Many concerns exist about the delivery of medications by nebulization during mechanical ventilation.1,2 These concerns include, but are not limited to, optimal technique to maximize pulmonary drug deposition, choice of nebulizer device, and effects of nebulization on mechanical ventilation itself.3,4 In the project reported in this manuscript, Jayakumaran et al5 used an in vitro model to evaluate the effects of in-line jet nebulization on tidal volumes, peak inspiratory pressure, and time to minimum pressure in pressure controlled and volume controlled ventilation modes with several different ventilators. When evaluating tidal volumes, the effects of jet nebulizer delivery on both the exhaled tidal volume measured by the ventilator and those actually delivered to the lungs were determined. These values were compared between 2 jet nebulizer flows and also between ventilators with internal and external flow sensors. The authors found that the use of jet nebulizers at both their high- and low-flow settings significantly affected the …
Correspondence: Michael D Davis PhD RRT FAARC, 1044 W. Walnut Street R3-126, Indianapolis, Indiana 46202. E-mail: MDD1{at}iu.edu
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