LAUSR

Abstract Aerosol delivery by nebulizers and pressurized metered-dose inhalers (pMDIs) attached through an adapter or spacer into a ventilation circuit during noninvasive mechanical ventilation (NIV) and high flow nasal cannula (HFNC) add great benefits in the management of obstructive lung disease patients. The inhaled medication, given during NIV and HFNC, offers better and quicker clinical effects than with unassisted breathing. Unfortunately, there is no specific recommendation or guidelines to guide therapists/clinicians in their decisions while delivering aerosols to ventilated patients which puts the patients at risk of receiving either a sub-therapeutic or toxic dose of their inhaled medications. This increases the urgency for the development of recommendations/guidelines by a trusted board/society for aerosol delivery to such critically ill patients. This review article could serve as a good guide in this field especially the methods used to quantify aerosol delivery during NIV or HFNC.