SynthesisCritical care (London, England)2017
Aerosol delivery during invasive mechanical ventilation: a systematic review.
Synthesis in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Comparison of the Application of Vibrating Mesh Nebulizer and Jet Nebulizer in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis.International journal of chronic obstructive pulmonary disease · 2024Pooled it
- Nebulized Magnesium Sulfate for Treatment of Persistent Pulmonary Hypertension of Newborn: A Pilot Randomized Controlled Trial.Indian journal of pediatrics · 2021Trial
- The Clinical Practice and Best Aerosol Delivery Location in Intubated and Mechanically Ventilated Patients: A Randomized Clinical Trial.BioMed research international · 2021Trial
- The isolated perfused lung: a bridge between in vitro and in vivo studies of inhaled medicinal products.AAPS PharmSciTech · 2026Review
- Timing of nebulized colistimethate sodium following bronchodilator airway conditioning in hospital-acquired pneumonia: a target trial emulation study.Frontiers in pharmacology · 2026Article
- Optimizing aerosol therapy in mechanically ventilated acute respiratory distress syndrome: a delivery-fidelity framework.Frontiers in medicine · 2026Review
- In Vitro and In Silico Evaluation of Polymyxin B Aerosol Delivery in Adult Mechanical Ventilation.Pharmaceutics · 2025Article
- The establishment of the population pharmacokinetic model needs to further address clinical needs while ensuring the standardization of data collection.Antimicrobial agents and chemotherapy · 2025Article
- In Vitro and In Vivo Antibacterial and Antibiofilm Activity of Zinc Sulfate (ZnSOAntibiotics (Basel, Switzerland) · 2025Article
- Polymyxin-containing regimens for treating of pneumonia caused by multidrug-resistant gram-negative bacteria: Mind the breakpoints and the standardization of nebulization therapy.Critical care (London, England) · 2024Article
- Albuterol Delivery via In-Line Intrapulmonary Percussive Ventilation Superimposed on Invasive Ventilation in an Adult Lung Model.Respiratory care · 2024Article
- Inhaled drug delivery: a randomized study in intubated patients with healthy lungs.Annals of intensive care · 2023Article
- Aerosol therapy in adult critically ill patients: a consensus statement regarding aerosol administration strategies during various modes of respiratory support.Annals of intensive care · 2023Article
- Impact of gas humidification and nebulizer position under invasive ventilation: preclinical comparative study of regional aerosol deposition.Scientific reports · 2023Article
- Influence of Mechanical Ventilation Modes on the Efficacy of Nebulized Bronchodilators in the Treatment of Intubated Adult Patients with Obstructive Pulmonary Disease.Pharmaceutics · 2023Article
- Pulmonary drug delivery for acute respiratory distress syndrome.Pulmonary pharmacology & therapeutics · 2023Review
- AnFrontiers in medicine · 2023Article
- An ex vivo rat trachea model reveals abnormal airway physiology and a gland secretion defect in cystic fibrosis.PloS one · 2023Article
- Pulmonary delivery of siRNA against acute lung injury/acute respiratory distress syndrome.Acta pharmaceutica Sinica. B · 2022Review
- Position of different nebulizer types for aerosol delivery in an adult model of mechanical ventilation.Frontiers in medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis systematic review aimed to assess inhaled drug delivery in mechanically ventilated patients or in animal models. Whole lung and regional deposition and the impact of the ventilator circuit, the artificial airways and the administration technique for aerosol delivery were analyzed.
methodsIn vivo studies assessing lung deposition during invasive mechanical ventilation were selected based on a systematic search among four databases. Two investigators independently assessed the eligibility and the risk of bias.
resultsTwenty-six clinical and ten experimental studies were included. Between 30% and 43% of nominal drug dose was lost to the circuit in ventilated patients. Whole lung deposition of up to 16% and 38% of nominal dose (proportion of drug charged in the device) were reported with nebulizers and metered-dose inhalers, respectively. A penetration index inferior to 1 observed in scintigraphic studies indicated major proximal deposition. However, substantial concentrations of antibiotics were measured in the epithelial lining fluid (887 (406-12,819) μg/mL of amikacin) of infected patients and in sub-pleural specimens (e.g., 197 μg/g of amikacin) dissected from infected piglets, suggesting a significant distal deposition. The administration technique varied among studies and may explain a degree of the variability of deposition that was observed.
conclusionsLung deposition was lower than 20% of nominal dose delivered with nebulizers and mostly occurred in proximal airways. Further studies are needed to link substantial concentrations of antibiotics in infected pulmonary fluids to pulmonary deposition. The administration technique with nebulizers should be improved in ventilated patients in order to ensure an efficient but safe, feasible and reproducible technique.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.