventions

Effect of Oxygen Flow on Aerosol Delivery From a Nebulizer With a Holding Chamber

Contact Info

Product

Resources

About