Respiratory care最新文献

{"title":"Training Intensity Needed for Volume Linearity and Syringe D_LCO Check Quality Control.","authors":"Ellen A Becker, Ellen M Moran, Jason B Blonshine, Vanessa I Rodriguez, Susan B Blonshine","doi":"10.1089/respcare.12565","DOIUrl":"https://doi.org/10.1089/respcare.12565","url":null,"abstract":"<p><p><b>Background:</b> Technologists must assure the accuracy and precision of pulmonary function equipment prior to testing patients. This study aimed to identify the sources of failure and unacceptable submission rates for spirometry volume linearity and syringe diffusing capacity of the lung for carbon monoxide (D_LCO) check quality control (QC). In addition, we explored whether the time between training and first QC submission affected overall percentage of unacceptable submissions. <b>Methods:</b> Participants in a cross-sectional global study submitted QC for evaluation from October 2014 to May 2018 from 114 laboratories. Descriptive statistics summarized the percentage of unacceptable submissions and sources of failure for volume linearity and syringe D_LCO check maneuvers. Spearman's rho described the correlation between site-specific unacceptable submission rates, and both days between training and the first unacceptable submission and the days between training and first submission. <b>Results:</b> The unacceptable submission rate from 5,083 volume linearity assessments was 10% compared with a 6.2% rate from 4,992 syringe D_LCO check maneuvers. Aggregate volume linearity rates of procedural errors (5.8%) and equipment errors (6.2%) were similar, whereas there were more syringe D_LCO check equipment errors (5.9%) than procedural errors (0.78%). The time between training and submitting a QC test was not related to overall unacceptable submission rates for volume linearity and syringe D_LCO check, <i>r_sp</i> = 0.11, <i>P</i> = .27 and <i>r_sp</i> = 0.19, <i>P</i> = .052, respectively. Higher unacceptable rates occurred when the first QC failure occurred close to the completion of training for volume linearity and syringe D_LCO check, <i>r_sp</i> = -0.41, <i>P</i> < .001 and <i>r_sp</i> = -0.38, <i>P</i> < .001, respectively. <b>Conclusions:</b> A single QC training session does not adequately prepare technologists to conduct QC. Technologists need clear and consistent guidelines for conducting QC procedures and regular follow-up from experts to properly interpret QC findings, resolve equipment problems, and assure their testing systems are in-control.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Power: Using Ideal Body Weight to Identify Injurious Mechanical Ventilation Thresholds.","authors":"William M LeTourneau, Alice Gallo De Moraes","doi":"10.1089/respcare.11815","DOIUrl":"https://doi.org/10.1089/respcare.11815","url":null,"abstract":"<p><p>Identifying the mechanisms of ventilator/ventilation-induced lung injury requires an understanding of the pulmonary physiology involved in the mechanical properties of the lung along with the involvement of the inflammatory cascade. Accurately measuring parameters that represent physiologic lung stress and lung strain at the bedside can be clinically challenging. Although surrogates for lung stress and strain have been proposed, such as plateau pressure and driving pressure, these values only represent a static variable in the ventilator breath. It has been proposed that a single variable could be used as a unifying parameter to identify a threshold for the safe application of mechanical ventilation. The concept of \"mechanical power\" applies an energy load transfer designation to the ventilator settings and output of tidal volume, airway pressures, and flow. However, there is a potential disconnect between the use of \"absolute\" mechanical power and the variability of body weight throughout a mixed medical population. Using ideal body weight as an influential factor to express mechanical power can potentially allow for a more accurate depiction of energy applied to the lungs and a potentially reliable injurious mechanical ventilation threshold indicator.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Functional Decline and Relationship With Quality of Life.","authors":"Camila Dietrich, Caroline Cabral Robinson, Daniel Sganzerla, Maicon Falavigna, Daniel Schneider, Juliana Rezende Cardoso, Francine Hoffmann Dutra, Denise Souza, Gabriela Soares Rech, Maicon Quadro de Oliveira, Luisa Barbosa Anzolin, Sâmia Faria da Silva, Rosa da Rosa Minho Santos, Renata Kochhann, Mariana Martins S Santos, Lúcio Couto de Oliveira Júnior, Juliana Mara Stormosvski de Andrade, Lívia Correa E Castro, Cinthia Mucci Ribeiro, Rafael Trevizoli Neves, Juçara Gasparetto Maccari, Mariana Mattioni, José Mário Meira Teles, Regis Goulart Rosa, Cassiano Teixeira","doi":"10.1089/respcare.12146","DOIUrl":"https://doi.org/10.1089/respcare.12146","url":null,"abstract":"<p><p><b>Background:</b> Certain aspects of intensive care unit admission and care, including patient acuity and treatments to manage acute critical illnesses, can intensify loss of functionality and decrease quality of life after hospital discharge. We sought to identify the risk factors associated with functional decline following critical illness and explore its impact on health-related quality of life in a post hoc analysis of a prospective multi-center cohort study. <b>Methods:</b> The study involved 1,301 critically ill subjects who were assessed 3 months after their discharge from the ICU. The subjects were selected from 10 representative hospitals located across the 5 regions of Brazil, and the assessment period ranged from May 2014 to December 2018. <b>Results:</b> Subjects who were previously able to independently manage their activities of daily living (Barthel score of ≥76) were assessed during their ICU stay and 3 months following ICU discharge. Out of the 954 subjects considered in the analysis, 562 (58.9%) experienced functional decline. The study identified several risk factors associated with functional decline (<i>P</i> < .05), including age ≥65 years (relative risk, 1.179; 95% CI 1.06-1.31), lower educational level (relative risk, 1.14; 95% CI 1.00-1.31), high risk of death in the ICU (relative risk, 1.003; 95% CI 1.001-1.005), and the development of symptoms such as anxiety, depression, or ICU-acquired weakness during ICU stay. Functional decline was also associated with lower scores in both the physical domain (34.7 vs 44.0, <i>P</i> < .001) and the mental domain (48.3 vs 54.1, <i>P</i> < .001) of the Short-Form Health Survey score that measured health-related quality of life. <b>Conclusions:</b> Functional decline is a common outcome following ICU stay, and it is associated with characteristics presented before ICU admission and with the severity of the critical illness. Furthermore, functional decline impacts the quality of life of ICU survivors.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Ultrasound Training for Respiratory Therapists.","authors":"Ling Luo, Tyler Weiss, Andrea D Zorce, Sara Mirza, Jacob Rintz, Xiukai Chen, Jie Li","doi":"10.1089/respcare.12291","DOIUrl":"https://doi.org/10.1089/respcare.12291","url":null,"abstract":"<p><p><b>Background:</b> Bedside ultrasound is widely utilized for critically ill patients, yet there is no standardized approach for teaching lung ultrasound to medical staff, particularly respiratory therapists (RTs), in the United States. Thus, we aimed to evaluate the efficacy of a lung ultrasound training program designed for RTs. <b>Methods:</b> With approval from the ethics committee, we recruited RTs with over 3 months of experience at Rush University Medical Center to participate in our lung ultrasound training program. The program comprised of a 1-h didactic lecture followed by hands-on practice on a healthy volunteer. A refresher training session was provided 6-9 months later for those who remained interested in lung ultrasound and were still employed at Rush University Medical Center. Pre- and post-training assessments were conducted to evaluate the effectiveness of the training and identify areas requiring further knowledge development. <b>Results:</b> Between October 2022 and April 2023, 23 RTs completed the initial training, and 7 attended both the initial and the refresher training sessions. Following the initial session, total scores significantly improved (post-training 11.0 [9.0-14.0] versus pre-training 1.0 [0-2.0], <i>P</i> < .001), with the subgroup focusing on \"identification of patterns\" achieving the highest percentage of correct answers. Among the 7 RTs who attended the refresher training, total scores significantly decreased over 6-9 months (12.9 ± 2.3 vs 4.4 ± 1.8, <i>P</i> = .001). However, scores significantly rebounded after the refresher training (post-training 11.3 ± 3.1 vs pre-training 4.4 ± 1.8, <i>P</i> = .008), with no significant difference in post-training total scores between the initial and the refresher sessions. <b>Conclusions:</b> Both the initial and refresher training sessions of our lung ultrasound training programs effectively improved participants' knowledge. The observed decline in knowledge retention over 6-9 months highlights the necessity for periodic refresher courses and ongoing use of lung ultrasound in clinical practice to maintain skills. Incorporating a visual format may be beneficial for acquiring and retaining knowledge.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic Therapies for Severe Asthma in School-Age Children.","authors":"Leonard B Bacharier","doi":"10.1089/respcare.12562","DOIUrl":"https://doi.org/10.1089/respcare.12562","url":null,"abstract":"<p><p>Children with severe asthma incur substantial disease-related morbidity. Despite treatment with inhaled corticosteroids and additional controller medications, many patients continue to experience recurrent exacerbations, impaired lung function, and diminished quality of life. Most children with severe asthma demonstrate evidence of a phenotype consistent with ongoing type 2 inflammation. Fortunately, the advent of biologic therapies, monoclonal antibodies that target specific pathways relevant to asthma pathogenesis, has allowed most children with severe asthma to experience marked improvements in disease control and clinical outcomes. Four biologic medications that target various aspects of type 2 inflammation-specifically omalizumab, mepolizumab, benralizumab, and dupilumab-are currently approved by the United States Food and Drug Administration for use in children 6-11 years of age with specific phenotypes of severe asthma. The selection of the most appropriate biologic for a patient's phenotype is driven by a biomarker-based approach, including assessments of blood eosinophil counts, fraction of exhaled nitric oxide levels, and allergic sensitization and total immunoglobulin E levels. These biologic medications have been demonstrated to significantly reduce the rates of asthma exacerbations between 27% and 59% relative to placebo, although they vary in their impact on lung function. The overall safety profiles of these biologics have been reassuring. This review discusses the role of biologics in childhood asthma, including the strategy for phenotyping patients, summarizes the data supporting the efficacy and safety of biologics in this population, and presents an approach for choosing a biologic and monitoring patient outcomes.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Prone Position on Regional Ventilation/Perfusion Matching in Patients With ARDS Over Time: A Prospective Physiological Study.","authors":"Yuxian Wang, Jieqiong Song, Shengyao Lin, Xin Zheng, Zhanqi Zhao, Ming Zhong","doi":"10.1089/respcare.12247","DOIUrl":"https://doi.org/10.1089/respcare.12247","url":null,"abstract":"<p><p><b>Background:</b> We sought to investigate the short- and long-term effects of prone positioning (PP) on ventilation/perfusion matching in patients with ARDS using contrast-enhanced electrical impedance tomography (EIT). <b>Methods:</b> EIT measurements were performed in 18 mechanically ventilated subjects with ARDS before PP (supine position [SP]), 1 h after turning subjects to PP (PP₁), 3 h after PP (PP₃), 9 h after (PP₉), 16 h after PP (PP₁₆; the end of PP), and 3 h after returning to the supine position (Re-SP₃). <b>Results:</b> The <math><mrow><mrow><msub><mi>P</mi><mrow><mi>a</mi><mrow><msub><mi>O</mi><mn>2</mn></msub></mrow></mrow></msub></mrow></mrow></math>/<math><mrow><mrow><msub><mi>F</mi><mrow><mi>I</mi><mrow><msub><mi>O</mi><mn>2</mn></msub></mrow></mrow></msub></mrow></mrow></math> increased gradually during the PP period (110.68 vs 158.44 vs 210.15 vs 215.22 vs 236.04 vs 163.77 mm Hg, mean values at SP, PP₁, PP₃, PP₉, PP₁₆, and Re-SP₃, respectively<i>, P</i> < .001). Global ventilation/perfusion matched percent significantly increased within PP duration (54.13% vs 63.15% vs 63.02% vs 63.75% vs 66.63% vs 57.42, <i>P</i> < .005). Compared with SP, dorsal ventilation significantly increased at PP₁ (<i>P</i> < .001) and increased gradually during PP. However, the dorsal flow commenced to improve at PP₉ and persisted in enhancement until PP₁₆ (40.61% vs 48.78% vs 50.56%, mean values at PP₃, PP₉, and PP₁₆, respectively<i>, P</i> < .05). There was a significant reduction in global Shunt-EIT percentage within PP duration, primarily localized in the dorsal area. Dead Space-EIT percentage remained unchanged during PP. <b>Conclusions:</b> Oxygenation remained improved or maintained throughout the 16-h duration of PP. Ventilation is susceptible to immediate gravitational effects; however, changes in blood flow may occur later after 9 h, which supports prolonged PP treatment. The shunt continuously decreases, but no significant changes were observed for dead space. <b>Trial registration:</b> ClinicalTrials.gov, NCT04725227. Registered on January 25, 2021.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aerosol Delivery to Simulated Spontaneously Breathing Tracheostomized Adult Patients With Heated Humidified High Flow Oxygenation.","authors":"Xiukai Chen, Fai A Albuainain, Jie Li","doi":"10.1089/respcare.12467","DOIUrl":"https://doi.org/10.1089/respcare.12467","url":null,"abstract":"<p><p><b>Background:</b> Heated and humidified high-flow (HHHF) oxygen therapy is frequently used for spontaneous breathing tracheostomized patients when the ventilator is weaned off. However, the efficacy of in-line placement of nebulizer via HHHF remains unclear. We aimed to assess the impact of nebulizer placements, flow settings, and interfaces on aerosol delivery using a vibrating mesh nebulizer with HHHF in a tracheostomized model. <b>Methods:</b> A simulated spontaneous breathing model of a tracheostomized adult with tracheostomy tube size 8.0 mm was utilized. A collecting filter was placed between the tracheostomy tube and the model lung. Albuterol sulfate (2.5 mg/3 mL) was aerosolized via a vibrating mesh nebulizer in-line with HHHF (Airvo2). The aerosol delivery was evaluated with the nebulizer placed distally (near the humidifier) and proximally to the airway, using tracheostomy adapter and tracheostomy collar at gas flows of 15, 30, and 45 L/min. Each condition was tested five times. The drug was eluted from the collecting filter and assayed with ultraviolet spectrophotometry (276 nm). <b>Results:</b> When delivering aerosol via an in-line vibrating mesh nebulizer with HHHF in a tracheostomized model, the inhaled dose increased as flow decreased, regardless of the interfaces and nebulizer placements (all <i>P</i> < .05). With the tracheostomy adapter, distal placement resulted in higher inhaled doses than the proximal placement at all flows (all <i>P</i> < .05). With the tracheostomy collar, inhaled doses were lower with distal placement than proximal placement, except at 15 L/min (21.3 ± 1.9 vs 16.4 ± 2.1%, <i>P</i> = .009). Compared with the tracheostomy adapter, the tracheostomy collar had higher inhaled doses with the vibrating mesh nebulizer placed proximally at 30 and 45 L/min but a lower inhaled dose with the vibrating mesh nebulizer placed distally at 30 L/min. <b>Conclusions:</b> During aerosol delivery via in-line placement of vibrating mesh nebulizer with HHHF in a tracheostomized model, the inhaled dose increased as flow decreased. Distal nebulizer placement resulted in higher inhaled doses than proximal placement with the tracheostomy adapter at all flows and with the tracheostomy collar at 15 L/min.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Roadmap for Implementation of American Association for Respiratory Care Clinical Practice Guidelines.","authors":"Lynda T Goodfellow","doi":"10.1089/respcare.12925","DOIUrl":"https://doi.org/10.1089/respcare.12925","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using an Interactive Decision Model to Train and Evaluate High-Flow Nasal Cannula Therapy Knowledge.","authors":"Kenneth J Plummer, John M Sowa, Shawna B Papenfuss, Karina M Jackson","doi":"10.1089/respcare.12343","DOIUrl":"https://doi.org/10.1089/respcare.12343","url":null,"abstract":"<p><p><b>Background:</b> Respiratory therapy training is an educational space that relies on clinical practice to assist respiratory therapists (RTs) in making split-second decisions in emergency situations. A large percentage of education programs in the field have turned to simulation training to address this critical training need. Research indicates that while respiratory therapy simulation training is effective, its implementation faces challenges such as high costs, limited faculty expertise, gaps in skill and content coverage, and the need for proper learner support. Decision-based learning (DBL) has shown potential in helping students work through the decision-making process of experts in a variety of academic fields and thus could provide an effective scaffold prior to trainees entering simulations or clinical practice. This study investigates the impact of DBL on RTs' decision-making abilities regarding a bronchiolitis high-flow nasal cannula algorithm along with subject matter experts' experiences developing decision models for use in training. <b>Methods:</b> A mixed-method study design was employed, utilizing pre- and postperformance tests to quantitatively assess the impact of DBL on decision-making abilities. In addition, qualitative interviews were conducted to gather in-depth insights from participants regarding their experiences with DBL. <b>Results:</b> The study found an improvement in test scores following DBL training, indicating its potential to enhance RTs' proficiency in protocol utilization and clinical decision-making. Collaborative experiences during the creation of DBL modules led to consensus among health care specialists and educators, improving protocol understanding and suggesting revisions for standardized care practices. Participants perceived DBL as filling a training gap by providing standardized practice and immediate feedback, although some expressed concerns about the method's perceived rigidity in decision-making. <b>Conclusions:</b> DBL shows promise as an educational tool in respiratory therapy, with potential to improve clinical decision-making and patient outcomes. However, the study also identifies areas for refinement in future implementations addressing concerns about flexibility in decision-making processes.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Decoupling Humidity Control on Aerosol Drug Delivery During HFNC for Infants.","authors":"Madeline X Zhang, Reinout A Bem, Tom Huijgen, Rozalinde Klein-Blommert, Daniel Bonn, Cees J M van Rijn","doi":"10.4187/respcare.12283","DOIUrl":"10.4187/respcare.12283","url":null,"abstract":"<p><p><b>Background:</b> Aerosol therapy is commonly used during treatment with high-flow nasal cannula (HFNC) in the ICU. Heated humidification inside the HFNC tubing circuit leads to unwanted condensation, which may greatly limit the efficiency of drug delivery. In this study, we aimed to investigate whether a novel humidification system, which decouples temperature and humidity control, can improve the delivered dose. <b>Methods:</b> In a bench study setup, fluorescein sodium solution was nebulized using a vibrating mesh nebulizer in an infant HFNC circuit to measure the delivered dose, with a conventional versus a decoupled humidifier. The deposition of fluorescein inside each breathing circuit component and a final collection filter at the end of the nasal cannula was collected and quantified with a UV-vis spectrometer. Droplet sizes at different sections of the breathing circuit were measured by laser diffraction. Three air flows, 5, 10, and 15 L/min; and 2 nebulizer positions, (1) at the humidifier and (2) after the inspiratory tube, were tested. <b>Results:</b> The delivered dose decreased with increasing flow for the conventional setup and was higher when the nebulizer was placed after the inspiratory tube. Turning off the conventional humidifier 10 min before and during nebulization did not improve the delivered dose. The decoupled humidifier achieved a significantly higher (<i>P</i> = .002) delivered dose than the conventional setup. The highest delivered dose obtained by the decoupled humidifier was 62.4% when the nebulizer was placed after the humidifier, while the highest dose obtained for the conventional humidifier was 36.3% by placing the nebulizer after the inspiratory tube. <b>Conclusions:</b> In this bench study, we found that the delivered dose for an infant HFNC nebulization setup could be improved significantly by decoupling temperature and humidity control inside the HFNC circuit, as it reduced drug deposition inside the breathing circuit.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"327-336"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}