Ein Mesh-Vernebler für alle? In-vitro-Evaluation der Medikamentenverneblung bei spontan atmenden, nicht invasiv und invasiv beatmeten prähospitalen Notfallpatient*innen

Zusammenfassung

Ziel der Studie

Ziel der In-vitro-Studie war es herauszufinden, welcher für den Rettungsdienst verfügbare Verneblertyp die höchste Medikamentendepositionsrate erreicht und bei welcher Beatmungsform diese zu erwarten ist.

Methodik

Ein Jet-Vernebler und ein Mesh-Vernebler wurden in einem In-vitro-Modell spontan atmender, nicht invasiv und invasiv beatmeter Notfallpatient*innen verglichen.

Ergebnisse

Der Mesh-Vernebler erreichte unter Spontanatmung und NIV signifikant höhere Salbutamoldepositionsraten als der Jet-Vernebler. Beide Vernebler zeigten zudem unter NIV signifikant höhere Depositionsraten als unter Spontanatmung.

Schlussfolgerung

Die standardmäßige Verwendung von Mesh-Verneblern könnte die Aerosoltherapie von Notfallpatient*innen unter Spontanatmung und NIV verbessern. Eine Verzögerung oder Unterbrechung der NIV-Therapie zugunsten einer Vernebelung unter Spontanatmung scheint im Rettungsdienst nicht indiziert.

Abstract

Objective

Aim of the present in vitro study was to evaluate which type of nebulizer available for use in the emergency medical service (EMS) would achieve the highest drug deposition rates and if those rates would be found during spontaneous breathing, non-invasive ventilation (NIV) or invasive ventilation.

Methods

A jet nebulizer and a vibrating mesh nebuliser were compared in an in vitro model of spontaneously breathing, non-invasively and invasively ventilated emergency patients.

Results

During spontaneous breathing and NIV, the vibrating mesh nebulizer showed significantly higher salbutamol deposition rates compared to the jet nebulizer. Additionally, both nebulizers showed significantly higher deposition rates during NIV when compared to spontaneous breathing.

Conclusion

The standard use of a vibrating mesh nebulizer might improve aerosol therapy of spontaneously breathing as well as non-invasively ventilated prehospital emergency patients. Delaying or interrupting NIV therapy in favour of nebulization under spontaneous breathing does not appear to be indicated in the EMS.

Schlüsselwörter

Notfallmedizin - Rettungsdienst - Medikamentenvernebelung - Vernebler - in vitro

Keywords

emergency medicine - emergency medical services - inhalation therapy - nebulizer - in vitro

Publication History

Received: 06 August 2023

Accepted after revision: 12 December 2023

Article published online:
29 January 2024

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