The opportunity for aerosol mediated therapy exists across all patient types and all patient settings. Patients ranging from very low birth weight premature infants to the elderly and obese may benefit from aerosol therapy, and whilst it is well understood that the associated range of breathing patterns has a significant bearing on the ultimate efficiency of delivery of aerosol to the lung, so too does the interface that facilitates connection between the aerosol generator and the patient airway.
The aim of this review was to assess the effect of selected interfaces on the quantity of aerosol being delivered to the lung. For the purposes of this review, patient interventions were broadly divided between those for use with spontaneously breathing patients and those for use with patients requiring ventilatory support. The aerosol generators included in the review were Vibrating Mesh Nebulisers (VMN), Jet Nebulisers (JN) and pressurised Metered Dose Inhalers (pMDI).
The patient interventions and associated interfaces assessed included facemasks, mouthpieces, tracheostomy tubes, high flow nasal therapy, endotracheal tubes and mask-mediated non-invasive ventilation.
Following a review of the literature it is clear that the different aerosol generators can be significantly affected by choice of interface and published data is provided to support the contention that each interface introduces the risk of altered aerosol therapy.
This work should allow end users and drug developers make more informed decisions around interface and paired device selection early in their respective decision making and development processes.