Vibrating Mesh Nebulizer Compared With Metered-Dose Inhaler in Mechanically Ventilated Subjects

Abstract

[OR] 1.3, 95% CI 1.14-1.49, P < .001) and mortality (OR 1.12, 95% CI 1.04-1.21, P ‫؍‬ .002). Higher APACHE II scores increased the odds of mortality (OR 1.05, 95% CI 1.001-1.092, P ‫؍‬ .044). CONCLUSION: We found no association between an MDI or vibrating mesh nebulizer and our primary outcomes, days receiving ventilation, in-hospital mortality, or VAP, in mechanically ventilated subjects.

Aerosolized Amikacin as Adjunctive Therapy of Ventilator-associated Pneumonia Caused by Multidrug-resistant Gram-negative Bacteria

“…[16] Third, to optimize the drug delivery and to improve the deposition of amikacin particles in the deep lung tissue, a nebulization procedure protocol including operational specification, nebulizer type, drug formulation, and ventilator settings were optimized and standardized before the beginning of this study and carefully followed up during the study. [1718192021] We believed that these three improvements make our results to be a better evaluation of the therapeutic effects of AA on VAP caused by MDR-GNB.…”

Use of a Metered-Dose Inhaler Compared With a Vibrating Mesh Nebulizer During Mechanical Ventilation: Does It Really Matter?

“…12,17,18 Current studies to establish whether contaminated medicated aerosol devices are a contributor to the development of VAP are lacking. The study by Dubosky et al 13 suggests that there is no greater incidence of VAP and, therefore, no increase in ventilator days or mortality in a population receiving medicated aerosol via a vibrating mesh nebulizer compared with treatments delivered via a pMDI. The study by Dubosky et al 13 did not specifically report ventilatorassociated events.…”

“…vibrating mesh nebulizer, unlike other traditional smallvolume nebulizers, does not introduce additional flow into the circuit and can remain in the circuit on the dry side of the humidifier. 14 The study by Dubosky et al 13 suggests that the use of a vibrating mesh nebulizer during mechanical ventilation is an alternative to pMDI use without increasing the risk of VAP. Moreover, the vibrating mesh nebulizer in particular is designed such that its particle size is more consistent, less condensate develops within the circuit during treatments, and residual waste is negligible.…”

“…A study by Ari et al 14 suggested that the use of a vibrating mesh nebulizer during mechanical ventilation was superior to the use of traditional jet nebulizer with a 2-4-fold greater drug delivery, but there may be significant variance among certain models of vibrating mesh nebulizers affecting the overall consistency of dosing. 22 The outcome data provided by Dubosky et al 13 suggest that the vibrating mesh nebulizer should be considered a safe option for the delivery of aerosol therapy during mechanical ventilation. Future studies are needed and should be ongoing to evaluate the latest nebulizers as their use is increased.…”

“…[9][10][11][12] In this issue of RESPIRATORY CARE, Dubosky et al 13 compare the use of a pMDI with the use of a vibrating mesh nebulizer during mechanical ventilation.…”