Aerosol therapy in adult critically ill patients: a consensus statement regarding aerosol administration strategies during various modes of respiratory support - Sorbonne Université Access content directly
Journal Articles Annals of Intensive Care Year : 2023

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

Jie Li
Kai Liu
  • Function : Author
Shan Lyu
  • Function : Author
Guoqiang Jing
  • Function : Author
Bing Dai
  • Function : Author
Rajiv Dhand
  • Function : Author
Hui-Ling Lin
  • Function : Author
Paolo Pelosi
  • Function : Author
Ariel Berlinski
  • Function : Author
Jordi Rello
  • Function : Author
Antoni Torres
  • Function : Author
Jean-Bernard Michotte
  • Function : Author
Qin Lu
  • Function : Author
Gregory Reychler
  • Function : Author
Laurent Vecellio
  • Function : Author
Armèle Dornelas de Andrade
  • Function : Author
James Fink
  • Function : Author
Stephan Ehrmann
  • Function : Author

Abstract

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.
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hal-04260027 , version 1 (26-10-2023)

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Jie Li, Kai Liu, Shan Lyu, Guoqiang Jing, Bing Dai, et al.. Aerosol therapy in adult critically ill patients: a consensus statement regarding aerosol administration strategies during various modes of respiratory support. Annals of Intensive Care, 2023, 13 (1), pp.63. ⟨10.1186/s13613-023-01147-4⟩. ⟨hal-04260027⟩
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