What question did this study set out to answer?

To assess the efficacy of delivering multiple aerosol medications concurrently during mechanical ventilation.

March 14, 2026

Multidrug Aerosol Delivery During Mechanical Ventilation

Key Points

To assess the efficacy of delivering multiple aerosol medications concurrently during mechanical ventilation.
Utilized i-AIRE dual-port jet nebulizer and Aerogen Solo vibrating mesh nebulizers for medication delivery.
Tested two adult breathing patterns over a 4-hour infusion with radiolabeled saline or bolus injections.
Monitored inhaled mass in real-time and documented aerosol delivery transients.
Linear inhaled mass percentage was observed during continuous infusion with specified means for both nebulizer types.
Reported spontaneous interruption of aerosol delivery in 50% of continuous runs for VMN and 56% for bolus delivery.
Tapping the VMN device could restart function in several instances.

Abstract

Background:Continuous nebulization of pulmonary vasodilators is an off-label therapy for hypoxemia. Patients may require additional aerosol therapies such as bronchodilators and antibiotics. This study evaluates delivery of concurrent therapy of multiple medications during continuous nebulization without interruption or circuit disconnection. Methods:One i-AIRE dual-port breath-enhanced jet nebulizer (BEJN) or two Aerogen Solo vibrating mesh nebulizers (VMN) were installed on the dry side of the humidifier. VMN were stacked; one for infusion, the second for bolus drug delivery. The BEJN was powered by air at 3.5 L/min, 50 psig. Radiolabeled saline was infused at 5 bolus delivery stopped spontaneously in 9 of 16 runs (56%). Tapping restarted VMN function during 3 of 4 continuous runs and 7 of 9 bolus delivery runs. Bolus delivery IM% (mean ± SD): 22.17 ± 7.65%, 14.37 ± 10.62% for BEJN and VMN, respectively. Conclusions:Simultaneous continuous and bolus nebulization without circuit disconnection is possible for both jet and mesh technology. Monitoring of VMN devices may be necessary in case of spontaneous interruption of nebulization.

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