| Special problems in aerosol delivery: artificial airways. | |
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MedLine Citation:
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PMID: 10894456 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Several factors interact in influencing aerosol deposition during mechanical ventilation. Among these factors, the artificial airway is a significant barrier for aerosol deposition. Earlier studies overemphasized the impediments created by the artificial airway to aerosol delivery, because the aerosol generator was placed adjacent to the endotracheal tube or was connected to it. When the aerosol generator is placed away from the endotracheal tube, the fraction that deposits within the tube is reduced and greater aerosol deposition occurs in the lungs. The type of aerosol generator used and the ventilator settings have a greater effect than the size of the tube on the amount of aerosol that deposits in the artificial airway. To minimize aerosol loss within artificial airways, an endotracheal tube of the appropriate size should be selected. "Priming" the tube with a few doses of aerosol before use decreases the electrostatic charge on its walls and may reduce aerosol deposition within the tube. Similarly, using a spacer with the MDI, and placement of the combination in the inspiratory limb at a distance of at least 15 cm from the endotracheal tube reduces aerosol loss within the endotracheal tube. Use of nebulizers that produce submicronic aerosols, and placing them closer to the ventilator instead of closer to the patient also decreases aerosol impaction in the artificial airway. Use of a low inspiratory flow (30-60 L/min in adults), higher duty cycle (> 0.3), and helium-oxygen mixture instead of air or oxygen are other measures to reduce aerosol loss in the airway and thereby improve aerosol delivery to the lower respiratory tract of mechanically ventilated patients. |
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Authors:
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R Dhand |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Respiratory care Volume: 45 ISSN: 0020-1324 ISO Abbreviation: Respir Care Publication Date: 2000 Jun |
Date Detail:
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Created Date: 2000-11-15 Completed Date: 2000-11-15 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7510357 Medline TA: Respir Care Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 636-45 Citation Subset: IM |
Affiliation:
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Division of Pulmonary and Critical Care Medicine, Loyola University of Chicago Stritch School of Medicine, and Hines Veterans Affairs Hospital, Illinois 60141, USA. dhand@research.hines.med.va.gov |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aerosols*
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pharmacokinetics Bronchodilator Agents / administration & dosage Humans Intubation, Intratracheal* / instrumentation Nebulizers and Vaporizers* Pulmonary Ventilation Respiration, Artificial* |
| Chemical | |
Reg. No./Substance:
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0/Aerosols; 0/Bronchodilator Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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