Inhalation therapy in patients receiving mechanical ventilation: an update.

Area of Science:

• Pulmonary Medicine
• Critical Care
• Pharmacology

Background:

• Aerosol therapy during mechanical ventilation has advanced significantly.
• Pressurized metered-dose inhalers (pMDIs) and nebulizers are widely used in intensive care units (ICUs).
• Bronchodilator therapy is common in mechanically ventilated patients, even without confirmed airflow obstruction.

Purpose of the Study:

• To review factors influencing aerosol delivery via pMDIs and nebulizers in mechanically ventilated patients.
• To correlate in-vitro aerosol delivery estimates with in-vivo lung deposition measurements.
• To explore the expanding use of inhaled therapies beyond bronchodilators in critical care.

Main Methods:

• Literature review of factors affecting aerosol delivery devices.
• Analysis of in-vitro and in-vivo studies on aerosol deposition.
• Examination of clinical applications and potential of various inhaled agents.

Main Results:

• Aerosol delivery is affected by numerous factors, some specific to ventilated patients.
• Understanding these factors helps bridge the gap between in-vitro predictions and in-vivo deposition.
• Bronchodilator efficacy supports interest in other inhaled therapies for ICU patients.

Conclusions:

• Optimizing aerosol delivery devices and techniques is vital for effective inhaled therapies in mechanically ventilated patients.
• Further research correlating in-vitro and in-vivo data can refine aerosol therapy protocols.
• Expanding inhaled therapies holds promise for improving outcomes in critically ill patients.