Facemask or mouthpiece for delivery of nebulized bronchodilator aerosols?

Steventon, R. D.; Wilson, Robert S.

doi:10.1016/s0007-0971(81)80012-5

Cited by 24 publications

(5 citation statements)

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“…Oronasal delivery by valved mask and oral delivery by mouthpiece used instead of the nasal cannula for salbutamol delivery within a high flow system showed approximately comparable percentages of urinary salbutamol excretion 24 hr post‐inhalation of 8.8% and 8.45%, respectively. The only significant difference between these two interfaces in aerosol delivery within a high flow system appeared in the percentage of salbutamol excreted after 30 min of inhalation which gave rise to higher pulmonary deposition of the drug by mouthpiece over valved facemask because of the absence of any aerosol leakage by the mouthpiece 24,25 . These results were consistent with our in‐vitro study testing these three interfaces within the high flow system at three different flows of 10, 20, and 30 L/min which demonstrated that valved facemask and mouthpiece delivered the highest fraction of the drug as long as gas flow is below 20 L/min ensuring the well‐known inverse relationship between the flow and the delivered dose within this system 12,18,20,26,27 .…”

Section: Discussionsupporting

confidence: 86%

“…The only significant difference between these two interfaces in aerosol delivery within a high flow system appeared in the percentage of salbutamol excreted after 30 min of inhalation which gave rise to higher pulmonary deposition of the drug by mouthpiece over valved facemask because of the absence of any aerosol leakage by the mouthpiece. 24,25 These results were consistent with our in-vitro study testing these three interfaces within the high flow system at three different flows of 10, 20, and 30 L/min which demonstrated that valved facemask and mouthpiece delivered the highest fraction of the drug as long as gas flow is below 20 L/min ensuring the well-known inverse relationship between the flow and the delivered dose within this system. 12,18,20,26,27 A previous work comparing mouthpiece with a facemask for nebulised albuterol delivery in asthmatic children came to encourage our results of equal effectiveness of two interfaces for aerosol delivery.…”

Section: Nasal Inhalation Oral Inhalation Oronasalsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 52%

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The impact of changing patient interfaces on delivering aerosol with titrated oxygen in the high flow system

et al. 2020

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Introduction Despite the widespread oxygen‐culture as more is better in prehospital and hospital settings, the use of titrated oxygen‐flow within a high‐flow system can be beneficial especially when combined with aerosol‐delivery and also save the patient from unnecessary‐hyperoxia. Methods Forty‐five COPD patients were included in this study where they allocated in three‐groups (nasal‐delivery, oral‐delivery, and oronasal‐delivery groups). All patients were received their inhaled‐salbutamol dose using Aerogen Solo nebuliser by one of the three interfaces, eg, nasal‐cannula, mouthpiece, and facemask in two conditions; with oxygen‐flow and without any oxygen‐flow. Pulmonary and systemic salbutamol deposition was estimated by collecting two urine‐samples from the patient; 30 min post‐inhalation and cumulatively 24 hr post‐inhalation. The quantity of salbutamol in these collected samples was measured by high‐performance liquid chromatography. Lung function measurement was performed pre‐bronchodilator inhalation and 30 min post‐bronchodilator to estimate the change in pulmonary functions post‐inhalation regarding all tested interfaces. Results COPD patients showed the highest salbutamol percentage excreted 30 min post‐inhalation of 5.7% (1.4) with mouthpiece interface when combined with oxygen at P < .002. While with the same condition using oxygen, valved‐facemask showed the highest salbutamol percentage excreted in 24 hr post inhalation samples but the difference is only significantly compared with nasal cannula (P < .006). Moreover, without oxygen delivery, mouthpiece and valved facemask showed approximately the same salbutamol percentage excreted in 30 min post‐inhalation samples, higher than that delivered by nasal cannula (P < .001). Of note, salbutamol delivery is significantly increased with oxygen flow for all interfaces (P < .05) except with nasal cannula. Conclusions The nasal cannula is a more comfortable and tolerable interface despite the lower fraction of the delivered drug compared with other tested interfaces. The use of oxygen‐flow with aerosol delivery within a high flow system positively affects the delivered drug fraction and the pulmonary deposition of the drug.

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Section: Discussionsupporting

confidence: 86%

Section: Nasal Inhalation Oral Inhalation Oronasalsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 52%

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The impact of changing patient interfaces on delivering aerosol with titrated oxygen in the high flow system

et al. 2020

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“…The nebulisers were driven by compressed air because oxygen inactivates acetylcysteine.7 A fresh nebuliser was used for each treatment and face masks were used with the nebulisers for better patient compliance. 8 The drugs were administered with the patient sitting upright, either in bed or in a chair. The deep breathing exercises and assisted coughing were repeated at 10 minute intervals as before.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of nebulised acetylcysteine and normal saline in the treatment of sputum retention following thoracotomy.

Gallon

1996

Thorax

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Background-The use of acetylcysteine as a mucolytic agent is controversial. In 1962 it was claimed to be "the most effective agent ... for the liquefaction of ... secretions" but was subsequently taken off the market as a respirator solution. Normal saline, on the other hand, is becoming increasingly popular. A study was undertaken to determine which solution is more effective at clearing retained secretions following thoracotomy. Methods-The study included 10 patients and was of single blind, two-way crossover design. Measurements taken before and after each treatment included sputum viscosity, difficulty of expectoration, weight of sputum expectorated, and oxygen saturation.Results -Following nebulisation of acetylcysteine, sputum viscosity was reduced, difficulty of expectoration was reduced, the weight of sputum expectorated was increased, and oxygen saturation was increased. There were no changes after nebulisation of normal saline. Conclusions -This study shows that, following thoracotomy, nebulised acetylcysteine reduces sputum viscosity, making expectoration easier and improving oxygenation. Nebulised normal saline has no effect. (Thorax 1996;51:429-432) Keywords: nebulised acetylcysteine, sputum viscosity, physiotherapyPostoperative pulmonary complications following abdominal and thoracic surgery are the most significant cause of morbidity and mortality in the postoperative period.' Thoracotomy results in reduced lung volumes, impaired gas exchange, and damaged respiratory defence mechanisms.2 Mucus secretion and viscosity are therefore increased and mucociliary clearance is decreased, leading to retention of secretions, atelectasis, infection, and hypoxaemia.34The use of nebulised mycolytic agents is one method of enhancing mucociliary clearance. Acetylcysteine has been shown to reduce mucus viscosity in vitro5 but this has not been demonstrated in vivo in the postoperative period. Nebulised normal saline has been shown to increase the clearance of secretions when included in a physiotherapy regimen for the treatment of patients with bronchiectasis.6 No studies of nebulised drugs have measured sputum viscosity in patients following thoracotomy. A controlled trial was therefore undertaken to compare the efficacy ofnebulised acetylcysteine and normal saline in the treatment of sputum retention following thoracotomy in order to establish which is the more effective drug at increasing mucociliary clearance and facilitating cough. Methods PATIENTSEleven patients (10 men) aged 36-77 years (mean 64 7) took part in the study. All patients undergoing thoracotomy were assessed by the author and recruited if they met the following entry criteria: (1) difficulty expectorating tenacious secretions, and (2) adequate analgesia to enable effective coughing.Patients were excluded ifthey had a recurrent laryngeal nerve palsy. Withdrawal criteria included (1) severe bronchospasm, (2) pulmonary oedema, (3) adult respiratory distress syndrome, (4) surgical emphysema, or (5) serious cardiac complications.The stud...

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“…In two small studies involving b 2 agonists, no difference in response was observed between children who received treatment with mouthpieces and those who received treatment with facemasks. (15,16) In a larger, randomized, single-blind study including 64 children with acute asthma aged 6 to 19 years, albuterol was administered using either a facemask or a mouthpiece. Both methods of delivery were found to be equally effective based on spirometry measurements (i.e., FVC, FEV 1 , and FEF 25-75% ).…”

Section: Discussionmentioning

confidence: 99%

Effective Once-Daily Administration of Budesonide Inhalation Suspension by Nebulizer with Facemasks or Mouthpieces for Persistent Asthma in Infants and Young Children

Georgitis

McWilliams²,

Cruz-Rivera

et al. 2001

Pediatric Asthma, Allergy & Immunology

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This study is a retrospective analysis comparing nebulized budesonide inhalation suspension(BIS; Pulmicort Respules™, AstraZeneca, Wilmington, DE) administered once daily by facemask or mouthpiece in 359 infants and young children with persistent asthma. The efficacy and safety of once-daily BIS (0.25, 0.5, and 1.0 mg) administered by facemask or mouthpiece were demonstrated in a multicenter, randomized, double-blind, placebo-controlled, parallel-group study reported by Kemp et al. (Ann Allergy Asthma Immunol 1999; 83:231-239). Three hundred fifty-nine children aged 6 months to 8 years with mild, persistent asthma received nebulized BIS 0.25, 0.5, or 1.0 mg once daily or placebo for 12 weeks via facemask or mouthpiece. Efficacy variables included nighttime and daytime asthma symptom scores, use of breakthrough bronchodilator medications, and pulmonary function tests (in children capable of consistently performing spirometry or peak flows). Changes in nighttime and daytime asthma symptom scores were not significantly different between children using facemasks and those using mouthpieces. Use of breakthrough medications and pulmonary function test results (in the subset of children able to perform them) also were not significantly different in facemask users and mouthpiece users. These results suggest that BIS is equally effective whether administered by facemask or mouthpiece and that young children who require the use of a facemask may be successfully treated. (Pediatr Asthma Allergy Immunol 2001; 15[1]:3-13.)

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Facemask or mouthpiece for delivery of nebulized bronchodilator aerosols?

Cited by 24 publications

References 0 publications

The impact of changing patient interfaces on delivering aerosol with titrated oxygen in the high flow system

The impact of changing patient interfaces on delivering aerosol with titrated oxygen in the high flow system

Evaluation of nebulised acetylcysteine and normal saline in the treatment of sputum retention following thoracotomy.

Effective Once-Daily Administration of Budesonide Inhalation Suspension by Nebulizer with Facemasks or Mouthpieces for Persistent Asthma in Infants and Young Children

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