АЭРОЗОЛЬНАЯ ТЕРАПИЯ ВО ВРЕМЯ НЕИНВАЗИВНОЙ ВЕНТИЛЯЦИИ ЛЕГКИХ
Аннотация
К настоящему времени получены доказательства эффективности ингаляционной лекарственной терапии во время неинвазивной вентиляции легких (НВЛ). Доставка аэрозольных препаратов во время НВЛ зависит от многих факторов, таких как выбор ингаляционного устройства и маски, положение порта утечки и позиция устройства в контуре респиратора. Технологические инновации в области ингаляционной терапии привели к созданию новых устройств, способных оптимизировать легочную депозицию и уменьшить время ингаляционной терапии. По сравнению со стандартными струйными небулайзерами мембранные небулайзеры способны доставить в дыхательные пути пациента в 4 раза большую дозу лекарственного препарата. Необходимо проведение дальнейших исследований, посвященных возможности проведения аэрозольной терапии во время высокопоточной кислородотерапии с помощью носовых канюль.
Об авторе
С. Н. Авдеев
ФГАОУ ВО «Первый МГМУ им. И. М. Сеченова» МЗ РФ;
ФГБУ «НИИ пульмонологии» ФМБА России
Россия
Россия
Авдеев Сергей Николаевич – доктор медицинских наук, профессор, член-корреспондент РАН, заведующий кафедрой пульмонологии ФГАОУ ВО «Первый МГМУ им. И. М. Сеченова» МЗ РФ
119048, Москва, ул. Доватора, д. 15, стр. 2, УКБ № 4
Список литературы
1. Авдеев С. Н. Неинвазивная вентиляция легких у пациентов c хронической обструктивной болезнью легких в стационаре и домашних условиях // Пульмонология. ‒ 2017. ‒ Т. 27, № 2. ‒ С. 232-249.
2. Abdelrahim M. E., Plant P., Chrystyn H. In-vitro characterisation of the nebulised dose during non-invasive ventilation // J. Pharm. Pharmacol. ‒ 2010. ‒ Vol. 62. ‒ Р. 966–972.
3. Ari A., Harwood R., Sheard M. et al. In-vitro comparison of heliox and oxygen in aerosol delivery using pediatric high flow nasal cannula // Pediatr. Pulmonol. ‒ 2011. ‒ Vol. 46. ‒ P. 795–801.
4. Avdeev S., Nuralieva G., Aung Kyaw Soe, Fink J. Comparison of response to aerosol drug delivery with mesh and jet nebulizers during non-invasive ventilation (NIV) in acute exacerbation of COPD // Eur. Respir. J. ‒ 2017. ‒ Vol. 50 (suppl. 61): PA1894; DOI: 10.1183/1393003.congress-2017.PA1894
5. Bhashyam A. R., Wolf M. T., Marcinkowski A. L. et al. Aerosol delivery through nasal cannulas: An in-vitro study // J. Aerosol. Med. Pulm. Drug. Deliv. ‒ 2008. ‒ Vol. 21. ‒ Р. 181–188.
6. Branconnier M. P., Hess D. R. Albuterol delivery during noninvasive ventilation // Respir. Care. ‒ 2005. ‒ Vol. 50. ‒ Р. 1649–1653.
7. Brandao D. C., Lima V. M., Galindo Filho V. et al. Reversal of bronchial obstruction with bi-level positive airway pressure and nebulization in patients with acute asthma // J. Asthma. ‒ 2009. ‒ Vol. 46. ‒ Р. 356–361.
8. Cabrini L., Landoni G., Oriani A. et al. Noninvasive ventilation and survival in acute care settings: a comprehensive systematic review and meta-analysis of randomized controlled trials // Crit. Care Med. ‒ 2015. ‒ Vol. 43. ‒ Р. 880–888.
9. Chatmongkolchart S., Schettino G. P., Dillman C. et al. In-vitro evaluation of aerosol bronchodilator delivery during noninvasive positive pressure ventilation: effect of ventilator settings and nebulizer position // Crit. Care Med. ‒ 2002. ‒ Vol. 30. ‒ Р. 2515–2519.
10. Dai B., Kang J., Sun L. F. et al. Influence of exhalation valve and nebulizer position on albuterol delivery during noninvasive positive pressure ventilation // J. Aerosol. Med. Pulm. Drug. Deliv. ‒ 2014. ‒ Vol. 27. ‒ Р. 125–132.
11. Demoule A., Chevret S., Carlucci A. et al. Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries // Int. Care Med. ‒ 2016. ‒ Vol. 42. ‒ Р. 82‒92.
12. Dhand R., Duarte A. G., Jubran A. Dose-response to bronchodilator delivered by metered-dose inhaler in ventilator-supported patients // Am. J. Respir. Crit. Care Med. ‒ 1996. ‒ Vol. 154. ‒ Р. 388–393.
13. Dhand R. Aerosol therapy in patients receiving noninvasive positive pressure ventilation // J. Aerosol. Med. Pulm. Drug. Deliv. ‒ 2012. ‒ Vol. 25. ‒ Р. 63–78.
14. Ehrmann S., Guillon A., Mercier E. et al. Administration d’aerosols medicamenteux au cours de la ventilation mecanique // Reanimation. ‒ 2012. ‒ Vol. 21. ‒ Р. 42–54.
15. Ehrmann S., Mercier E., Vecellio L. et al. Pharmacokinetics of high-dose nebulized amikacin in mechanically ventilated healthy subjects // Int. Care Med. ‒ 2008. ‒ Vol. 34. ‒ Р. 755–762.
16. Ehrmann S., Roche-Campo F., Bodet-Contentin L. et al. Aerosol therapy in intensive and intermediate care units: prospective observation of 2808 critically ill patients // Int. Care Med. ‒ 2016. ‒ Vol. 42. ‒ Р. 192‒201.
17. Ehrmann S., Roche-Campo F., Sferrazza Papa G. F. et al. Aerosol therapy during mechanical ventilation: an international survey // Int. Care Med. ‒ 2013. ‒ Vol. 39. ‒ Р. 1048–1056.
18. El Taoum K. K., Jinxiang X., Kim J. et al. In-vitro evaluation of aerosols delivered via the nasal route // Respir. Care. ‒ 2015. ‒ Vol. 60. ‒ Р. 1015–1025.
19. Elman M., Goldstein I., Marquette C. H. et al. Influence of lung aeration on pulmonary concentration of nebulized and intravenous amikacin in ventilated piglets with severe bronchopneumonia // Anesthesiology. ‒ 2002. ‒ Vol. 97. ‒ Р. 199–206.
20. Esquinas A. M., Benhamou M. O., Glossop A. J., Mina B. Noninvasive mechanical ventilation in acute ventilatory failure: rationale and current applications // Sleep Med. Clin. ‒ 2017. ‒ Vol. 12. ‒ Р. 597‒606.
21. Everard M. L., Hardy J. G., Milner A. D. Comparison of nebulized aerosol deposition in the lungs of healthy adults following oral and nasal inhalation // Thorax. ‒ 1993. ‒ Vol. 48. ‒ Р. 1045–1046.
22. Fauroux B., Itti E., Pigeot J. et al. Optimization of aerosol deposition by pressure support in children with cystic fibrosis: an experimental and clinical study // Am. J. Respir. Crit. Care Med. ‒ 2000. ‒ Vol. 162. ‒ Р. 2265–2271.
23. Fok T. F., Monkman S., Dolovich M. et al. Efficiency of aerosol medication delivery from a metered dose inhaler versus jet nebulizer in infants with bronchopulmonary dysplasia // Pediatr. Pulmonol. ‒ 1996. ‒ Vol. 21. ‒ Р. 301–309.
24. Franca E. E., Dornelas de Andrade A. F., Cabral G. et al. Nebulization associated with bi-level noninvasive ventilation: analysis of pulmonary radioaerosol deposition // Respir. Med. ‒ 2006. ‒ Vol. 100. ‒ Р. 721–728.
25. Frat J. P., Thille A. W., Mercat A. et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure // N. Engl. J. Med. ‒ 2015. ‒ Vol. 372. ‒ Р. 2185–2196.
26. Galindo-Filho V. C., Ramos M. E., Rattes C. S., Barbosa A. K., Brandao D. C., Brandao S. C., Fink J. B., de Andrade A. D. Radioaerosol pulmonary deposition using mesh and jet nebulizers during noninvasive ventilation in healthy subjects // Respir. Care. ‒ 2015. ‒ Vol. 60. ‒ Р. 1238–1246.
27. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2018. www.ginasthma.org
28. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. www.goldcopd.org
29. Heijerman H., Westerman E., Conway S., Touw D., Doring G. Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus // J. Cystic. Fibrosis. ‒ 2009. ‒ Vol. 5. ‒ Р. 295‒315.
30. Kohnlein T., Windisch W., Kohler D. et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial // Lancet Respir. Med. ‒ 2014. ‒ Vol. 2. ‒ Р. 698–705.
31. Lim W. J., Mohammed Akram R., Carson K. V. et al. Noninvasive positive pressure ventilation for treatment of respiratory failure due to severe acute exacerbations of asthma // Cochrane Database Syst. Rev. ‒ 2012. ‒ Vol. 12: CD004360.
32. Maccari J. G., Teixeira C., Savi A. et al. Nebulization during spontaneous breathing, CPAP, and bi-level positive-pressure ventilation: a randomized analysis of pulmonary radioaerosol deposition // Respir. Care. ‒ 2014. ‒ Vol. 59. ‒ Р. 479–484.
33. McPeck M. Improved aerosol drug delivery with an electronic mesh nebulizer during non-invasive ventilation // Am. J. Respir. Crit. Care Med. – 2012. – Vol. 185. – Р. A3136.
34. Michotte J. B., Jossen E., Roeseler J., Liistro G., Reychler G. In-vitro comparison of five nebulizers during noninvasive ventilation: Analysis of inhaled and lost doses // J. Aerosol. Med. Pulm. Drug Deliv. – 2014. – Vol. 27. – Р. 430–440.
35. Millar J., Lutton S., O’Connor P. The use of high-flow nasal oxygen therapy in the management of hypercarbic respiratory failure // Ther. Adv. Respir. Dis. – 2014. – Vol. 8. – Р. 63–64.
36. Mogayzel P. J., Naureckas E. T., Robinson K. A. et al. Cystic fibrosis pulmonary guidelines. Chronic medications for maintenance of lung health // Am. J. Respir. Crit. Care Med. – 2013. – Vol. 187. – Р. 680–689.
37. Morgan S. E., Mosakowski S., Solano P. et al. High-flow nasal cannula and aerosolized β-agonists for rescue therapy in children with bronchiolitis: A case series // Respir. Care. – 2015. – Vol. 60. – Р. e161–е165.
38. Mukhopadhyay A., Dela Pena E., Wadden B. Effects of inhalational bronchodilator treatment during noninvasive ventilation in severe chronic obstructive pulmonary disease exacerbations // J. Crit. Care. – 2009. – Vol. 24. – 474.e1-5.
39. Nava S., Karakurt S., Rampulla C. et al. Salbutamol delivery during non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease: a randomized, controlled study // Int. Care Med. – 2001. – Vol. 27. – Р. 1627–1635.
40. Parkes S. N., Bersten A. D. Aerosol kinetics and bronchodilator efficacy during continuous positive airway pressure delivered by face mask // Thorax. – 1997. – Vol. 52. – Р. 171–175.
41. Perry S. A., Kesser K. C., Geller D. E. et al. Influence of cannula size and flow rate on aerosol drug delivery through the Vapotherm humidified high-flow nasal cannula system // Pediatr. Crit. Care Med. – 2013. – Vol. 14. – Р. 250–256.
42. Pollack C. V., Fleisch K. B., Dowsey K. Treatment of acute bronchospasm with beta-adrenergic agonist aerosols delivered by a nasal bilevel positive airway pressure circuit // Ann. Emerg. Med. – 1995. – Vol. 26. – Р. 552–557.
43. Reminiac F., Bodet-Contentin L., Vecellio L., Dequin P.-F., Ehrmann S. Aerosoltherapie au cours de l’assistance respiratoire non invasive // Reanimation. – 2016. – Vol. 25. – Р. 11–20.
44. Reychler G., Leal T., Roeseler J. et al. Effect of continuous positive airway pressure combined to nebulization on lung deposition measured by urinary excretion of amikacin // Respir. Med. – 2007. – Vol. 101. – Р. 2051–2055.
45. Smaldone G. C., Messina M. S. Enhancement of particle deposition by flow-limiting segments in humans // J. Appl. Physiol. – 1985. – Vol. 59. – Р. 509–514.
46. Smaldone G. C., Sangwan S., Shah A. Facemask design, facial deposition, and delivered dose of nebulized aerosols // J. Aerosol. Med. – 2007. – Vol. 20 (suppl. 1). – Р. S66‒S75.
47. Sunbul F. S., Fink J. B., Harwood R. et al. Comparison of HFNC, bubble CPAP and SiPAP on aerosol delivery in neonates: An in-vitro study // Pediatr. Pulmonol. ‒ 2015. ‒ Vol. 50. ‒ Р. 1099–10106.
48. Sutherasan Y., Ball L., Raimondo P., Caratto V., Sanguineti E., Costantino F., Ferretti M., Kacmarek R. M., Pelosi P. Effects of ventilator settings, nebulizer and exhalation port position on albuterol delivery during non-invasive ventilation: an in-vitro study // BMC Pulmonary Med. ‒ 2017. ‒ Vol. 17. ‒ Р. 9.
49. White C. C., Crotwell D. N., Shen S., Salyer J., Yung D., Zheng J., DiBlasi R. M. Bronchodilator delivery during simulated pediatric noninvasive ventilation // Respir. Care. ‒ 2013. ‒ Vol. 58. ‒ Р. 1459–1466.
50. Zainudin B. M., Biddiscombe M., Tolfree S. E. et al. Comparison of bronchodilator responses and deposition patterns of salbutamol inhaled from a pressurized metered dose inhaler, as a dry powder, and as a nebulised solution // Thorax. ‒ 1990. ‒ Vol. 45. ‒ Р. 469–473.
Для цитирования:
Авдеев С.Н. АЭРОЗОЛЬНАЯ ТЕРАПИЯ ВО ВРЕМЯ НЕИНВАЗИВНОЙ ВЕНТИЛЯЦИИ ЛЕГКИХ. Вестник анестезиологии и реаниматологии. 2018;15(2):45-54. https://doi.org/10.21292/2078-5658-2018-15-2-45-54
For citation:
Аvdeev S.N. AEROSOL THERAPY DURING NON-INVASIVE VENTILATION. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2018;15(2):45-54. (In Russ.) https://doi.org/10.21292/2078-5658-2018-15-2-45-54
Просмотров: 197
Послать статью по эл. почте 
