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This Month’s Editor’s Choice is a bench study by Kontoudios et al who investigated aerosol delivery using two high-frequency airway clearance (HFAC) systems, focusing on systems providing positive expiratory pressure (PEP) or oscillatory positive airway pressure (OPAP). The study utilized an upper airway model with a filter to measure inhaled aerosol delivery, also accounting for fugitive aerosols. The findings highlighted that nebulizer type, circuit design, and handset play crucial roles in effective aerosol delivery with HFAC therapy. Gilmore, in his accompanying commentary, discusses various nuances affecting aerosol delivery and overall airway clearance during HFAC, emphasizing the need for clinical evidence to assess the necessity of these therapies.
Louis et al evaluated the use of electrical impedance tomography (EIT) to observe the effects of PEEP on regional ventilation distribution and risks including collapse, overdistension, hypoventilation, and pendelluft in mechanically ventilated patients with ARDS. In their study of 9 subjects with moderate to severe ARDS at three PEEP levels, they found that higher PEEP reduced pendelluft but increased overdistension. They concluded that EIT could support personalized PEEP settings in …
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