Aerosol therapy in adult critically ill patients: a consensus statement regarding aerosol administration strategies during various modes of respiratory support

Jie Li*, Kai Liu, Shan Lyu, Guoqiang Jing, Bing Dai, Rajiv Dhand, Hui Ling Lin, Paolo Pelosi, Ariel Berlinski, Jordi Rello, Antoni Torres, Charles Edouard Luyt, Jean Bernard Michotte, Qin Lu, Gregory Reychler, Laurent Vecellio, Armèle Dornelas de Andrade, Jean Jacques Rouby, James B. Fink, Stephan Ehrmann

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

8 Scopus citations

Abstract

Background: Clinical practice of aerosol delivery in conjunction with respiratory support devices for critically ill adult patients remains a topic of controversy due to the complexity of the clinical scenarios and limited clinical evidence. Objectives: To reach a consensus for guiding the clinical practice of aerosol delivery in patients receiving respiratory support (invasive and noninvasive) and identifying areas for future research. Methods: A modified Delphi method was adopted to achieve a consensus on technical aspects of aerosol delivery for adult critically ill patients receiving various forms of respiratory support, including mechanical ventilation, noninvasive ventilation, and high-flow nasal cannula. A thorough search and review of the literature were conducted, and 17 international participants with considerable research involvement and publications on aerosol therapy, comprised a multi-professional panel that evaluated the evidence, reviewed, revised, and voted on recommendations to establish this consensus. Results: We present a comprehensive document with 20 statements, reviewing the evidence, efficacy, and safety of delivering inhaled agents to adults needing respiratory support, and providing guidance for healthcare workers. Most recommendations were based on in-vitro or experimental studies (low-level evidence), emphasizing the need for randomized clinical trials. The panel reached a consensus after 3 rounds anonymous questionnaires and 2 online meetings. Conclusions: We offer a multinational expert consensus that provides guidance on the optimal aerosol delivery techniques for patients receiving respiratory support in various real-world clinical scenarios.

Original languageEnglish
Article number63
Pages (from-to)63
Number of pages25
JournalAnnals of Intensive Care
Volume13
Issue number1
DOIs
StatePublished - 12 07 2023

Bibliographical note

© 2023. The Author(s).

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