Aerosolized medications are routinely used for the treatment of critically ill patients. This paper reviews aerosol delivery devices with a focus on issues related to their performance in pulmonary critical care. Factors affecting aerosol drug delivery to mechanically ventilated adults and spontaneously breathing patients with artificial airways are reviewed. Device selection, optimum device technique, and unmet medical needs of aerosol medicine in pulmonary critical care are also discussed.
Keywords: aerosols; artificial airways; drug delivery; endotracheal tube; mechanical ventilation; metered-dose inhalers; nebulizers; spacers; tracheostomy tube.
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