Safe bronchodilator treatment in mechanically ventilated COVID-19 patients: A single center experience

Miller, Asaf; Epstein, Danny

doi:10.1016/j.jcrc.2020.04.010

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…79,83 They have been shown to significantly improve drug deposition during COVID-19 low-tidal volume ventilation strategies, 84 in addition to reducing staff workload and the risk of fugitive emissions. 85 –87 This is because they can be used in-line for up to 28-days, making them the only mode of nebulisation compatible with a completely closed circuit. The no-additional flow requirements of the in-line VMN system reduces the potential generation of bioaerosols, 9,79,87 and the separation of the medication reservoir from the breathing circuit reduces the likelihood of bacterial contamination of the reservoir between doses.…”

Section: Vibrating Mesh Nebulisersmentioning

confidence: 99%

Nebuliser therapy in critical care: The past, present and future

Arnott,

Watson,

Sim

2023

Journal of the Intensive Care Society

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Nebulisers are devices that reduce a body of liquid into a fine aerosol suitable for inhalation. Utilising the efficiency of pulmonary drug absorption, they offer a safe and powerful modality for local and systemic drug delivery in the treatment of critical illness. In comparison to conventional jet (JN) and ultrasonic nebulisers (USN), the advent of vibrating mesh nebulisers (VMN) has significantly improved the therapeutic potential of modern devices. This review article aims to summarise the history and evolution of nebulisers from first inception through to the modern vibrating mesh technology. It provides an overview on the basic science of nebulisation and pulmonary drug delivery, and the current use of nebulised therapies in critical care.

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Section: Vibrating Mesh Nebulisersmentioning

confidence: 99%

Nebuliser therapy in critical care: The past, present and future

Arnott,

Watson,

Sim

2023

Journal of the Intensive Care Society

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“…Alternatively, it is likely safer to use metered-dose inhalers with spacers in lieu of nebulisers [ 54 ]. In any case, it is advisable to avoid the opening of the ventilator circuit and to use a closed system that requires minimal staff handling and no circuit opening, thereby reducing workload and increasing safety [ 55 ].…”

Section: β 2 -Agonistsmentioning

confidence: 99%

Pharmacological management of COVID-19 patients with ARDS (CARDS): A narrative review

Matera

Rogliani

Calzetta

et al. 2020

Respiratory Medicine

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Coronavirus disease 2019 (COVID-19) is highly infectious. It has been highlighted that if not expertly and individually managed with consideration of the vasocentric features, a COVID-19 patient with an acute respiratory distress syndrome (CARDS) may eventually develop multiorgan failure. Unfortunately, there is still no definite drug for CARDS that is capable of reducing either short-term or long-term mortality and no specific treatments for COVID-19 exist right now. In this narrative review, based on a selective literature search in EMBASE, MEDLINE, Scopus, The Cochrane Library, Web of Science, and Google Scholar and ClinicalTrials.gov , we have examined the emerging evidence on the possible treatment of CARDS. Although numerous pharmacologic therapies to improve clinical outcomes in CARDS have been studied also in clinical trials, none have shown efficacy and there is great uncertainty about their effectiveness. There is still no recommendation for the therapeutic use of any specific agent to treat CARDS because no drugs are validated to have significant efficacy in clinical treatment of COVID-19 patients in large-scale trials. However, there exist a number of drugs that may be useful at least in some patients. The real challenge now is to link the right patient to the right treatment.

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“…Regular administration of bronchodilator may be needed, to minimize the virus transmission to others multiple health care patient. In order to alleviate these hazards, Aeroneb Solo (Aerogen©, Galway, Ireland) has been successfully made for COVID-19 patients which continuously delivers medication via inhalation without circuit opening and requires minimal health-care workers for handling ( Miller and Epstein, 2020 ).…”

Section: Adjuvant/supportive Carementioning

confidence: 99%

Novel β-Coronavirus (SARS-CoV-2): Current and future aspects of pharmacological treatments

Tiwari¹,

Upadhyay²,

Ansari³

et al. 2020

Saudi Pharmaceutical Journal

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The novel coronavirus outbreak has reported to be rapidly spreading across the countries and becomes a foremost community health alarm. At present, no vaccine or specific drug is on hand for the treatment of this infectious disease. This review investigates the drugs, which are being evaluated and found to be effective against nCOVID-19 infection. A thorough literature search was performedon the recently published research papers in between January 2020 to May 2020, through various databases like “Science Direct”, “Google Scholar”, “PubMed”,“Medline”, “Web of Science”, and “World Health Organization (WHO)”. We reviewed and documented the information related with the current and future aspects for the management and cure of COVID-19. As of 21st July 2020 a total of 14,562,550 confirmed cases of coronavirus and 607,781 deaths have been reported world-wide. The main clinical feature of COVID-19 ranges from asymptomatic disease to mild lower respiratory tract illness to severe pneumonia, acute lung injury, acute respiratory distress syndrome (ARDS), multiple organ dysfunction, and death. The drugs at present used in COVID-19 patients and ongoing clinical trials focusing on drug repurposing of various therapeutic classes of drug e.g. antiviral, anti-inflammatory and/or immunomodulatory drugs along with adjuvant/supportive care. Many drugs on clinical trials shows effective results on preliminary scale and now used currently in patients. Adjuvant/supportive care therapy are used in patients to get the best results in order to minimize the short and long-term complications. However, further studies and clinical trials are needed on large scale of population to reach any firm conclusion in terms of its efficacy and safety.

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Safe bronchodilator treatment in mechanically ventilated COVID-19 patients: A single center experience

Cited by 5 publications

References 6 publications

Nebuliser therapy in critical care: The past, present and future

Nebuliser therapy in critical care: The past, present and future

Pharmacological management of COVID-19 patients with ARDS (CARDS): A narrative review

Novel β-Coronavirus (SARS-CoV-2): Current and future aspects of pharmacological treatments

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