Fundamentals of aerosol therapy in critical care

Table 2 Common applications of aerosol therapy in intensive care^a

	Drug class
Feature	Bronchodilators	Anti-inflammatory	Antimicrobial agents	Vasoactive agents	Heliox
Indications	Bronchospasm (e.g. acute asthma, COPD exacerbation)	Airway inflammation (e.g. acute asthma or COPD exacerbation, acute interstitial lung disease)	MDR tracheobronchitis MDR pneumonia	Right ventricular failure	Asthma
Indications	Bronchospasm (e.g. acute asthma, COPD exacerbation)		Aspergillus prevention (lung transplant)	Pulmonary hypertension	Asthma
Site of action	Airways	Airways or alveoli	Airways or alveoli	Alveoli	Airways
Preferred device	pMDI with spacer	pMDI with spacer	VMN	VMN
Drugs	Beta-agonists (e.g. salbutamol, salmeterol)	Budesonide	Antibiotics (e.g. tobramycin, colistin, amikacin, ceftazidime, amphotericin B)	Epoprostenol	Helium
Drugs	Anticholinergics (e.g. ipratropium, tiotropium)	Fluticasone		Iloprost	Helium
Formulations available	Yes	Yes	Some	Yes

Table derived from references [19, 24, 37, 87, 132–151]
^aAnaesthetic gases were not in the objectives of this analysis
Heliox helium and oxygen, COPD chronic obstructive pulmonary disease, MDR multidrug resistant, pMDI pressurized metered dose inhaler, VMN vibrating mesh nebulizer

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