Document Detail

Aerosol Delivery and Humidification With the Boussignac Continuous Positive Airway Pressure (CPAP) Device.
MedLine Citation:
PMID:  21513584     Owner:  NLM     Status:  Publisher    
BACKGROUND: A simple method for effective bronchodilator aerosol delivery while continuing continuous positive airway pressure (CPAP) would be useful in patients with severe bronchial obstruction. We assessed the effectiveness of bronchodilator aerosol delivery during CPAP generated by a small open device, the Boussignac CPAP system, as well as the optimal humidification system. METHODS: First, we assessed the relationship between flow and pressure generated in the mask using the Boussignac CPAP system. Second, we measured inspired-gas humidity during CPAP with several humidification strategies in nine healthy volunteers, and then we measured particle size of bronchodilator during CPAP with and without heat-moisture exchanger in a bench study. Third, we compared work of breathing and gas exchange after a β₂-agonist bronchodilator aerosol (Terbutaline) delivered using CPAP or a standard nebulization in seven patients with acute respiratory failure and airway obstruction. RESULTS: Optimal humidity was obtained only using heat-moisture exchangers or heated humidifiers, and use of heat-moisture exchanger had no influence on particle size of bronchodilator. Work of breathing decreased similarly after bronchodilator aerosol delivery using the standard nebulization or CPAP, but PaO₂ increased significantly only after CPAP delivery. CONCLUSIONS: CPAP bronchodilator delivery decreases the work of breathing as effectively as does standard nebulization but produces a greater oxygenation improvement in patients with airway obstruction. To optimize airway humidification, a heat-moisture exchanger could be used with the Boussignac CPAP system without modify aerosol delivery.
Arnaud W Thille; Jean-François Bertholon; Marie-Hélène Becquemin; Monique Roy; Aissam Lyazidi; François Lellouche; Esther Pertusini; Georges Boussignac; Bernard Maître; Laurent Brochard
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-19
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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