- Inhalation technique practical skills and knowledge among physicians and nurses in two pediatric emergency settings. [Journal Article]J Asthma 2019; :1-7JA
- CONCLUSIONS: Healthcare professionals' practical skills and knowledge on inhalation therapy were not completely mastered and could be improved with a mandatory training program.
- Dose Response to Transnasal Pulmonary Administration of Bronchodilator Aerosols via Nasal High-Flow Therapy in Adults with Stable Chronic Obstructive Pulmonary Disease and Asthma. [Journal Article]Respiration 2019; :1-9R
- CONCLUSIONS: With a nasal cannula at 15-20 L/min, transnasal pulmonary delivery of 1.5 mg albuterol resulted in similar bronchodilator response as 4 actuations of MDI + VHC.
- In vitro evaluation of aerosol drug delivery with and without high flow nasal cannula in children. [Journal Article]Pediatr Pulmonol 2019PP
- CONCLUSIONS: Aerosol administered via facemask over HFNC was less efficient than removing HFNC during administration. When delivering medical aerosol by facemask, the benefit of increased aerosol delivery must be weighed against the changes in oxygen delivery and risk of lung derecruitment when nasal prongs are removed.
- Evaluation of Disposable and Traditional Accessory Devices for Use With a Pressurized Metered-Dose Inhaler. [Journal Article]Respir Care 2019RC
- CONCLUSIONS: The valved holding chamber and the paper spacer had better aerodynamic characteristics than the other devices tested. We consider the antistatic devices to be the optimum devices for aerosol delivery due to their high efficacy compared to non-antistatic devices.
- Comment on "Optimizing the Delivery of Inhaled Medication for Respiratory Patients: The Role of Valved Holding Chambers". [Comment]Can Respir J 2019; 2019:6475651CR
- Paediatric in vitro models showed significant variations in fluticasone proprionate output from valved holding chambers. [Journal Article]Acta Paediatr 2019AP
- CONCLUSIONS: The VHC and facemasks chosen had a considerable and significant impact on FP delivery. The facemask seal should be checked whenever a VHC facemask combination is used. Young children should be taught to use the VHC mouthpiece as early as possible to optimise FP delivery and achieve more effective asthma therapy.
- Metered-dose inhaler therapy with spacers: Are newborns capable of using this system correctly? [Journal Article]Pediatr Pulmonol 2019; 54(9):1417-1421PP
- CONCLUSIONS: In neonates, the MDI therapy with a spacer chamber and face mask is susceptible to failure due to the inability of most patients in this age range to generate a negative inspiratory pressure sufficient to open the spacer valve.
- Effects of flow rate on transnasal pulmonary aerosol delivery of bronchodilators via high-flow nasal cannula for patients with COPD and asthma: protocol for a randomised controlled trial. [Journal Article]BMJ Open 2019; 9(6):e028584BO
- Both in vitro and in vivo radiolabelled studies on nebulisation via high-flow nasal cannula showed that inhaled dose decreases as the administered gas flow increases. In our previous in vitro study, we investigated the effects of the ratio of gas flow to subject's peak inspiratory flow (GF:IF) on the aerosol deposition, which increased as the GF:IF decreased, with an optimal GF:IF between 0.1 and…
Both in vitro and in vivo radiolabelled studies on nebulisation via high-flow nasal cannula showed that inhaled dose decreases as the administered gas flow increases. In our previous in vitro study, we investigated the effects of the ratio of gas flow to subject's peak inspiratory flow (GF:IF) on the aerosol deposition, which increased as the GF:IF decreased, with an optimal GF:IF between 0.1 and 0.5 producing a stable 'lung' deposition in both quiet and distressed breathing. Thus, we aim to validate our in vitro findings in subjects with reversible airflow limitations by assessing their response to inhaled bronchodilator.
- Bioavailability of Beclometasone From Two HFA-BDP Formulations With a Spacer. [Journal Article]Respir Care 2019; 64(10):1222-1230RC
- CONCLUSIONS: The difference in the BDP particle size between formulations as well as spacer size greatly affected drug deposition in different regions of the respiratory tract.
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- Valved holding chamber drug delivery is dependent on breathing pattern and device design. [Journal Article]ERJ Open Res 2019; 5(1)EO
- Small children with airway obstruction breathe with very low tidal volumes (V T) and high respiratory rates (RRs). These extreme respiratory patterns affect drug delivery unpredictably through valved holding chambers (VHCs). We compared in an in vitro study the effectiveness of two VHCs, one small (140 mL, Optichamber Diamond) and one large (350 mL, Babyhaler) without facemasks, to deliver salbut…
Small children with airway obstruction breathe with very low tidal volumes (V T) and high respiratory rates (RRs). These extreme respiratory patterns affect drug delivery unpredictably through valved holding chambers (VHCs). We compared in an in vitro study the effectiveness of two VHCs, one small (140 mL, Optichamber Diamond) and one large (350 mL, Babyhaler) without facemasks, to deliver salbutamol to filters positioned between the VHC mouthpieces and a breathing simulator. Different tidal volumes (from 30 mL to 200 mL) and RRs (25·min-1 and 50·min-1) were applied through a breathing simulator. The amount of salbutamol delivered increased with increasing V T in both VHCs for both RRs (ρ>0.87 and p<0.001 for both devices at both rates). The effect of RR was not as evident, but drug delivery tended to be higher at the higher rate. Drug delivery was significantly higher through the Optichamber Diamond as compared with the Babyhaler at every combination of RR and V T up to a 12-fold difference. We found marked differences in salbutamol delivery between the Babyhaler and Optichamber Diamond VHCs. The delivered dose of salbutamol increased with increasing V T and RR with both VHCs but with differences related to valve dead spaces. Instead of considering all VHCs equal in clinical paediatric practice, each device should be tested in vitro with respiratory patterns relevant to small children with respiratory difficulties.