Dosing Efficiency and Particle-size Characteristics of Pressurized Metered-dose Inhaler Aerosols in Narrow Catheters

Taylor, Robert H.; Lerman, Jerrold; Chambers, Carole B.; Dolovich, Myrna

doi:10.1378/chest.103.3.920

Cited by 28 publications

(12 citation statements)

References 14 publications

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“…Several in vitro and in vivo studies have been conducted in order to quantify the relative lung deposition efficiencies of different nebulizers and pMDIs. In vitro studies indicated that aerosol drug delivery to the lower respiratory tract can vary from 0 to 42% with nebulizers (Fuller et al , 1992; O’Doherty et al , 1992; O’Riordan et al , 1992; Thomas et al , 1993; Ari et al , 2010a) and ranges from 0.3% to 97.5% with pMDIs (MacIntyre et al , 1985; Fuller et al , 1990; Rau et al , 1992; Taylor et al , 1993; Thomas et al , 1993; Diot et al , 1995; Fink et al , 1996, 1999; Ari et al , 2010a).…”

Section: Device‐related Factorsmentioning

confidence: 99%

Factors affecting bronchodilator delivery in mechanically ventilated adults

Ari

Fink

2010

Nursing in Critical Care

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Bronchodilator delivery during mechanical ventilation is factor and technique dependent. A clear understanding of the factors affecting aerosol drug delivery during mechanical ventilation is very important in optimizing the efficiency of bronchodilator delivery in mechanically ventilated adults. Through the recommendations made in this paper, clinicians will be able to optimize both their technique and the therapeutic outcomes of aerosol drug delivery in patients receiving ventilator support.

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Section: Device‐related Factorsmentioning

confidence: 99%

Factors affecting bronchodilator delivery in mechanically ventilated adults

Ari

Fink

2010

Nursing in Critical Care

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“…For patients whose tracheas are intubated, the tracheal tube itself influences drug delivery. Previous studies with different sizes of tracheal tubes have shown that the total dose of drug delivered is inversely related to the length of the tube and its internal diameter . It should be noted, however, that the total dose is not the key parameter as small tubes are used when managing small patients and the dose delivered per kg body weight becomes important.…”

Section: Impact Of Respiratory Support Equipment On Drug Deliverymentioning

confidence: 99%

“…It should be noted, however, that the total dose is not the key parameter as small tubes are used when managing small patients and the dose delivered per kg body weight becomes important. Studies attempting to bypass the tracheal tube with catheters have suggested that the impact of the tracheal tube can be reduced by this approach, although this produces its own problems .…”

Section: Impact Of Respiratory Support Equipment On Drug Deliverymentioning

confidence: 99%

Current options in aerosolised drug therapy for children receiving respiratory support

et al. 2017

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Inhalation of aerosolised medications are the mainstay of treatment for a number of chronic lung diseases and have several advantages over systemically-administered medications. These include more rapid onset of action for drugs such as β-adrenergic agonists when compared with oral medication, high luminal doses for inhaled antibiotics when used to treat endobronchial infection, and an improved therapeutic index compared with systemic delivery for these and other classes of drugs such as corticosteroids. The use of aerosolised drugs to treat patients whose tracheas are intubated is less well established, in part because systemic delivery via the intravenous route can be a simpler alternative for many drugs. Consequently, research in this area is largely limited to a number of in vitro studies and very few clinical trials. Unfortunately, a lack of focus in this area has resulted in a number of practices which at best are ineffective, and at worst dangerous for the patient. Although there have been some attempts to re-invigorate research in order to improve delivery systems, current devices are, to a great extent, based on long-standing technology developed more than 50 years ago. In this review, we explore current knowledge and provide guidance as to when and how the inhaled route may be of value when treating patients whose tracheas are intubated, and we set out the challenges facing those attempting to advance the topic. We conclude by reviewing current areas of interest that may lead to more effective and widespread use of aerosols in the treatment of intubated patients.

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“…52 In vitro bench models have demonstrated 0-42% with a nebulizer and 0.3-97.5% with an MDI. [53][54][55][56][57][58][59] It was concluded that the factors listed above contributed to the wide variability in the observed results.…”

Section: Aerosol Therapymentioning

confidence: 99%

Mechanical Ventilation: A Tutorial for Pharmacists

Cawley

2007

Pharmacotherapy

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Mechanical ventilation is an integral part of the critical care environment and requires orchestration by a multidisciplinary team of clinicians to optimize therapeutic outcomes. By tradition, pharmacists have not been included on this team since this therapeutic modality is not considered relevant to their scope of practice. However, pharmacists play a critical role in the management of patients receiving mechanical ventilation by assisting in the development of institutional guidelines and protocols, by maintaining accuracy of prescribed drug dosages, by monitoring for drug-drug and drug-disease interactions, by assisting with alternative drug selections, and by maintaining continued quality assessment of drug administration. Pharmacists able to understand and integrate mechanical ventilation with the pharmacotherapeutic needs of patients are better qualified practitioners. The goal of this article is to help clinical pharmacists better understand the complexities of mechanical ventilation and to apply this information in optimizing delivery of pharmaceutical agents to critical care patients.

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Dosing Efficiency and Particle-size Characteristics of Pressurized Metered-dose Inhaler Aerosols in Narrow Catheters

Cited by 28 publications

References 14 publications

Factors affecting bronchodilator delivery in mechanically ventilated adults

Factors affecting bronchodilator delivery in mechanically ventilated adults

Current options in aerosolised drug therapy for children receiving respiratory support

Mechanical Ventilation: A Tutorial for Pharmacists

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