TY - JOUR T1 - Editor’s Commentary JF - Respiratory Care SP - i LP - i VL - 67 IS - 1 A2 - , Y1 - 2022/01/01 UR - http://rc.rcjournal.com/content/67/1/i.abstract N2 - This month’s Editor’s Choice is a bench study evaluating the transnasal aerosol delivery during high-flow nasal cannula (HFNC). Li and colleagues determined drug delivery to a filter positioned in the simulated trachea of a manikin. They varied the type of HFNC device, HFNC circuit, and position of either a vibrating mesh nebulizer (VMN) or small volume nebulizer (SVN) in the circuit. They reported greater drug delivery when the nebulizers were placed at the humidifier and the VMN outperformed the SVN.Beuvon and others evaluated bronchodilator delivery (salbutamol) via HFNC in subjects with an exacerbation of COPD. Using a crossover design, 15 subjects performed pulmonary function tests during HFNC alone, and again with HFNC with salbutamol via a VMN. The primary endpoint was the change in FEV1 and secondary endpoints included changes in forced vital capacity (FVC), peak expiratory flow (PEF), airway resistance, and clinical parameters. Following salbutamol nebulization there were small but statistically significant increases in FEV1, FVC, and PEF.Saunders and Davis consider both studies and provide insight into the role of aerosol delivery during HFNC. They also note that transnasal delivery of certain drugs, specifically vasodilators, have the risk of absorption in the nasopharynx … ER -