Aerosol therapy with a variety of drugs is superior to oral and, except perhaps in status asthmaticus, parenteral therapy. An understanding of aerosol physics and the physiologic characteristics relating to ventilation allows optimum aerosol delivery for maximum benefit in the majority of patients. In those patients who are unable to use metered-dose inhalers effectively, simple inhalation devi...

Chitosan-graft-polyethylenimine (CHI-g-PEI) copolymer has been used for the improvement of low transfection efficiency of chitosan. The present study aims to test the pulmonary toxicity and efficiency of CHI-g-PEI as an aerosol gene carrier. Mice were exposed to aerosol containing green-fluorescent protein (GFP)-polyethylenimine (PEI) or GFP-CHI-g-PEI complexes for 30 min during the development...

BACKGROUND A simple method for effective bronchodilator aerosol delivery while administering continuing continuous positive airway pressure (CPAP) would be useful in patients with severe bronchial obstruction. OBJECTIVE To assess the effectiveness of bronchodilator aerosol delivery during CPAP generated by the Boussignac CPAP system and its optimal humidification system. METHODS First we a...

Noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC) are increasingly used for patients with acute respiratory failure. Some patients receiving these therapies might also benefit from inhaled drug delivery. Thus, it is attractive to combine aerosol therapy with NIV or HFNC. The purpose of this paper is to review the available evidence related to the use of inhaled aerosols with NIV ...

BACKGROUND Nasal CPAP is widely used in neonatal ICUs. Aerosolized medications such as inhaled steroids and β agonists are commonly administered in-line through nasal CPAP, especially to infants with bronchopulmonary dysplasia. We hypothesized that aerosol delivery to the lungs via variable-flow nasal CPAP in an in vitro model would be unreliable, and that the delivery would depend on the posit...

The therapeutic administration of medical aerosols has been a standard adjunct to treatment of critically ill patients since positive-pressure mechanical ventilators were introduced over 60 years ago, and most ventilators can operate a jet nebulizer in synchrony with mechanically delivered breaths. However, for the first 40 years, little was known about the efficiency of aerosol delivery during...

Among the devices employed for aerosol generation (metered-dose inhalers, nebulizers, and dry powder inhalers) only metered-dose inhalers and nebulizers are routinely employed for aerosol delivery to mechanically ventilated patients. The ventilator circuit and artificial airway were previously thought to be major barriers to effective aerosol delivery to mechanically ventilated patients. In the...

The low tidal volume and flow in preschool children may reduce the efficiency of aerosol delivery from a pressurized metered-dose inhaler (pMDI) through a traditional holding chamber. A prototype small-volume steel holding chamber with two one-way valves was devised to prolong aerosol availability in the chamber and to ensure unidirectional airflow. Dead space between the valves was minimized t...

Early studies have shown that only a small fraction of the nominal nebulizer dose (1–12%) is available for delivery to the lungs in intubated children and adults.1-3 Since then, the characterization of forces governing aerosol delivery in ventilated patients has led to improvements in techniques, and the development of newer aerosol generators with the ability to deliver as much drug to ventila...

BACKGROUND Different types of nebulizers and interfaces are used for the treatment of adults and children with pulmonary diseases. The purpose of this study was to determine the efficiency of a mesh nebulizer (MN) with a proprietary adapter and a jet nebulizer (JN) under different configurations in adult and pediatric models of spontaneous breathing. We hypothesize that delivery efficiency of J...