How Best to Deliver Aerosol Medications to Mechanically Ventilated Patients

Rajiv Dhand, Vamsi P. Guntur

Research output: Contribution to journalReview article

61 Citations (Scopus)

Abstract

Pressurized metered-dose inhalers (pMDIs) and nebulizers are employed routinely for aerosol delivery to ventilator-supported patients, but the ventilator circuit and artificial airway previously were thought to be major barriers to effective delivery of aerosols to patients receiving mechanical ventilation. In the past two decades, several investigators have shown that careful attention to many factors, such as the position of the patient, the type of aerosol generator and its configuration in the ventilator circuit, aerosol particle size, artificial airway, conditions in the ventilator circuit, and ventilatory parameters, is necessary to optimize aerosol delivery during mechanical ventilation. The best techniques for aerosol delivery during noninvasive positive-pressure ventilation are not well established as yet, and the efficiency of aerosol delivery in this setting is lower than that during invasive mechanical ventilation. The most efficient methods of using the newer hydrofluoroalkane-pMDIs and vibrating mesh nebulizers in ventilator-supported patients also require further evaluation. When optimal techniques of administration are employed, the efficiency of aerosolized drug delivery in mechanically ventilated patients is comparable to that achieved in ambulatory patients.

Original languageEnglish (US)
Pages (from-to)277-296
Number of pages20
JournalClinics in Chest Medicine
Volume29
Issue number2
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

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Aerosols
Mechanical Ventilators
Artificial Respiration
Metered Dose Inhalers
HFA 134a
Nebulizers and Vaporizers
Positive-Pressure Respiration
Particle Size
Research Personnel
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Cite this

How Best to Deliver Aerosol Medications to Mechanically Ventilated Patients. / Dhand, Rajiv; Guntur, Vamsi P.

In: Clinics in Chest Medicine, Vol. 29, No. 2, 01.06.2008, p. 277-296.

Research output: Contribution to journalReview article

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