, Volume 29, Issue 7, pp 1041-1042
Date: 15 May 2003

Maximizing aerosol delivery during mechanical ventilation: go with the flow and go slow

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During the past decade the unprecedented improvements in technology for delivery of inhaled drugs were matched by an equally impressive growth in clinical applications. Especially notable were the impressive gains in knowledge and understanding of methods to deliver inhaled therapies to mechanically ventilated patients. In the recent past optimal techniques for delivery of inhaled drugs to patients receiving mechanical ventilation were defined, and they are now widely applied in clinical practice. Early on investigators employed γ-scintigraphy after administration of radiolabeled aerosols to determine lung deposition in ventilator-dependent patients [1, 2]. These investigators suggested that the efficiency of aerosol delivery is significantly lower in mechanically ventilated than in ambulatory patients. Thus in the early 1990s the consensus of opinion was that the ventilator tubing and endotracheal tube are formidable barriers to effective drug delivery in ventilator-supported patients