Aerosol delivery through an artificial airway.
For both lung and systemic diseases, aerosol delivery of drugs into the lungs can often offer substantial advantages over other routes of administration. In the intensive care unit, however, the artificial airway can be a substantial barrier to aerosol delivery, so clinicians must pay careful attention to the ventilator pattern, the delivery gas humidity/density, the device characteristics, and the circuit/tube properties. When those are optimized, aerosol delivery from a nebulizer or metered-dose inhaler and through an endotracheal tube can begin to approach that seen in a nonintubated patient. Novel approaches, such as generating the aerosol within the airway, offer the opportunity to greatly increase deposition efficiency and focal drug targeting in intubated patients.
MacIntyre
Neil R
NR
Respiratory Care Services, Duke University Medical Center, Durham, North Carolina 27710, USA. neil.macintyre@duke.edu
D000336:Aerosols / Q000008:administration & dosage*; D016503:Drug Delivery Systems / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal; D036501:Metered Dose Inhalers; D009330:Nebulizers and Vaporizers
D000336:Aerosols