Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients

Moustafa, Islam O.F.; Ali, Mohammed R A; Hallag, Moataz Al; Rabea, Hoda; Fink, James B.; Dailey, P. A.; Abdelrahim, Mohamed

doi:10.1016/j.hrtlng.2017.08.004

Cited by 51 publications

(44 citation statements)

References 33 publications

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“…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: 77%

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

Abdelrahim

2018

Pulm Ther

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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.

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Section: Effect Of Fill Volume and Humidity On Aerosol Deliverysupporting

confidence: 77%

“…1 [13, 17], but when using a dual-limb ventilation circuit, it is better to place the aerosol generator in the inspiratory limb, as shown in Fig. 2 [24,30] for better aerosol delivery.…”

Section: Introductionmentioning

confidence: 99%

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

Abdelrahim

2018

Pulm Ther

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“…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.…”

Section: Study Protocolmentioning

confidence: 99%

“…37 The urine sample volumes were measured, and aliquots were retained for salbutamol content solid-phase extraction with an Oasis MCX 60 mg, 10 mL XL cartridge (Waters Corporation, Milford, Massachusetts) with the application of a low vacuum (Ͻ3 bars) through a VAC-ELUT 10 manifold (Varian, PaloAlto,California)extractionstation. 36 Thesalbutamolamount in each extract was determined by using high-performance liquid chromatography, described in the High-Performance Liqud Chromatography Analysis.…”

Section: Study Protocolmentioning

confidence: 99%

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

et al. 2018

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The T-piece and large spacer were equally efficient for salbutamol delivery from the mesh nebulizer in patients with COPD and on single-limb noninvasive ventilation. Adding a preliminary bronchodilator dose by pMDI prenebulization showed a trend toward greater pulmonary bioavailability of nebulized salbutamol and may be worth considering to maximize delivery of salbutamol to patients who are severely ill.

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Methods of Detecting Aerosol Delivery to the Lung

Abdelrahim

Saeed

Harb

et al. 2021

Essentials of Aerosol Therapy in Critically Ill Patients

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Lung deposition and systemic bioavailability of different aerosol devices with and without humidification in mechanically ventilated patients

Cited by 51 publications

References 33 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

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

Methods of Detecting Aerosol Delivery to the Lung

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