Aerosol Administration and Mechanical Ventilation

Thomas and co-workers (221) have studied deposition of technetium-labeled human serum albumin particles, administered through a Siemens Servo 945 nebulizer system and a system 22 Acorn nebulizer unit. Total pulmonary deposition by percentage of the dose in the nebulizer was on the average 2.2%. There was considerable variability between subjects, with a coefficient of variation of 46%, but within subjects reproducibility was close, with a coefficient of variation of 15%. 

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Durbin (244) concludes that many questions remain to be answered relative to aerosol therapy in mechanically ventilated patients Among them, what are the optimal ventilation parameters and what is the optimal delivery device or circuit for intubated patients He argues that both physiological- and deposition-driven endpoints must be used. 

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