The following is a summary of “Aerosol therapy in adult critically ill patients: a consensus statement regarding aerosol administration strategies during various modes of respiratory support,” published in the July 2023 issue of Critical Care by Li et al.
Due to complex scenarios and limited clinical evidence, aerosol delivery in critically ill adults is controversial. Researchers performed a retrospective and cohort study to establish a consensus for aerosol delivery during respiratory support and identify research gaps. A modified Delphi method was used to reach a consensus on aerosol delivery for critically ill patients on different types of respiratory support. This included mechanical ventilation, noninvasive ventilation, and high-flow nasal cannula.
After conducting a comprehensive literature search and review, a panel of 17 international participants with extensive research experience and publications on aerosol therapy was formed. This multi-professional panel assessed the evidence, reviewed, revised, and voted on recommendations to establish a consensus. They compiled a detailed document of 20 statements that evaluated the effectiveness and safety of inhaled agents for adults requiring respiratory support. Recommendations primarily rely on low-level evidence from in-vitro and experimental studies, highlighting the importance of conducting randomized clinical trials. The panel achieved a consensus through three anonymous questionnaires and two online meetings.
The study offered multinational expert consensus and provides guidance on the best aerosol delivery techniques for patients receiving respiratory support in diverse real-world clinical situations.