Influence of Jet Nebulization and Oxygen Delivery on the Fraction of Inspired Oxygen: An Experimental Model

Caille, Vincent; Ehrmann, Stéphan; Boissinot, E; Perrotin, D.; Diot, Patrice; Dequin, Pierre‐François

doi:10.1089/jamp.2008.0718

Cited by 16 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, differences in the point of entry of aerosol into humidified/ non-humidified air across the various delivery modalities may also be a contributing factor, where aerosol is entrained in the gas flow in the most efficient manner, thereby avoiding impactional losses within the circuit and patient interface. Clinical studies demonstrate that the connection of a nebulizer to a HFNT circuit enables continuous nebulization, therefore improving efficiency and tolerance of the therapy [20, 28, 29]. Valencia and colleagues recently reported that the use of a nebulizer incorporated into HFNT results in an increased level of comfort and satisfaction compared to the use of a conventional JN in bronchiolitis patients who require HFNT [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of aerosol delivery across combinations of drug delivery interfaces with and without concurrent high-flow nasal therapy

Bennett

Joyce

Fernández

et al. 2019

ICMx

View full text Add to dashboard Cite

Background Current clinical practice during high-flow nasal therapy (HFNT) involves utilization of a nasal cannula to provide humidification, with a facemask placed over the cannula to deliver aerosol. Few studies have compared aerosol delivery across various delivery interfaces during HFNT. The objective of this study was to address this gap in the literature and evaluate aerosol delivery using two nebulizer types across different drug delivery interfaces, nasal cannula, facemask, and mouthpiece, during simulated adult HFNT. Methods A facemask or mouthpiece and/or a nasal cannula were positioned on an anatomically correct adult head model. The head model was connected to a breathing simulator via a collection filter. Both healthy breathing pattern and distressed breathing patterns were utilized. Aerosol dose was determined by quantifying the mass of drug captured on a filter positioned distal to the trachea. Results During simulated healthy breathing, a significantly greater aerosol dose was observed when the vibrating mesh nebulizer (VMN) was integrated with HFNT alone, supplying aerosol and humidified air simultaneously (2.88 ± 0.15%), as opposed to using with a facemask (0.33 ± 0.07%, 1.62 ± 0.46%, and 1.07 ± 0.25% at 0 L/min (LPM), 2LPM, and 6LPM, respectively) or mouthpiece (0.56 ± 0.13%, 2.16 ± 0.06%, and 1.82 ± 0.41% at 0LPM, 2LPM, and 6LPM). In addition, aerosol delivery was also significantly greater when the VMN was integrated into simulated HFNT (2.88 ± 0.15%), in comparison with using the jet nebulizer (JN) with a facemask (0.82 ± 0.16%) or a mouthpiece (0.86 ± 0.11%). During simulated distressed breathing, a significantly greater aerosol dose was observed when the VMN was integrated with HFNT, supplying aerosol and humidified air simultaneously (6.81 ± 0.45%), compared with using a facemask (0.86 ± 0.04%, 2.96 ± 0.26%, and 4.23 ± 0.93% at 0LPM, 2LPM, and 6LPM) or mouthpiece (0.73 ± 0.37%, 0.97 ± 0.20%, and 3.11 ± 0.53% at 0LPM, 2LPM, and 6LPM, respectively). Aerosol delivery was also greater when the VMN was integrated into HFNT (6.81 ± 0.45%), in comparison with using the JN with a facemask (5.72 ± 0.71%) or a mouthpiece (0.69 ± 0.53%). Furthermore, across all drug delivery interfaces, and in line with previous reports, aerosol delivery was greater during simulated distressed breathing, in comparison with simulated healthy adult breathing. Conclusions This article will be of considerable benefit in enhancing the understanding of aerosol delivery during HFNT, an increasingly adopted therapeutic intervention by healthcare professionals.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of aerosol delivery across combinations of drug delivery interfaces with and without concurrent high-flow nasal therapy

Bennett

Joyce

Fernández

et al. 2019

ICMx

View full text Add to dashboard Cite

show abstract

“…(12) The connection of a nebulizer to the HFT circuit may be considered as a simple solution that may enable continuous nebulization without interrupting HFT, thereby improving the efficiency and tolerance of the overall procedure. (13,14) Nevertheless, several barriers may impede efficient nebulization through HFT circuits. First, aerosol deposition in the HFT circuit may be favored by humidification and high flow rates used in the adult setting in a similar way as observed during mechanical ventilation.…”

Section: Introductionmentioning

confidence: 99%

Aerosol Therapy in Adults Receiving High Flow Nasal Cannula Oxygen Therapy

Réminiac

Vecellio

Heuzé-Vourc’h

et al. 2016

Journal of Aerosol Medicine and Pulmonary Drug Delivery

Self Cite

125

View full text Add to dashboard Cite

show abstract

“…The vast majority of studies have used air- or oxygen-driven pneumatic nebulizers. Oxygen-driven jet nebulization is preferable in the hypoxemic patient, but the expected FiO2 values are low because of the absence of an oxygen reservoir coupled to aerosol masks [114]. With their lower residual volume, ultrasonic nebulizers and vibrating mesh nebulizers have the same efficacy as pneumatic nebulizers and metered dose inhalers used with valved holding chambers [115].…”

Section: Resultsmentioning

confidence: 99%

Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies

Conte

Terzi

Mortamet

et al. 2019

Ann. Intensive Care

Self Cite

View full text Add to dashboard Cite

BackgroundThe French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients.ResultsThe guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines.ConclusionThe conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

show abstract

Influence of Jet Nebulization and Oxygen Delivery on the Fraction of Inspired Oxygen: An Experimental Model

Abstract: Oxygen delivery through a nasal device during air-driven jet nebulization significantly increases the FiO(2), whereas oxygen-driven jet nebulization dramatically decreases FiO(2) compared with standard oxygen therapy.

Cited by 16 publications

References 22 publications

Comparison of aerosol delivery across combinations of drug delivery interfaces with and without concurrent high-flow nasal therapy

Comparison of aerosol delivery across combinations of drug delivery interfaces with and without concurrent high-flow nasal therapy

Aerosol Therapy in Adults Receiving High Flow Nasal Cannula Oxygen Therapy

Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies

Contact Info

Product

Resources

About