Table 1 Clinical studies using trans-nasal aerosol delivery via HFNC in adults and children
From: A narrative review on trans-nasal pulmonary aerosol delivery
Author, year | Study type | Patient | Inhaled medication | Comparison | Finding |
|---|---|---|---|---|---|
Bräunlich and Wirtz 2018 [9] | RCT crossover | Adults: 26 stable COPD | Salbutamol 2.5 mg + ipratropium 0.5 mg | JN via HFNC at 35 L/min vs JN alone | FEV1 change: 9.4 ± 13.6 vs 11.1 ± 17.2%, p = 0.5 |
Réminiac et al., 2018 [10] | RCT crossover | Adults: 25 stable patients with reversible airflow obstruction | 2.5 mg albuterol | VMN via HFNC at 30 L/min vs JN with mask | FEV1 improvement: 0.33 (0.14, 0.39) vs 0.35 (0.18, 0.55) L, p = 0.11 |
Madney et al., 2019 [11] | RCT crossover | Adults: 12 stable COPD | 5 mg salbutamol | VMN via HFNC at 5 L/min vs JN via HFNC | Urinary salbutamol excretion at 30 min and 24 h were higher with VMN than JN via HFNC (p < 0.05) |
Li et al., 2019 [12] | Prospective dose response study | Adults: 42 stable asthma and COPD patients | Albuterol at an escalating dose of 0.5, 1.5, 3.5, and 7.5 mg | VMN via HFNC at 15–20 L/min vs MDI+Spacer | FEV1 increment at cumulative dose of 1.5 mg via HFNC was similar to 400 mcg albuterol via MDI+Spacer: 0.34 ± 0.18 vs. 0.34 ± 0.12 L, p = 0.878 |
Ammar et al., 2018 [13] | Retrospective | Adults: 29 patients with hypoxemia and PH | Epoprostenol | VMN via HFNC at 39 ± 11 L/min | PaO2/FIO2 improvement of 60 ± 50 mmHg |
Li et al., 2019 [14] | Retrospective | Adults: 11 ICU refractory hypoxemia patients comorbid with PH and/or RVD | Epoprostenol | VMN via HFNC at 35–40 L/min | 45.5% had SpO2/FIO2 improvement > 20% |
Li et al., 2020 [15] | Retrospective Cohort comparison | Adults: 51 ICU patients with PH and/or RVD | Epoprostenol | VMN via HFNC at constant flow (n = 26) vs flow titrated based on individual response to inhaled epoprostenol (n = 25) | The percentage of patients who met the criteria for a positive response was higher in the flow titration group compared to the group with constant flow (85.7% vs. 50%, p = 0.035). |
Morgan et al., 2015 [16] | Retrospective | Pediatrics: 5 infants acute bronchiolitis with respiratory distress | Albuterol | VMN via HFNC at 5–8 L/min vs JN and face mask | Compared to JN with mask, HR increment was higher after inhaling albuterol with VMN via HFNC; patient agitation was improved |
Valencia-Ramos et al., 2018 [17] | RCT crossover | Pediatrics: 6 infants with bronchiolitis | Albuterol | VMN via HFNC around 8 L/min vs JN with mask | Increased level of comfort and satisfaction |
Al-Subu et al., 2020 [18] | Retrospective | Pediatrics: 28 children with asthma or bronchiolitis | Albuterol | VMN via HFNC at 2–4 L/min vs VMN with mask | HR increased by 9.98 (95% CI 3.72–16.2) with VMN via HFNC vs 0.64 (95% CI, 1.65–2.93) beats/min with VMN via mask (p < 0.001) |
Baudin et al., 2017 [19] | Retrospective | Pediatrics: 39 status asthmaticus (10 had severe acidosis at admission) | Albuterol | VMN via HFNC at maximum 1 L/kg/min vs standard oxygen without HFNC | In HFNC group, HR (165 ± 21 vs. 141 ± 25/min, p < 0.01) and RR (40 ± 13 vs. 31 ± 8/min, p < 0.01) decreased, and blood gas improved in the first 24 h |