Journal Article

A narrative review on trans-nasal pulmonary aerosol delivery

MacLoughlin, Ronan, Dhand, Rajiv, Li, Jie, Fink, James B.

2020

Overview

The use of trans-nasal pulmonary aerosol delivery via high-flow nasal cannula (HFNC) has expanded in recent years. However, various factors influencing aerosol delivery in this setting have not been precisely defined, and no consensus has emerged regarding the optimal techniques for aerosol delivery with HFNC. Based on a comprehensive literature search, we reviewed studies that assessed trans-nasal pulmonary aerosol delivery with HFNC by in vitro experiments, and in vivo, by radiolabeled, pharmacokinetic and pharmacodynamic studies. In these investigations, the type of nebulizer employed and its placement, carrier gas, the relationship between gas flow and patient’s inspiratory flow, aerosol delivery strategies (intermittent unit dose vs continuous administration by infusion pump), and open vs closed mouth breathing influenced aerosol delivery. The objective of this review was to provide rational recommendations for optimizing aerosol delivery with HFNC in various clinical settings.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Administration, Intranasal - instrumentation / Administration, Intranasal - methods / Administration, Intranasal - standards / Aerosol therapy / Aerosols / Asthma / Cannula - standards / Cannula - trends / Chronic obstructive pulmonary disease / Critical care / Critical Care Medicine / Drug dosages / Efficiency / Emergency Medicine / Epoprostenol / Equipment Design - standards / Equipment Design - trends / Gas flow / High-flow nasal cannula / Humans / Intensive / Intubation / Medicine / Medicine & Public Health / Nasal Sprays / Oxygen therapy / Patients / Pediatrics / Pulmonary hypertension / Review / Scintigraphy