Aerosol therapy in patients receiving noninvasive positive pressure ventilation

Journal of Aerosol Medicine and Pulmonary Drug Delivery

Volumn 25, Issue 2, 2012, Pages 63-78

  Dhand, Rajiv ^a  

^a University of Missouri   (United States)

Author keywords

acute exacerbation of COPD; bronchodilator therapy; continuous positive airway pressure; inhalation therapy; mechanical ventilation; metered dose inhalers; nebulizers; noninvasive ventilation; pressure support ventilation

Indexed keywords

AEROSOL; ARTIFICIAL VENTILATION; ASTHMA; BREATHING; CHRONIC OBSTRUCTIVE LUNG DISEASE; DRUG DELIVERY SYSTEM; FACE MASK; FORCED EXPIRATORY VOLUME; FORCED VITAL CAPACITY; GAS FLOW; HUMAN; HUMIDITY; NASOGASTRIC TUBE; NEBULIZER; NONINVASIVE POSITIVE PRESSURE VENTILATION; PATIENT SELECTION; PEAK INSPIRATORY FLOW; POSITIVE END EXPIRATORY PRESSURE; RESPIRATORY AIRFLOW; RESPIRATORY DISTRESS; REVIEW;

AEROSOLS; DRUG DELIVERY SYSTEMS; HUMANS; INTENSIVE CARE UNITS; MASKS; NEBULIZERS AND VAPORIZERS; PHARMACEUTICAL PREPARATIONS; POSITIVE-PRESSURE RESPIRATION; RESPIRATORY INSUFFICIENCY;

EID: 84859386983     PISSN: 19412711     EISSN: 19412703     Source Type: Journal    
DOI: 10.1089/jamp.2011.0929     Document Type: Review

References (132)

1. Nava S, and Hill NS: Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374:250-259.
2. Vitacca M, Ambrosino N, Clini E, Porta R, Rampulla C, Lanini B, and Nava S: Physiologic response to pressure support ventilation delivered before and after extubation in patients not capable of totally spontaneous breathing. Am J Respir Crit Care Med. 2001;164:638-641.
3. Ambrosino N, and Vagheggini G: Noninvasive positive pressure ventilation in the acute care setting: where are we? Eur Respir J. 2008;31:874-886.
4. Mehta S, and Hill NS: Noninvasive ventilation. Am J Respir Crit Care Med. 2001;163:540-577.
5. Bott J, Carroll MP, Conway JH, Keilty SE, Ward EM, Brown AM, Paul EA, Elliott MW, Godfrey RC, and Wedzicha JA. Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet. 1993;341:1555-1557.
6. Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A, Simonneau G, Benito S, Gasparetto A, Lemaire F, Isabey D, and Harf A: Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995;333:817-822.
7. Kramer N, Meyer TJ, Meharg J, Cece RD, and Hill NS: Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med. 1995;151:1799-1806.
8. Ram FSF, Picot J, Lightowler J, and Wedzicha JA: Noninvasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2004;3: CD004104.
9. Carlucci A, Richard JC, Wysocki M, Lepage E, Brochard L, and the SRLF Collaborative group on Mechanical Ventilation: Noninvasive versus conventional mechanical ventilation: an epidemiologic survey. Am J Respir Crit Care Med. 2001;163:874-880.
10. Mukhopadhyay A, Dela Pena E, Wadden B, Procyshyn M, and Lim TK: Effects of inhalational bronchodilator treatment during noninvasive ventilation in severe chronic obstructive pulmonary disease exacerbations. J Crit Care. 2009;24:474.e1-474.e5.
11. Dhand R: Inhalation therapy in invasive and noninvasive mechanical ventilation. Curr Opin Crit Care. 2007;13:27-38.
12. Dhand R: Bronchodilator therapy. In: Principles and Practice of Mechanical Ventilation, 3rd Ed. MJ Tobin (ed). McGraw Hill, New York; 2011.
13. Hess DR: The mask for noninvasive ventilation: principles of design and effects on aerosol delivery. J Aerosol Med. 2007;20(Suppl 1):S85-S99.
14. Fink JB: Aerosol delivery to ventilated infant and pediatric patients. Respir Care. 2004;49:653-665.
15. Parkes SN, Bersten AD: Aerosol kinetics and bronchodilator efficacy during continuous positive airway pressure delivered by face mask. Thorax. 1997;52:171-175
16. Schwartz AR, Kacmarek RM, and Hess DR: Factors affecting oxygen delivery with bi-level positive airway pressure. Respir Care. 2004;49:270-275.
17. Hess DR: Noninvasive ventilation in neuromuscular disease: equipment and application. Respir Care. 2006;51:896- 911; discussion 911-912.
18. Mancebo J, Isabey D, Lorino H, Lofaso F, Lemaire F, and Brochard L: Comparative effects of pressure support ventilation and intermittent positive pressure breathing (IPPB) in non-intubated healthy subjects. Eur Respir J. 1995;8: 1901-1909.
19. Masip J, Roque M, Sánchez B, Fernández R, Subirana M, and Expó sito JA: Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and metaanalysis. JAMA. 2005;294:3124-3130.
20. Peter JV, Moran JL, Phillips-Hughes J, Graham P, and Bersten AD: Effect of non-invasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis. Lancet. 2006;367:1155-1163.
21. Abou-Shala N, and Meduri U: Noninvasive mechanical ventilation in patients with acute respiratory failure. Crit Care Med. 1996;24:705-715.
22. Diaz O, Iglesia R, Ferrer M, Zavala E, Santos C, Wagner PD, Roca J, and Rodriguez-Roisin R: Effects of non-invasive ventilation on pulmonary gas exchange and hemodynamics during acute hypercapnic exacerbations of chronic obstructive airways disease. Am J Respir Crit Care Med. 1997;156:1840-1845.
23. Girault C, Richard JC, Chevron V, Tamion F, Pasquis P, Leroy J, and Bonmarchand G: Comparative physiologic effects of non-invasive assist control and pressure support ventilation in acute hypercapnic respiratory failure. Chest. 1997;111:1639-1648.
24. Simonds AK, Parker RA, and Branthwaite MA: The effect of intermittent positive-pressure hyperinflation in restrictive chest wall disease. Respiration. 1989;55:136-143.
25. Appendini L, Patessio A, Zanaboni S, Carone M, Gukov B, Donner CF, and Rossi A: Physiologic effects of positive end-expiratory pressure and mask pressure support during exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1994;149:1069-1076.
26. Gay PC, Hess D, and Hill N: Noninvasive proportional assist ventilation for acute respiratory insufficiency comparison with pressure support ventilation. Am J Respir Crit Care Med. 2001;164:1606-1611.
27. Reychler G, Keyeux A, Cremers C, Veriter C, Rodenstein DO, and Liistro G: Comparison of lung deposition in two types of nebulization. Intrapulmonary percussive ventilation vs. jet nebulization. Chest. 2004;125:502-508.
28. Thomas SH, Langford JA, George RJ, and Geddes DM: Aerosol deposition in the human lung: effect of highfrequency scillation on the deposition characteristics of an inhaled nebulized aerosol. Clin Sci (Lond). 1988;75:535-542.
29. Hill NN, Carlisle C, and Kramer NR: Effect of a nonrebreathing exhalation valve on long-term ventilation using a bilevel device. Chest. 2002;122:84-91.
30. Saatci E, Miller DM, Stell IM, Lee KC, and Moxham J: Dynamic dead space in face masks used with noninvasive ventilators: a lung model study. Eur Respir J. 2004;23:129-135.
31. Dhand R and Tobin MJ: Inhaled drug therapy in mechanically- ventilated patients. Am J Respir Crit Care Med. 1997;156:3-10.
32. Fink JB, Dhand R, Grychowski J, Fahey PJ, and Tobin MJ: Reconciling in vitro and in vivo measurements of aerosol delivery from a metered-dose inhaler during mechanical ventilation and defining efficiency-enhancing factors. Am J Respir Crit Care Med. 1999;159:63-68.
33. Miller DD, Amin MM, Palmer LB, Shah AR, and Smaldone GC: Aerosol delivery and modern mechanical ventilation: in vitro/in vivo evaluation. Am J Respir Crit Care Med. 2003;168:1205-1209.
34. Wilkes AR: Heat and moisture exchangers: structure and function. Respir Care Clin N Am. 1998;4:261-279.
35. Lange CF, and Finlay WH: Overcoming the adverse effect of humidity in aerosol delivery via pressurized metereddose inhalers during mechanical ventilation. Am J Respir Crit Care Med. 2000;161:1614-1618.
36. Thille AW, Bertholon JF, Becquemin MH, Roy M, Lyazidi A, Lellouche F, Pertusini E, Boussignac G, Maitre B, and Brochard L: Aerosol delivery and humidification with the Boussignac continuous positive airway pressure (CPAP) device. espir Care. 2011 [E pub ahead of print] doi:10.4187/respcare.00847.
37. Lellouche F, Maggiore SM, Lyazidi A, Deye N, Taille S, and Brochard L: Water content of delivered gases during oninvasive ventilation in healthy subjects. Intensive Care Med. 2009;35:987-995.
38. Chanques G, Constantin JM, Sauter M, Jung B, Sebbane M, Verzilli D, Lefrant JY, and Jaber S: Discomfort associated with underhumidified high-flow oxygen therapy in critically ill patients. Intensive Care Med. 2009;35:996-1003.
39. Richards GN, Cistulli PA, Ungar GR, Berthon-Jones M, and Sullivan CE: Mouth leak with nasal continuous positive airway pressure increases nasal airway resistance. Am J Respir Crit Care Med. 1996;154:182-186.
40. Fontanari P, Burnet H, Zattara-Hartmann MC, and Jammes Y: Changes in airway resistance induced by nasal inhalation of cold dry, dry, or moist air in normal individuals. J Appl Physiol. 1996;81:1739-1743.
41. Jolliet P, Tassaux D, Thouret JM, and Chevrolet JC: Beneficial effects of helium:oxygen versus air:oxygen noninvasive pressure support in patients with decompensated chronic obstructive pulmonary disease. Crit Care Med. 1999;27:2422-2429.
42. Jaber S, Fodil R, Carlucci A, Boussarsar M, Pigeot J, Lemaire F, Harf A, Lofaso F, Isabey D, and Brochard L: Noninvasive ventilation with helium-oxygen in acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2000;161:1191-1200.
43. Tassaux D, Jolliet P, Thouret JM, Roeseler J, Dorne R,Chevrolet JC: Calibration of seven ICU ventilators for mechanical ventilation with helium-oxygen mixtures. Am J Respir Crit Care Med. 1999;160:22-32.
44. Anderson M, Svartengren M, Bylin G, Philipson K, and Camner P: Deposition in asthmatics of particles inhaled in air or in helium-oxygen. Am Rev Resp Dis. 1993;147:524-528.
45. Peterson JB, Prisk GK, and Darquenne C: Aerosol deposition in the human lung periphery is increased by reduceddensity gas breathing. J Aerosol Med Pulm Drug Deliv. 2008;21:159-168.
46. Goode ML, Fink JB, Dhand R, and Tobin MJ: Improvement in aerosol delivery with helium-oxygen mixtures during mechanical ventilation. Am J Respir Crit Care Med. 2001; 163:109-114.
47. Hess DR, Acosta FL, Ritz RH, Kacmarek RM, and Camargo CA Jr: The effect of heliox on nebulizer function using a beta-agonist bronchodilator. Chest. 1999;115:184-189.
48. Nava S, Navalesi P, and Gregoretti C: Interfaces and humidification for non-invasive mechanical ventilation. Respir Care. 2009;54:71-82.
49. Navalesi P, Fanfulla F, Frigerio P, Gregoretti C, and Nava S: Physiologic evaluation of noninvasive mechanical ventilation delivered with three types of mask in patients with chronic respiratory failure. Crit Care Med. 2000;28:1785-1790.
50. Kwok H, McCormack J, Cece R, Houtchens J, and Hill NS: Controlled trial of oronasal mask ventilation in the treatment of acute respiratory failure. Crit Care Med. 2003; 31:468-473.
51. Girault C, Briel A, Benichou J, Hellot MF, Dachraoui F, Tamion F, and Bonmarchand G: Interface strategy during non-invasive positive pressure ventilation for hypercapnic acute respiratory failure. Crit Care Med. 2009;37:124-131.
52. Fraticelli AT, Lellouche F, LHer E, Taille S, Mancebo J, and Brochard L: Physiologic effects of different interfaces during noninvasive ventilation for acute respiratory failure. Crit Care Med. 2009;37:939-945.
53. Chua HL, Collis GG, Newbury AM, Chan K, Bower GD, Sly PD, and Le Souef PN: The influence of age on aerosol deposition in children with cystic fibrosis. Eur Respir J. 1994;7:2185-2191.
54. Everard ML, Hardy JG, and Milner AD: Comparison of nebulised aerosol deposition in the lungs of healthy adults following oral and nasal inhalation. Thorax. 1993;48:1045-1046.
55. Nikander K, Agertoft L, and Pedersen S: Breath-synchronized nebulization diminishes the impact of patient-device interfaces (face mask or mouthpiece) on the inhaled mass of nebulized budesonide. J Asthma. 2000;37:451-459.
56. Kishida M, Suzuki I, Kabayama H, Koshibu T, Izawa M, Takeshita Y, Kurita F, Okada M, Shinomiya N, and Aoki T: Mouthpiece versus facemask for delivery of nebulized salbutamol in exacerbated childhood asthma. J Asthma. 2002;39:337-339.
57. Chen YS: Aerosol deposition in the extrathoracic region. Aerosol Sci Technol. 2003;37:659-671.
58. Kelly JT, Asgharian B, Kimbell JS, and Wong B: Particle deposition in human nasal airway replicas manufactured by different methods. Part I: inertial regime particles. Aerosol Sci Technol. 2004;38:1063-1071.
59. Erzinger S, Schueepp KG, Brooks-Wildhaber J, Devadason SG, and Wildhaber JH: Facemasks and aerosol delivery in vivo. J Aerosol Med. 2007;20(Suppl 1):S78-S83.
60. Hayden JT, Smith N, Woolf DA, Barry PW, and OCallaghan C: A randomised crossover trial of facemask efficacy. Arch Dis Child. 2004;89:72-73.
61. Sangwan S, Gurses BK, and Smaldone GC: Facemasks and facial deposition of aerosols. Pediatr Pulmonol. 2004;37: 447-452.
62. Bisquerra RA, Botz GH, and Nates JL: Ipratropiumbromide- induced acute anisocoria in the intensive care setting due to ill-fitting face masks. Respir Care. 2005;50: 1662-1664.
63. Parke RL, McGuinness SP, and Eccleston ML: A preliminary randomized controlled trial to assess effectiveness of nasal high-flow oxygen in intensive care patients. Respir Care. 2011;56:265-270.
64. Dysart K, Miller TL, Wolfson MR, and Shaffer TH: Research in high flow therapy: mechanisms of action. Respir Med. 2009;103:1400-1405.
65. Bhashyam AR, Wolf MT, Marcinkowski AL, Saville A, Thomas K, Carcillo JA, and Corcoran TE: Aerosol delivery through nasal cannulas: an in vitro study. J Aerosol Med Pulm Drug Deliv. 2008;21:181-188.
66. Hindle M, and Longest PW: Evaluation of enhanced condensational growth (ECG) for controlled respiratory drug delivery in a mouth-throat and upper tracheobronchial model. Pharmaceut Res. 2010;27:1800-1811.
67. Longest PW, Tian G, and Hindle M: Improving the lung delivery of nasally administered aerosols during noninvasive ventilation-an application of enhanced condensational growth (ECG). J Aerosol Med Pulm Drug Deliv. 2011;24:103-118.
68. Diot P, Morra L, and Smaldone GC: Albuterol delivery in a model of mechanical ventilation. Comparison of metereddose inhaler and nebulizer efficiency. Am J Respir Crit Care Med. 1995;152:1391-1394.
69. Bishop MJ, Larson RP, and Buschman DL: Metered dose inhaler aerosol characteristics are affected by the endotracheal tube actuator/adapter used. Anesthesiology. 1990;73: 1263-1265.
70. Rau JL, Harwood RJ, and Groff JL: Evaluation of a reservoir device for metered-dose bronchodilator delivery to intubated adults. An in vitro study. Chest. 1992; 102:924-930.
71. Fuller HD, Dolovich MB, Turpie FH, and Newhouse MT: Efficiency of bronchodilator aerosol delivery to the lungs om the metered dose inhaler in mechanically ventilated patients. A study comparing four different actuator devices. Chest. 1994;105:214-218.
72. Dhand R, Jubran A, and Tobin MJ: Bronchodilator delivery by metered-dose inhaler in ventilator-supported patients. Am J Respir Crit Care Med. 1995;151:1827-1833.
73. Dhand R, Duarte AG, Jubran A, Jenne JW, Fink JB, Fahey PJ, and Tobin MJ: Dose-response to bronchodilator delivered by metered-dose inhaler in ventilator-supported patients. Am J Respir Crit Care Med. 1996;154:388-393.
74. Leach CL, Davidson PJ, and Boudreau RJ: Improved airway targeting with the CFC-free HFA-beclomethasone metered-dose inhaler compared with the CFC-beclomethasone. Eur Respir J. 1998;12:1346-1353.
75. Dolovich MB, and Dhand R: Aerosol drug delivery: developments in device design and clinical use. Lancet. 2011;377:1032-1045.
76. Laube BL, Janssens HM, de Jongh FHC, Devadason S, Dhand R, Diot P, Everard ML, Horvath I, Navalesi P, Voshaar T, and Chrystyn H: ERS/ISAM Task Force Report: What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011;37:1308-1331.
77. Wildhaber JH, Hayden MJ, Dore ND, Devadason SG, and LeSou ëf PN: Salbutamol delivery froma hydrofluoralkane pressurized metered-dose inhaler in pediatric ventilator circuits. Chest. 1998;113:186-191.
78. Lugo RA, Kenney JK, Keenan J, Salyer JW, Ballard J, and Ward RM: Albuterol delivery in a neonatal ventilated lung model: nebulization versus chlorofluorocarbon- and hydrofluoroalkane- pressurized metered dose inhalers. Pediatr Pulmonol 2001;31:247-254.
79. Mitchell JP, Nagel MW, Wiersema KJ, Doyle CC, and Migounov VA: The delivery of chlorofluorocarbon-propelled versus hydrofluoroalkane-propelled beclomethasone dipropionate aerosol to the mechanically ventilated patient: a laboratory study. Respir Care. 2003;48:1025-1032.
80. Branconnier MP, and Hess DR: Albuterol delivery during noninvasive ventilation. Respir Care. 2005; 50:1649-1653.
81. ORiordan TG, Greco MJ, Perry RJ, and Smaldone GC: Nebulizer function during mechanical ventilation. Am Rev Respir Dis. 1992;145:1117-1122.
82. ODoherty MJ, Thomas SH, Page CJ, Treacher DF, and Nunan TO: Delivery of a nebulized aerosol to a lung model during mechanical ventilation. Effect of ventilator settings and nebulizer type, position, and volume of fill. Am Rev Respir Dis. 1992;146:383-388.
83. Hughes JM, Saez J: Effects of nebulizer mode and position in a mechanical ventilator circuit on dose efficiency. Respir Care. 1987;32:1131-1135.
84. Ari A, Areabi H, and Fink JB: Evaluation of aerosol generator devices at 3 locations in humidified and non-humidified. circuits during adult mechanical ventilation. Respir Care. 2010;55:837-844.
85. Hess D, Fisher D, Williams P, Pooler S, and Kacmarek RM: Medication nebulizer performance. Effects of diluent volume, nebulizer flow, and nebulizer brand. Chest. 1996;110: 498-505.
86. Rau JL: Design principles of liquid nebulization devices currently in use. Respir Care. 2002;47:1257-1275; discussion 1275-1278.
87. Calvert LD, Jackson JM, White JA, Barry PW, Kinnear WJ, and OCallaghan C: Enhanced delivery of nebulized salbutamol during non-invasive ventilation. J Pharm Pharmacol. 2006;58:1553-1557.
88. Abdelrahim ME, Plant P, and Chrystyn H: In-vitro characterization of the nebulized dose during non-invasive ventilation. J Pharm Pharmacol. 2010;62:966-972.
89. Jashnani RN, Byron PR, and Dalby RN: Testing of dry powder aerosol formulations in different environmental conditions. Int J Pharm. 1995;113:123-130.
90. ORiordan TG, Palmer LB, and Smaldone GC: Aerosol deposition in mechanically ventilated patients. Optimizing nebulizer delivery. Am J Respir Crit Care Med. 1994;149:214-219.
91. Reychler G, Leal T, Roeseler J, Thys F, Delvau N, and Liistro G: Effect of continuous positive airway pressure combined to nebulization on lung deposition measured by urinary excretion of amikacin. Respir Med. 2007;101:2051-2055.
92. Phipps PR, and Gonda I: Droplets produced by medical nebulizers. Some factors affecting their size and solute concentration. Chest. 1990;97:1327-1332.
93. Laube BL, Geller DE, Lin TC, Dalby RN, West-Diener M, and Zeitlin PL: Positive expiratory pressure changes aerosol distribution in patients with cystic fibrosis. Respir Care. 2005;50:1438-1444.
94. Chatmongkolchart S, Schettino GP, Dillman C, Kacmarek RM, and 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;30:2515-2519.
95. Dhand R: Maximizing aerosol delivery during mechanical ventilation: go with the flow and go slow. Intensive Care Med. 2003;29:1041-1042.
96. Dhand R: Aerosol therapy during mechanical ventilation: getting ready for prime time. Am J Respir Crit Care Med. 2003;168:1148-1149.
97. Dolovich MA: Influence of inspiratory flow rate, particle size, and airway caliber on aerosolized drug delivery to the lung. Respir Care. 2000;45:597-608.
98. Laube BL, Links JM, LaFrance ND, Wagner HN, and Rosenstein BJ: Homogeneity of bronchopulmonary distribution of 99mTc aerosol in normal subjects and in cystic fibrosis patients. Chest. 1989;95:822-830.
99. Smaldone GC: Assessing new technologies: patient-device interactions and deposition. Respir Care. 2005;50:1151-1160.
100. Petrof BJ, Legare M, Goldberg P, Milic-Emili J, and Gottfried SB: Continuous positive airway pressure reduces work of breathing and dyspnea during weaning from mechanical ventilation in severe chronic obstructive pulmonary disease. Am Rev Respir Dis. 1990;141:281-289.
101. Brochard L, Isabey D, Piquet J, Amaro P, Mancebo J, Messadi AA, Brun-Buisson C, Rauss A, Lemaire F, and Harf A: Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med. 1990;323:1523-1530.
102. Shenfield GM, Evans ME, Walker SR, and Paterson JW: The fate of nebulized salbutamol (albuterol) administered by intermittent positive pressure respiration to asthmatic patients. Am Rev Respir Dis. 1973;108:501-505.
103. Dolovich MB, Killian D, Wolff RK, Obminski G, and Newhouse MT: Pulmonary aerosol deposition in chronic bronchitis: intermittent positive pressure breathing versus quiet breathing. Am Rev Respir Dis. 1977;115:397-402.
104. Franca EE, Dornelas de Andrade AF, Cabral G, Almeida Filho P, Silva KC, Galindo Filho VC, Marinho PE, Lemos A, and Parreira VF: Nebulization associated with bi-level noninvasive ventilation: analysis of pulmonary radioaerosol deposition. Respir Med. 2006;100:721-728.
105. Ehrmann S, Mercier E, Vecellio L, Ternant D, Paintaud G, and Dequin PF: Pharmacokinetics of high-dose nebulized amikacin in mechanically ventilated healthy subjects. Intensive Care Med. 2008;34:755-762.
106. ORiordan TG, Palmer LB, and Smaldone GC: Aerosol deposition in mechanically ventilated patients. Optimizing nebulizer delivery. Am J Respir Crit Care Med. 1994;149: 214-219.
107. Reychler G, Wallemacq P, Rodenstein DO, Cumps J, Leal T, and Liistro G: Comparison of lung deposition of amikacin by intrapulmonary percussive ventilation and jet nebulization by urinary monitoring. J Aerosol Med. 2006;19:199-207.
108. Shivaram U, Miro AM, Cash ME, Finch PJ, Heurich AE,and Kamholz SL: Cardiopulmonary responses to continuous positive airway pressure in acute asthma. J Crit Care 1993;8:87-92.
109. Frischknecht-Christensen E, Norregard O, and Dahl R: Treatment of bronchial asthma with terbutaline inhaled by conespacer combined with positive expiratory pressure mask. Chest. 1991;100:317-321.
110. Pollack CV Jr, Fleisch KB, and Dowsey K: Treatment of acute bronchospasm with beta-adrenergic agonist aerosols delivered by a nasal bilevel positive airway pressure circuit. Ann Emerg Med. 1995;26:552-557
111. Soroksky A, Stav D, Shpirer I. A pilot prospective, randomized, placebo-controlled trial of bilevel positive airway pressure in acute asthmatic attack. Chest. 2003;123:1018-1025.
112. Brandao DC, Lima VM, Filho VG, Silva TS, Campos TF, Dean E, and De Andrade AD: Reversal of bronchial obstruction with bi-level positive airway pressure and nebulization in patients with acute asthma. J Asthma. 2009;46: 356-361.
113. Gupta D, Nath A, Agarwal R, and Behera D: A prospective randomized controlled trial on the efficacy of noninvasive ventilation in severe acute asthma. Respir Care 2010;55:536-543.
114. Intermittent Positive Pressure Breathing Trial Group: Intermittent positive pressure breathing therapy of chronic obstructive pulmonary disease: a clinical trial. Ann Intern Med. 1983;99:612-620.
115. Nava S, Karakurt S, Rampulla C, Braschi A, and Fanfulla F: Salbutamol delivery during non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease: a randomized, controlled study. Intensive Care Med 2001;27:1627-1635.
116. Fink JB, Dhand R, Duarte AG, Jenne JW, and Tobin MJ: Aerosol delivery from a metered-dose inhaler during. mechanical ventilation. An in vitro model. Am J Respir Crit Care Med. 1996;154:382-387.
117. Malliotakis P, Mouloudi E, Prinianakis G, Kondili E, and Georgopoulos D: Influence of respiratory efforts on b2- agonist induced bronchodilation in mechanically ventilated COPD patients: a prospective clinical study. Respir Med. 2007;101:300-307.
118. Tzoufi M, Mentzelopoulos SD, Roussos C, and Armaganidis A: The effects of nebulized salbutamol, external positive end-expiratory pressure, and their combination on respiratory mechanics, hemodynamics, and gas exchange in mechanically ventilated chronic obstructive pulmonary disease patients. Anesth Analg. 2005;101:843-850.
119. Fauroux B, Itti E, Pigeot J, Isabey D, Meignan M, Ferry G, Lofaso F, Willemot JM, Cl ément A, and Harf A: Optimization of aerosol deposition by pressure support in children with cystic fibrosis: an experimental and clinical study. Am J Respir Crit Care Med. 2000;162:2265-2271.
120. Sood N, Paradowski LJ, and Yankaskas JR: Outcomes of intensive care unit care in adults with cystic fibrosis. Am J Respir Crit Care Med. 2001;163:335-338.
121. Ellaffi M, Vinsonneau C, Coste J, Hubert D, Burgel PR, Dhainaut JF, and Dusser D: One-year outcome after severe pulmonary exacerbation in adults with cystic fibrosis. Am J Respir Crit Care Med. 2005;171:158-164.
122. Newhouse MT, Chapman KR, McCallum AL, Abboud RT, Bowie DM, Hodder RV, Paŕ PD, Mesic-Fuchs H, and Molfino NA: Cardiovascular safety of high doses of inhaled fenoterol and albuterol in acute severe asthma. Chest. 1996;110:595-603.
123. Kung M, Croley SW, and Phillips BA: Systemic cardiovascular and metabolic effects associated with the inhalation of an increased dose of albuterol. Influence of mouth rinsing and gargling. Chest. 1987;91:382-387.
124. Higgins RM, Cookson WO, Lane DJ, John SM, McCarthy GL, and McCarthy ST: Cardiac arrhythmias caused by nebulised beta-agonist therapy. Lancet. 1987;2: 863-864.
125. Breeden CC, and Safirstein BH: Albuterol and spacerinduced atrial fibrillation. Chest. 1990;98:762-763.
126. Papo MC, Frank J, and Thompson AE: A prospective, randomized study of continuous versus intermittent nebulized albuterol for severe status asthmaticus in children. Crit Care Med. 1993;21:1479-1486.
127. Shrestha M, Bidadi K, Gourlay S, and Hayes J: Continuous vs. intermittent albuterol, at high and low doses, in the treatment of severe acute asthma in adults. Chest. 1996;110: 42-47.
128. Manthous CA, Hall JB, Schmidt GA, and Wood LD: Metered- dose inhaler versus nebulized albuterol in mechanically ventilated patients. Am Rev Respir Dis. 1993;148: 1567-1570.
129. Burggraaf J, Westendorp RG, int Veen JC, Schoemaker RC, Sterk PJ, Cohen AF, and Blauw GJ: Cardiovascular side effects of inhaled salbutamol in hypoxic asthmatic patients. Thorax. 2001;56:567-569.
130. Gross NJ, and Bankwala Z. Effects of an anticholinergic bronchodilator on arterial blood gases of hypoxemic patients with chronic obstructive pulmonary disease. Comparison with a beta-adrenergic agent. Am Rev Respir Dis. 1987;136:1091-1094.
131. Khoukaz G, and Gross NJ: Effects of salmeterol on arterial blood gases in patients with stable chronic obstructive pulmonary disease. Comparison with albuterol and ipratropium. Am J Respir Crit Care Med. 1999;160:1028-1030.
132. Allon M, Dunlay R, and Copkney C. Nebulized albuterol for acute hyperkalemia in patients on hemodialysis. Ann Intern Med. 1989;110:426-429.