Academic Journal
Aerosol Delivery With a Vibrating Mesh Nebulizer Across Tidal Volume-Based Pediatric Invasive Ventilation Models: An In Vitro Evaluation.
| Τίτλος: | Aerosol Delivery With a Vibrating Mesh Nebulizer Across Tidal Volume-Based Pediatric Invasive Ventilation Models: An In Vitro Evaluation. |
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| Συγγραφείς: | Miura S; Division of Pediatric Critical Care, Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan., Igarashi Y; Department of Clinical Engineering, St. Marianna University Hospital, Kawasaki, Japan., Shono K; Division of Pediatric Critical Care, Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan., Shima S; Division of Pediatric Critical Care, Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan., Kawaguchi A; Division of Pediatric Critical Care, Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan. |
| Πηγή: | Critical care explorations [Crit Care Explor] 2026 Jun 04; Vol. 8 (6), pp. e1430. Date of Electronic Publication: 2026 Jun 04 (Print Publication: 2026). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]- |
| Ιατρικοί όροι (MeSH): | Albuterol*/administration & dosage , Tidal Volume*/physiology , Respiration, Artificial*/methods , Respiration, Artificial*/instrumentation , Bronchodilator Agents*/administration & dosage , Nebulizers and Vaporizers*, Aerosols/administration & dosage ; Humans ; Child ; Administration, Inhalation ; Equipment Design |
| Περίληψη: | Context: Despite the widespread use of vibrating mesh nebulizers (VMNs) for aerosol therapy during mechanical ventilation, there is limited pediatric evidence on how tidal volume (TV)-based ventilation models and commonly modified ventilator- and circuit-related factors affect aerosol delivery. Hypothesis: We hypothesized that these ventilator- and circuit-related modifications would affect the efficacy of aerosol delivery with a VMN. Methods and Models: We conducted an in vitro experiment using six pediatric ventilation models with TVs set at 8 mL/kg (TV: 40-400 mL for 5-50 kg), representing children from infancy to adolescence. We nebulized salbutamol with a VMN positioned on the dry side of a heated humidifier, and quantified inhaled mass fraction by measuring the drug collected on a filter positioned distal to the endotracheal tube using a spectrophotometer. We evaluated the effects of TV-based models and variations in other settings, including endotracheal tube sizes, bias flows, inspiratory rise time, ventilator modes, circuit configurations, VMN positions, and drug concentrations. Results: In the baseline model with a TV of 80 mL, the mean ± sd of inhaled mass fraction was 11.2% ± 0.3%. It increased progressively across the TV-based models: 3.5% ± 0.2% (TV: 40 mL), 7.9% ± 0.4% (TV: 56 mL), 15.7% ± 0.2% (TV: 120 mL), 19.4% ± 0.4% (TV: 160 mL), and 21.3% ± 1.7% (TV: 400 mL; all p < 0.001 vs. baseline). No significant differences were observed in variations of the other ventilatory, endotracheal tube-, or circuit-related settings. Interpretation and Conclusions: VMN aerosol delivery increased across TV-based ventilation models and was minimally affected by other ventilator settings, endotracheal tube size, and circuit-related modifications. Consistent aerosol delivery at a given TV suggests that TV is the dominant determinant of aerosol delivery efficacy. (Copyright © 2026 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.) |
| Competing Interests: | Drs. Shono and Kawaguchi received provision of experimental equipment from Fisher & Paykel Healthcare and Aerogen for use in other research projects. The remaining authors have disclosed that they do not have any potential conflicts of interest. |
| References: | J Aerosol Med Pulm Drug Deliv. 2015 Jun;28(3):229-36. (PMID: 25393556) Respir Care. 2017 Jun;62(6):662-677. (PMID: 28546371) Respir Care. 2013 Jul;58(7):1124-33. (PMID: 23107173) Am J Respir Crit Care Med. 2003 Nov 15;168(10):1205-9. (PMID: 12893644) Ann Intensive Care. 2023 Jul 12;13(1):63. (PMID: 37436585) Respir Care. 2010 Jul;55(7):845-51. (PMID: 20587095) Intensive Care Med. 2003 Jul;29(7):1145-50. (PMID: 12750882) J Aerosol Med Pulm Drug Deliv. 2017 Oct;30(5):349-358. (PMID: 28463044) Respir Care. 2018 Nov;63(11):1370-1378. (PMID: 30108135) Respir Med. 2023 May;211:107210. (PMID: 36907367) Respir Care. 2014 Oct;59(10):1494-500. (PMID: 24865422) Respir Care. 2015 Jun;60(6):894-914; discussion 914-6. (PMID: 26070582) Respir Care. 2020 Oct;65(10):1419-1426. (PMID: 32694180) Respir Care. 2015 Oct;60(10):1424-30. (PMID: 25969513) Can J Respir Ther. 2022 Dec 16;58:199-203. (PMID: 36545463) Crit Care. 2000;4(4):227-34. (PMID: 11094505) |
| Contributed Indexing: | Keywords: aerosol therapy; mechanical ventilation; pediatric; tidal volume; vibrating mesh nebulizer |
| Substance Nomenclature: | QF8SVZ843E (Albuterol) 0 (Aerosols) 0 (Bronchodilator Agents) |
| Entry Date(s): | Date Created: 20260608 Date Completed: 20260611 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13236288 |
| DOI: | 10.1097/CCE.0000000000001430 |
| PMID: | 42255941 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2639-8028 |
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| DOI: | 10.1097/CCE.0000000000001430 |