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Bronchodilation and Humidification During Noninvasive Mechanical Ventilation

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Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care

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Abstract

The administration of inhalation therapy is a basic treatment option for patients with many respiratory tract diseases, including asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). Due to the exacerbations from which they often suffer, many of these patients also need non-invasive mechanical ventilation (NIV). Therefore, efforts have been made in recent years to put together both these therapies, on the assumption that the combined actions of both treatments can explicate a synergistic effect. The aim of this review is to discuss the most recent medical literature on the administration of inhalation therapy and on humidification during NIV.

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References

  1. Hess DR. Noninvasive ventilation for acute respiratory failure. Respir Care. 2013;58(6):950–72.

    Article  Google Scholar 

  2. Rzepka-Wrona P, Skoczynski S, Wrona D, Barczyk A. Inhalation techniques used in patients with respiratory failure treated with noninvasive mechanical ventilation. Can Respir J. 2018;2018:8959370.

    Article  Google Scholar 

  3. Dhand R. Aerosol therapy in patients receiving noninvasive positive pressure ventilation. J Aerosol Med Pulm Drug Deliv. 2012;25(2):63–78.

    Article  CAS  Google Scholar 

  4. Galindo-Filho VC, Brandão DC, de Ferreira R C, et al. Noninvasive ventilation coupled with nebulization during asthma crises: a randomized controlled trial. Respir Care. 2013;58(2):241–9.

    Article  Google Scholar 

  5. Mukhopadhyay A, Dela Pena E, Wadden B, Procyshyn M, Lim TK. Effects of inhalational bronchodilator treatment during noninvasive ventilation in severe chronic obstructive pulmonary disease exacerbations. J Crit Care. 2009;24:474.e1–5.

    Article  Google Scholar 

  6. Reychler G, Michotte JB. Development challenges and opportunities in aerosol drug delivery systems in non-invasive ventilation in adults. Expert Opin Drug Deliv. 2019;16(2):153–62.

    Article  CAS  Google Scholar 

  7. Esquinas Rodriguez AM, BaHammam A, Scala R, Soroksky A, Nasilowski J, Siekmeier R, Koksal GM, Celikel T, Shah PS, Mukhopadhyay A, Cosentini R, Papadakos PJ. Aerosol therapy during non-invasive mechanical ventilation. Review of key technical factors and clinical implications. Can J Respir Ther. 2013;49(1):11–7.

    Google Scholar 

  8. Michotte JB, Jossen E, Roeseler J, Liistro G, Reychler G. In vitro comparison of five nebulizers during noninvasive ventilation: analysis of inhaled and lost doses. J Aerosol Med Pulm Drug Deliv. 2014;27(6):430–40.

    Article  CAS  Google Scholar 

  9. Dhand R. How should aerosols be delivered during invasive mechanical ventilation? Respir Care. 2017;62(10):1343–67.

    Article  Google Scholar 

  10. Esquinas Rodriguez AM, Scala R, Soroksky A, BaHamman A, de Klerk A, Valipour A, Chiumello D, Martin C, Holland AE. Clinical review: humidifiers during non-invasive ventilation—key topics and practical implications. Crit Care. 2012;16(1):203, 7 pgs.

    Article  Google Scholar 

  11. Branson RD, Gentile MA. Is humidification always necessary during noninvasive ventilation in the hospital? Respir Care. 2010;35(2):209–16.

    Google Scholar 

  12. Plotnikov GA, Accoce M, Navarro E, Tiribelli N. Humidification and heating of inhaled gas in patients with artificial airway. A narrative review. Rev Bras Ter Intensiva. 2018;30(1):86–97.

    Google Scholar 

  13. Michotte JB, Staderini E, Aubriot AS, Jossen E, Dugernier J, Liistro G, Reychler G. Pulmonary drug delivery following continuous vibrating mesh nebulization and inspiratory synchronized vibrating mesh nebulization during noninvasive ventilation in healthy volunteers. J Aerosol Med Pulm Drug Deliv. 2018;31(1):33–41.

    Article  CAS  Google Scholar 

  14. Saeed H, Ali AMA, Elberry AA, Eldin AS, Rabea H, Abdelrahim MEA. Modeling and optimization of nebulizers’ performance in non-invasive ventilation using different fill volumes: comparative study between vibrating mesh and jet nebulizers. Pulm Pharmacol Ther. 2018;50:62–71. https://doi.org/10.1016/j.pupt.2018.04.005.

    Article  CAS  PubMed  Google Scholar 

  15. Harb HS, Elberry AA, Rabea H, Fathy M, Abdelrahim ME. Performance of large spacer versus nebulizer T-piece in single-limb noninvasive ventilation. Respir Care. 2018;63(11):1360–9.

    Article  Google Scholar 

  16. Bodet-Contentin L, Guillon A, Boulain T, Frat JP, Garot D, Le Pennec D, Vecellio L, Ehrmann S, Giraudeau B, Tavernier E, Dequin PF. Salbutamol nebulization during noninvasive ventilation in exacerbated chronic obstructive pulmonary disease patients: a randomized controlled trial. J Aerosol Med Pulm Drug Deliv. 2019;32(3):149–55.

    Article  CAS  Google Scholar 

  17. Xu MJ, Dai B, Peng Y, Su J, Tan W, Zhao HW. Effect of jet nebulization on noninvasive positive-pressure ventilation administered with non-invasive or intensive care unit ventilators: a bench study. Respiration. 2018;13:1–8.

    Google Scholar 

  18. Peng Y, Dai B, Hu CX, Su J, Tan W, Zhao HW, Kang J. Which nebulizer position should be avoided? An extended study of aerosol delivery and ventilator performance during noninvasive positive pressure ventilation. Respiration. 2018;95(3):145–53.

    Article  Google Scholar 

  19. Saeed H, Mohsen M, Salah Eldin A, Elberry AA, Hussein RRS, Rabea H, Abdelrahim MEA. Effects of fill volume and humidification on aerosol delivery during single-limb noninvasive ventilation. Respir Care. 2018;63(11):1370–8.

    Article  Google Scholar 

  20. Harb HS, Elberry AA, Rabea H, Fathy M, Abdelrahim ME. Is combihaler usable for aerosol delivery in single limb non-invasive mechanical ventilation? J Drug Deliv Sci Technol. 2017;40:28–34.

    Article  CAS  Google Scholar 

  21. Walenga RL, Longest PW, Kaviratna A, Hindle M. Aerosol drug delivery during noninvasive positive pressure ventilation: effects of intersubject variability and excipient enhanced growth. J Aerosol Med Pulm Drug Deliv. 2017;30(3):190–205.

    Article  CAS  Google Scholar 

  22. Rabea H, Ali AM, Salah Eldin R, Abdelrahman MM, Said AS, Abdelrahim ME. Modelling of in-vitro and in-vivo performance of aerosol emitted from different vibrating mesh nebulisers in non-invasive ventilation circuit. Eur J Pharm Sci. 2017;97:182–91.

    Article  CAS  Google Scholar 

  23. Hassan A, Salah Eldin R, Abdelrahman MM, Abdelrahim ME. In-vitro/in-vivo comparison of inhaled salbutamol dose delivered by jet nebulizer, vibrating mesh nebulizer and metered dose inhaler with spacer during non-invasive ventilation. Exp Lung Res. 2017;43(1):19–28.

    Article  CAS  Google Scholar 

  24. Hussein RRS, M A Ali A, Salem HF, Abdelrahman MM, Said ASA, Abdelrahim MEA. In vitro/in vivo correlation and modeling of emitted dose and lung deposition of inhaled salbutamol from metered dose inhalers with different types of spacers in noninvasively ventilated patients. Pharm Dev Technol. 2017;22(7):871–80.

    Article  CAS  Google Scholar 

  25. Sutherasan Y, Ball L, Raimondo P, Caratto V, Sanguineti E, Costantino F, Ferretti M, Kacmarek RM, Pelosi P. Effects of ventilator settings, nebulizer and exhalation port position on albuterol delivery during non-invasive ventilation: an in-vitro study. BMC Pulm Med. 2017;17(1):9.

    Article  Google Scholar 

  26. Galindo-Filho VC, Ramos ME, Rattes CS, Barbosa AK, Brandão DC, Brandão SC, Fink JB, de Andrade AD. Radioaerosol pulmonary deposition using mesh and jet nebulizers during noninvasive ventilation in healthy subjects. Respir Care. 2015;60(9):1238–46.

    Article  Google Scholar 

  27. Michotte JB, Staderini E, Le Pennec D, Dugernier J, Rusu R, Roeseler J, Vecellio L, Liistro G, Reychler G. In vitro comparison of a vibrating mesh nebulizer operating in inspiratory synchronized and continuous nebulization modes during noninvasive ventilation. J Aerosol Med Pulm Drug Deliv. 2016;29(4):328–36.

    Article  CAS  Google Scholar 

  28. Rodriguez Garcia L, Medina A, Modesto I, Alapont V, Palacios Loro ML, Mayordomo-Colunga J, Vivanco-Allende A, Rey C. Safety of aerosol therapy in children during noninvasive ventilation with helmet and total face mask. Med Intensiva. 2018;27:pii: S0210-5691(18)30184-0.

    Google Scholar 

  29. Miller DD, Amin MM, Palmer LB, Shah AR, Smaldone GC. Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation. Am J Resoir Crit Care Med. 2003;168:1205–9.

    Article  Google Scholar 

  30. Chatmongkolchart S, Schettino GP, Dillman C, Kacmarek RM, Hess DR. In vitro evaluation of aerosol bronchodilator delivery during noninvasive positive pressure ventilation: effect of ventilator settings and nebulizer position. Crit Care Med. 2002;30(11):2515–9.

    Article  Google Scholar 

  31. Velasco J, Berlinski A. Albuterol delivery efficiency in a pediatric model of noninvasive ventilation with double-limb circuit. Respir Care. 2018;63(2):141–6.

    Article  Google Scholar 

  32. Pollack CV Jr, Fleisch KB, Dowsey K. Treatment of acute bronchospasm with beta-adrenergic agonist aerosols delivered by a nasal bilevel positive airway pressure circuit. Ann Emerg Med. 1995;26(5):552–7.

    Article  Google Scholar 

  33. Brandao DC, Lima VM, Filho VG, Silva TS, Campos TF, Dean E, de Andrade AD. Reversal of bronchial obstruction with bi-level positive airway pressure and nebulization in patients with acute asthma. J Asthma. 2009;46(4):356–61.

    Article  Google Scholar 

  34. Boyer A, Vargas F, Hilbert G, Gruson D, Mousset-Hovaere M, Castaing Y, Dreyfuss D, Ricard JD. Small dead space heat and moisture exchangers do not impede gas exchange during noninvasive ventilation: a comparison with a heated humidifier. Intensive Care Med. 2010;36:1348–54.

    Article  Google Scholar 

  35. Lellouche F, Pignataro C, Maggiore SM, Girou E, Deye N, Taillé S, Fischler M, Brochard L. Short-term effects of humidification devices on respiratory pattern and arterial blood gases during noninvasive ventilation. Respir Care. 2012;57(11):1879–86.

    Article  Google Scholar 

  36. Lellouche F, L’Her E, Abroug F, et al. Impact of the humidification device on intubation rate during noninvasive ventilation with ICU ventilators: results of a multicenter randomized controlled trial. Intensive Care Med. 2014;40:211–9.

    Article  Google Scholar 

  37. Nilius G, Domanski U, Schroeder M, Woehrle H, Graml A, Franke K-J. Mask humidity during CPAP: influence of ambient temperature, heated humidification and heated tubing. Nat Sci Sleep. 2018;10:135–42.

    Article  Google Scholar 

  38. Alqahtani JS, Worsley P, Voegeli D. Effect of humidified noninvasive ventilation on the development of facial skin breakdown. Respir Care. 2018;63(9):1102–10.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, Catholic University of the Sacred Heart, Fondazione “Policlinico Universitario A. Gemelli” IRCCS, Rome, Italy

    Eloisa Sofia Tanzarella & Mariano Alberto Pennisi

Authors
  1. Eloisa Sofia Tanzarella
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  2. Mariano Alberto Pennisi
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Corresponding author

Correspondence to Mariano Alberto Pennisi .

Editor information

Editors and Affiliations

  1. Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

  2. Department of Pathophysiology and Pulmonary Rehab, Azienda Ospedaliera dei Colli PO Monaldi, Napoli, Italy

    Giuseppe Fiorentino

  3. Innovative Technologies for the Study of Sleep Breathing Disorders, Institute for Biomedical Research and Innovation (IRIB), Italian National Research Council, Palermo, Italy

    Giuseppe Insalaco

  4. Department of Pulmonary and CC Medicine, Lenox Hill Hospital, New York, NY, USA

    Bushra Mina

  5. Department of Respiratory and CC Medicine, First Affiliated Hospital of Chongqing M, Chongqing, China

    Jun Duan

  6. Anestesia and Pediatric Intensive Care Department, University Hospital Policlinico S. Orsola-Malpighi, Bologna, Italy

    Maria Cristina Mondardini

  7. Anestesia and Pediatric Intensive Care Department, University Hospital Policlinico S. Orsola-Malpighi, Bologna, Italy

    Fabio Caramelli

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Tanzarella, E.S., Pennisi, M.A. (2020). Bronchodilation and Humidification During Noninvasive Mechanical Ventilation. In: Esquinas, A.M., et al. Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-42998-0_16

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  • DOI: https://doi.org/10.1007/978-3-030-42998-0_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42997-3

  • Online ISBN: 978-3-030-42998-0

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