Year in Review 2014: Aerosol Delivery Devices

Myers, Timothy R

doi:10.4187/respcare.04224

Cited by 7 publications

(3 citation statements)

References 31 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Asthma, a highly prevalent chronic inflammatory disease of the airways, is characterized by a variable degree of airflow obstruction (D’Agostino et al, 2010) and bronchial hyperresponsiveness (Locksley, 2010; Roviezzo et al, 2016), caused by chronic exposition to allergens (Hamid and Tulic, 2009; Spaziano et al, 2015) or associated to other diseases such as gastroesophageal reflux (Gallelli et al, 2017; Rouget et al, 2004; D’Agostino et al, 2005). Chronic airway inflammation substantially contributes to airflow limitation, respiratory symptoms, and disease chronicity (Myers, 2015). Crucial players in the development of chronic airway inflammation in asthma are airway structural cells and immune cells infiltrating the lung (T cells and eosinophils) (Chaplin 2002; Singh et al, 2016), which are pivotal sources of inflammatory mediators such as leukotrienes (LT) (Filosa et al, 2015; Bruno et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Montelukast Improves Symptoms and Lung Function in Asthmatic Women Compared With Men

et al. 2019

View full text Add to dashboard Cite

Purpose: Gender differences exist in the prevalence of asthma and allergic diseases, partially due to the effects of sex hormones on the development of allergic manifestations. Women, compared with men, are more prone to suffer allergic asthma, experience difficulties in controlling asthma symptoms, and show adverse responses to drugs. However, there are knowledge gaps on the effectiveness of anti-leukotrienes drugs on lung function, symptoms, and pulmonary and systemic inflammation in adult asthmatic women compared with men. We conducted a prospective cohort study to characterize the effectiveness of an anti-leukotrienes drug, montelukast (MS), in asthmatic adult women and men. Methods: Twenty-one asthmatic subjects (11 women and 10 men), who were on low-dose inhaled corticosteroids (ICS), were treated with MS. The optimal control of the symptoms was achieved in both groups according to the Global Initiative for Asthma guidelines. At enrollment, and after 13 weeks from the beginning of MS, pulmonary function tests and asthma control tests were performed, and the fraction of exhaled nitric oxide and blood eosinophils levels were measured. Results: From baseline until the end of the study, women treated with MS + ICS had better control of the asthmatic symptoms, defined as higher asthma control test (ACT) score (17.00 ± 1.07 to 23.36 ± 0.45; p < 0.0015), improved pulmonary function [with higher forced expiratory volume in 1 s (from 77.25 ± 6.79 to 103.88 ± 6.24; p < 0.0077)], and forced vital capacity (from 91.95 ± 6.81 to 113.17 ± 4.79; p < 0.0183) compared with men. Interestingly, MS + ICS-treated women had significantly lower levels of blood eosinophils (from 5.27 ± 0.30 to 3.30 ± 0.31; p < 0.0449) and exhaled nitric oxide (from 44.70 ± 7.30 to 25.20 ± 3.90; p < 0.0294) compared with men. Conclusion: The treatment with MS, added to ICS, in women leads to better control of symptoms, better management of lung function, and decreased inflammation levels compared with ICS + MS treatment in men.

show abstract

Section: Introductionmentioning

confidence: 99%

Montelukast Improves Symptoms and Lung Function in Asthmatic Women Compared With Men

et al. 2019

View full text Add to dashboard Cite

show abstract

“…[12][13][14][15] Meanwhile, health-care workers all around the globe are increasingly challenged by the controversial issues related to prescription of nebulized antibiotics for severe respiratory infections. 16 Very limited outcome data comparing various delivery techniques are available, 17 including differences between nebulization in subjects who are spontaneously breathing and those who undergo noninvasive mechanical ventilation. 18 Safety considerations are important, particularly regarding humidification.…”

Section: See the Related Editorial On Page 1131mentioning

confidence: 99%

Intratracheal Administration of Antimicrobial Agents in Mechanically Ventilated Adults: An International Survey on Delivery Practices and Safety

et al. 2016

View full text Add to dashboard Cite

BACKGROUND: Intratracheal antibiotic administration is increasingly used for treating respiratory infections. Limited information is available on delivery devices, techniques, and safety. METHODS: An online survey on intratracheal administration of anti-infective agents in mechanically ventilated adults was answered by health-care workers from 192 ICUs to assess the most commonly used devices, current delivery practices, and safety issues. We investigated whether ICU usage experience (>3 y) impacted its performance. RESULTS: Intratracheal antibiotic administration was a current practice in 87 ICUs (45.3%), with 40 (46%) having experience with the technique (>3 y). Sixty-six (78.6%) of 84 health-care workers reported avoiding intratracheal antibiotic administration due to an absence of evidence-based guidelines (78.6%). Jet nebulizers were the most commonly used devices for delivery, in 24 less experienced ICUs (27.6%) and in 18 (20.7%) experienced ICUs. Direct tracheal instillation (6; 6.9%) was still considered for drug prescription in 12 ICUs (6.9%). More experience resulted in neither greater adherence to measures improving the drug's delivery efficiency (93 measures in the experienced group; 27.9%) nor a greater adoption of measures to increase safety. Indeed, the expiratory filter was changed after each nebulization in only 2 experienced ICUs (6.9%), whereas 15 (51.7%) changed it daily instead. CONCLUSIONS: Intratracheal antibiotic administration is a common therapeutic modality in ICUs, but inadequate practices were widely encountered, independent of the level of experience with the technique. This suggests a need to develop standardization to reduce variability and improve safety and efficacy.

show abstract

“…50 The most common smallvolume nebulizers are the jet nebulizer, the vibrating mesh nebulizer, and the ultrasonic nebulizer. Jet nebulizers often create turbulent flow and have a low drug delivery rate (only 15% of the aerosolized antibiotics are delivered to the lung parenchyma).…”

Section: Delivery Systemsmentioning

confidence: 99%

Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Zhang,

Berra,

Klompas

2016

Respir Care

View full text Add to dashboard Cite

In patients with ventilator-associated pneumonia, systemic use of antibiotics is the cornerstone of medical management. Supplemental use of aerosolized antibiotics with intravenous antibiotics in both experimental and clinical studies has been shown to have the following pharmacologic benefits: (1) aerosolized antibiotics reach the infected lung parenchyma without crossing the pulmonary alveolar capillary barrier; (2) aerosolized antibiotics increase anti-bacterial efficacy through increased local antibiotic concentration; and (3) aerosolized antibiotics decrease systemic toxicity. These benefits may be particularly beneficial to treat pneumonia caused by multidrug-resistant pathogens. Clinical data on the benefits of aerosolized antibiotics are more limited. Studies to date have not clearly shown improvements in time to extubation, mortality, or other patient-centered outcomes. At present, amikacin, colistin, and ceftazidime are the most frequently used and studied aerosolized antibiotics. This review summarizes the characteristics of aerosolized antibiotics, reviews the advantages and disadvantages of using aerosolized antibiotics, and calls for future investigations based on animal study data.

show abstract

Year in Review 2014: Aerosol Delivery Devices

Cited by 7 publications

References 31 publications

Montelukast Improves Symptoms and Lung Function in Asthmatic Women Compared With Men

Montelukast Improves Symptoms and Lung Function in Asthmatic Women Compared With Men

Intratracheal Administration of Antimicrobial Agents in Mechanically Ventilated Adults: An International Survey on Delivery Practices and Safety

Should Aerosolized Antibiotics Be Used to Treat Ventilator-Associated Pneumonia?

Contact Info

Product

Resources

About