Aerosol delivery during invasive mechanical ventilation is a common practice in ICU. Optimization of drug delivery has been evaluated in many studies by comparison of static conditions.1 In this issue of Respiratory Care, Lee et al reported a series of experiments involving the use of a breath-enhanced jet nebulizer placed on the dry side of the humidifier in a model of an adult receiving invasive respiratory support.2 The same group had previously reported another series of studies using the same nebulizer but placing it on the wet side of the humidifier.3 The authors realized after a more prolonged observation of the technology that placement of the nebulizer affected function of the ventilator. The investigators used radio-labeled aerosols to provide real-time delivery data using a newly developed technique.4 Lee et al2 compared a vibrating mesh nebulizer and a breath-enhanced …
Correspondence: Ariel Berlinski MD FAARC, 1 Children’s Way, Slot 512–17, Little Rock, AR 72202. E-mail: berlinskiariel{at}uams.edu
