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

Madney, Yasmin M.; Laz, Nabila Ibrahim; Elberry, Ahmed A.; Rabea, Hoda; Abdelrahim, Mohamed

doi:10.1111/ijcp.13898

Cited by 3 publications

(3 citation statements)

References 53 publications

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“…This meta-analysis demonstrated how probiotics affect critically ill ventilated subjects. [53][54][55][56][57][58][59][60] Further research is still required to clarify these potential connections as well as to assess the impact of probiotics on the outcomes under investigation. Larger, more homogeneous samples are required for such research.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of the effects of probiotics on various parameters in critically ill ventilated individuals

Wang¹,

Xie²,

Teng³

2023

Adv Clin Exp Med

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Background. According to reports, ventilator-associated pneumonia affects critically ill patients more frequently than any other nosocomial infection. Probiotic usage as a prophylactic intervention has shown promising results in numerous studies.Objectives. We performed a meta-analysis to evaluate the effect of probiotics on different parameters in critically ill ventilated subjects. Materials and methods.A systematic literature search up to June 2022 was performed and 5893 critically ill ventilated subjects at the baseline of the studies were identified; 2912 of them were using the probiotics, and there were 2981 controls. Odds ratio (OR) and mean difference (MD) with 95% confidence interval (95% CI) were calculated to assess the effect of probiotics on different parameters in critically ill ventilated subjects using the dichotomous and contentious methods with a random or fixed effects model. Results.The probiotics caused a significantly lower incidence of ventilator-associated pneumonia (OR = 0.52; 95% CI: 0.40-0.68, p < 0.001), shorter duration of mechanical ventilation (MD = −2.22; 95% CI: −3.33-−1. 11, p < 0.001), shorter intensive care unit (ICU) stay (MD = −2.09; 95% CI: −3.41-−0.77, p = 0.002), shorter hospital stay (MD = −2.36; 95% CI: −4.54-−0. 19, p = 0.03), and lower oropharyngeal colonization (OR = 0.59; 95% CI: 0.36-0.96, p = 0.03) in critically ill ventilated subjects compared with controls. However, probiotic use had no significant difference in terms of diarrhea incidence (OR = 0.74; 95% CI: 0.52-1.07, p = 0.11) and in-hospital mortality (OR = 0.90; 95% CI: 0.79-1.03, p = 0.14) in critically ill ventilated subjects compared with controls.Conclusions. Probiotics caused a significantly lower ventilator-associated pneumonia incidence, shorter duration of mechanical ventilation, shorter ICU and hospital stay, and lower oropharyngeal colonization. However, there was no significant difference in terms of diarrhea incidence and in-hospital mortality in subjects who used probiotics compared with controls. The low sample size of 9 out of 27 researches and the small number of studies in several comparisons requires attention when analyzing the results.

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Section: Discussionmentioning

confidence: 99%

A meta-analysis of the effects of probiotics on various parameters in critically ill ventilated individuals

Wang¹,

Xie²,

Teng³

2023

Adv Clin Exp Med

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“…The only difference was that they discovered a higher oxygen flow than we did. That could be due to their use of a higher tidal volume (750 mL), which is 250 mL higher than the normal tidal volume used in most in vitro studies (500 mL) but more realistic for some adult patients [22][23][24][25][26][27][28][29][30][31][32][33], as well as their use of a valved facemask only, for which we found the best oxygen flow was 3 L/min [21], implying that the higher tidal flow improved the benefit of oxygen delivered as a supplement to the aerosol within the HC.…”

Section: Discussionmentioning

confidence: 99%

Effect of oxygen flow on aerosol delivery from a vibrating mesh nebulizer with a holding chamber

Amin

Taha

Hussein

et al. 2022

Beni-Suef Univ J Basic Appl Sci

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Background A holding chamber (HC) was created to work with a vibrating mesh nebulizer (VMN) to boost the total inhalable dose for patients. In addition to the optional supply of supplemental oxygen, it facilitates intermittent and continuous nebulization. Our goal was to see how well a VMN coupled to a HC with a mouthpiece or valved facemask performed at varied oxygen flows starting at 0–6 L/min. In this study, we used a breathing simulator to simulate adults' spontaneous breathing patterns with a tidal volume of 500 mL and a 1:1 inhalation–exhalation ratio. For the combination of nebulizer and HC adapter with a valved facemask or mouthpiece, five determinations were made. Salbutamol was recovered and evaluated using high-performance liquid chromatography from the inhalation filter connected to the breathing simulator, the nebulizer reservoir chamber, and the HC. Results The amount of salbutamol in the nebulizer reservoir chamber and within the HC did not differ significantly when using a mouthpiece or a valved facemask. However, the supplied dose to the inhalation filter was increased until oxygen flow reached 2 and 3 L/min using the mouthpiece and valved facemask as interfaces, respectively. The supplied salbutamol was much higher at this flow than at the other oxygen flows. This was followed by a progressive reduction in the supplied salbutamol until the lowest given dose was reached at 6 L/min oxygen flow, p < 0.005. Conclusions The supplied doses of salbutamol to the inhalation filter were variable with the VMN connected to the HC and mouthpiece or valved facemask, with significant improvements until an oxygen flow of 2 L/min with a mouthpiece and 3 L/min with a valved facemask, followed by gradual decreases to lower values at an oxygen flow of 6 L/min. An in vivo investigation is required to further validate the findings.

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“…La DI disminuyó al aumentar el flujo de la CNAF, independientemente de la interfaz utilizada. 32 Bennett y cols. abordaron otro vacío en la literatura; evaluaron, en un modelo adulto, la administración de aerosoles en línea por encima de la CNAF utilizando dos tipos de nebulizadores (NMV vs NJ) y tres interfaces diferentes (cánula nasal, mascarilla y boquilla).…”

Section: Otras Situaciones Especialesunclassified

Aerosolterapia durante la aplicación de ventilación mecánica no invasiva o cánula nasal de alto-flujo en pacientes con asma y EPOC

et al. 2022

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La ventilación mecánica no invasiva (VMNi) y la cánula nasal de alto-flujo (CNAF) se utilizan cada vez más en los pacientes con insuficiencia respiratoria aguda y crónica exacerbada. Algunos pacientes que reciben estas terapias también podrían beneficiarse de la administración de fármacos inhalados. Por lo tanto, resulta atractivo combinar el tratamiento con aerosoles y soportes respiratorios no invasivos (SR-NI). Los dispositivos para realizar aerosolterapia que pueden adaptarse en línea con los SRNI son los inhaladores de dosis medida presurizados (IDMp) y los nebulizadores. En el subgrupo de los nebulizadores se encuentran tres tipos: nebulizadores tipo jet (NJ), nebulizadores ultrasónicos (NUs) y los nebulizadores de malla vibrante (NMV). La administración de aerosolterapia en línea con la CNAF parece una combinación novedosa y de gran aplicabilidad en pacientes seleccionados. En función de la evidencia disponible, parece oportuna la combinación de brindar VMNi y terapia de aerosoles en pacientes con obstrucción al flujo aéreo sin interrumpir el tratamiento respiratorio. El objetivo de este artículo es revisar la bibliografía disponible sobre la aerosolterapia durante los SRNI. Además, ofrecer recomendaciones basadas en la evidencia disponible.Palabras clave: aerosolterapia; cánula nasal de alto-flujo, ventilación no invasiva; nebulizador; inhaladores; nebulizador de malla vibrante.

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

Cited by 3 publications

References 53 publications

A meta-analysis of the effects of probiotics on various parameters in critically ill ventilated individuals

A meta-analysis of the effects of probiotics on various parameters in critically ill ventilated individuals

Effect of oxygen flow on aerosol delivery from a vibrating mesh nebulizer with a holding chamber

Aerosolterapia durante la aplicación de ventilación mecánica no invasiva o cánula nasal de alto-flujo en pacientes con asma y EPOC

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