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Inhalation therapy in invasive and noninvasive mechanical ventilation
1Division of Pulmonary, Critical Care and Environmental Medicine, Department of Internal Medicine, University of Missouri, Columbia, Missouri 65212, USA. dhandr@health.missouri.edu
Current Opinion in Critical Care
|January 2, 2007
Summary
Optimizing aerosol delivery in mechanically ventilated patients using metered-dose inhalers or nebulizers can achieve drug delivery efficiency comparable to ambulatory patients. Further research is needed for noninvasive ventilation techniques.
Area of Science:
- Respiratory Medicine
- Pharmacology
- Critical Care
Background:
- Mechanical ventilation is common in critical care.
- Inhaled therapies offer targeted drug delivery.
- Optimizing aerosol administration is crucial for efficacy.
Purpose of the Study:
- To review factors influencing aerosol delivery in mechanically ventilated patients.
- To clarify optimal aerosol administration techniques.
- To discuss inhaled therapies in invasive and noninvasive ventilation.
Main Methods:
- Literature review of aerosol delivery devices and techniques.
- Analysis of factors affecting inhaled drug deposition.
- Discussion of clinical applications in ventilated patients.
Main Results:
- Optimal techniques with metered-dose inhalers and nebulizers yield comparable delivery efficiency to ambulatory patients.
- Pressurized metered-dose inhalers are more efficient for routine bronchodilator/corticosteroid therapy.
- Nebulizers offer versatility for various inhaled medications.
Conclusions:
- Inhaled therapies are increasingly used in mechanically ventilated patients due to improved formulations and devices.
- Further research is needed to optimize aerosol delivery during noninvasive positive pressure ventilation.
- Pressurized metered-dose inhalers are preferred for routine therapy, while nebulizers are more versatile.
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