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Aerosol Delivery to a Critically Ill Patient: A Big Issue Easily Solved by Developing Guidelines

机译：气溶胶输送给重症患者：制定指南可以轻松解决一个大问题

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Nowadays, therapeutic aerosols are commonly delivered to mechanically ventilated patients by nebulizers and pressurized metered dose inhaler attached to an adapter or a spacer. Studies with asthmatics and chronic obstructive pulmonary disease patients have confirmed that aerosol delivery during mechanical ventilation is feasible. They have also reported that the inhaled drugs administered during mechanical ventilation provide greater and faster clinical outcomes than when delivering during spontaneous unassisted breathing. Researchers studied factors that would affect aerosol delivery during mechanical ventilation. Even with the tremendous amount of publications in this area, there have still been no recommendations or guidelines released to help respiratory therapists in their decision as to when to deliver aerosol to ventilated patients. Mostly, respiratory therapists read the literature and decide accordingly what to do and which device to use for their patients. This puts the patients at risk of receiving a sub-therapeutic or toxic dose of the inhaled aerosol. Some studies raise an alarm of physician decision upon reading any released publication related to aerosol delivery in mechanical ventilation without a trusted recommendation and guidelines. This increases the need for the development of recommendations and guidelines, by a trusted board or society, for aerosol delivery to such critically ill patients. To summarize, inhaled drugs administered to critically ill patients is of benefit compared to taking the patient off the ventilator and delivering during spontaneous unassisted breathing. However, dependable guidelines are needed to optimize aerosol delivery.
机译：如今，治疗性气雾剂通常通过雾化器和连接到适配器或垫片上的加压计量吸入器输送到机械通气的患者。对哮喘患者和慢性阻塞性肺疾病患者的研究证实，在机械通气期间进行气雾剂输送是可行的。他们还报告说，与自发无助呼吸时相比，在机械通气过程中吸入的药物可提供更大，更快的临床结果。研究人员研究了在机械通气期间会影响气溶胶输送的因素。即使在该领域有大量出版物，仍没有发布建议或指南来帮助呼吸治疗师决定何时向通气患者输送气雾剂。通常，呼吸治疗师会阅读文献并据此决定如何为患者使用哪种设备。这使患者处于接受亚治疗或中毒剂量吸入气雾剂的风险中。一些研究在没有任何可信赖的建议和指南的情况下，阅读了有关机械通气中气雾剂释放的任何已发表的出版物，引起了医生决定的警觉。这增加了由可信赖的委员会或协会制定建议和指南以将气雾剂输送给这类危重患者的需求。总而言之，与将患者从呼吸机上取下并在自发无助呼吸过程中分娩相比，向重症患者给药的吸入药物是有益的。但是，需要可靠的指导方针来优化气雾剂的输送。

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