High-flow nasal cannula and in-line aerosolised bronchodilator delivery during severe exacerbation of asthma in adults: a feasibility observational study

IF 3.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine Pub Date : 2024-10-01 DOI:10.1016/j.accpm.2024.101414

Nicolás Colaianni-Alfonso , Ada Toledo , Guillermo Montiel , Mauro Castro-Sayat , Claudia Crimi , Luigi Vetrugno

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引用次数: 0

Abstract

Background

Asthma is a common chronic respiratory disease affecting 1–29% of the population in different countries. Exacerbations represent a change in symptoms and lung function from the patient's usual condition that requires emergency department (ED) admission. Recently, the use of a High-Flow Nasal Cannula (HFNC) plus an in-line vibrating mesh nebulizer (VMN) for aerosol drug delivery has been advocated in clinical practice. Thus, this pilot observational study aims to investigate the feasibility of HFNC treatment with VMN for in-line bronchodilator delivery in patients with severe asthma.

Methods

This study was conducted from May 2022 to May 2023. Subjects ≥18 years old with a previous diagnosis of asthma who were admitted to the ED during severe exacerbation were included. The primary endpoint was the change in peak expiratory flow ratio (PEFR) after 2-h of treatment with bronchodilator delivered by HFNC with in-line VMN. Additional outcomes were changes in forced expiratory volume in 1 s (FEV₁) and clinical variables before treatment.

Results

30 patients, mean age of 43 (SD ± 16) years, mostly female (67%) were studied. A significant change in PEFR (147 ± 31 L/m vs. 220 ± 38 L/m; p < 0.001) was observed after treatment with HFNC and in-line VMN with significant improvement in clinical variables. And no subjects required invasive mechanical ventilation (IMV) during the study.

Conclusions

HFNC treatment with in-line VMN for bronchodilator delivery appears feasible and safe for patients with severe asthma exacerbation. These preliminary promising results should be confirmed with appropriately large-designed studies.

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成人哮喘严重恶化期间的高流量鼻导管和在线气雾支气管扩张剂给药：可行性观察研究。

背景：哮喘是一种常见的慢性呼吸道疾病，在不同国家影响着 1-29% 的人口。哮喘加重意味着患者的症状和肺功能与往常不同，需要入住急诊科（ED）。最近，临床实践中提倡使用高流量鼻导管（HFNC）和在线振动网状雾化器（VMN）进行气溶胶给药。因此，本试验性观察研究旨在调查 HFNC 治疗与 VMN 用于重症哮喘患者在线支气管扩张剂给药的可行性：本研究于 2022 年 5 月至 2023 年 5 月进行。研究对象包括年龄≥ 18 岁、既往诊断为哮喘且在严重哮喘加重期间入住急诊室的患者。主要终点是在使用带有线控 VMN 的 HFNC 支气管扩张剂治疗 2 小时后呼气峰值流量比 (PEFR) 的变化。其他结果包括 1 秒用力呼气容积（FEV1）的变化和治疗前的临床变量：研究的 30 名患者平均年龄为 43 岁（SD ± 16），大部分为女性（67%）。PEFR 有明显变化（147 ± 31 L/m vs. 220 ± 38 L/m；p 结论：治疗前，PEFR 有明显变化（147 ± 31 L/m vs. 220 ± 38 L/m；p）：对于严重哮喘加重的患者来说，使用线控 VMN 输送支气管扩张剂的高频数控治疗似乎是可行和安全的。这些初步的良好结果应通过适当的大型设计研究加以证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

期刊介绍： Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.