{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:32:45Z","timestamp":1775471565297,"version":"3.50.1"},"reference-count":14,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2023,9]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Aerosolized drug delivery via high-flow nasal cannula (HFNC) decreases as gas flow is increased. To improve aerosol delivery, breath-enhanced jet nebulizer may increase aerosol output. This study tested that hypothesis and compared breath-enhanced jet nebulizer to vibrating mesh nebulizer technology.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n First, in an isolated circuit, breath-enhanced jet nebulizer and vibrating mesh nebulizer aerosol outputs were measured during simulated HFNC by using infused saline solution at rates of 5\u201360 mL\/h. Limits were defined when nebulizer filling was detected. The devices were then tested by using\n 99m<\/jats:sup>\n Tc\/saline solution to measure maximum rates of aerosol production. After the output experiments, drug delivery was measured in vitro by using a model that consisted of an HFNC circuit interfaced to a realistic 3-dimensional printed head. The\n 99m<\/jats:sup>\n Tc\/saline solution was infused at rates of 5 to 60 mL\/h for the breath-enhanced jet nebulizer and 5 to 20 mL\/h for the vibrating mesh nebulizer with HFNC gas flows of 10 to 60 L\/min. Aerosol delivery to the trachea was measured by using a shielded ratemeter, which defined the rate of drug delivery (\n \n \n \n \u00b5<\/mml:mi>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n g NaCl\/min).\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n With increasing gas flow, breath-enhanced jet nebulizer output increased to a maximum of 50 mL\/h, the vibrating mesh nebulizer maximum was 12 mL\/h. At HFNC gas flow of 60 L\/min, breath-enhanced jet nebulizer delivered 3.16 to 316.8\n \n \n \n \u00b5<\/mml:mi>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n g NaCl\/min, the vibrating mesh nebulizer delivered 23.5 to 61.7\n \n \n \n \u00b5<\/mml:mi>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n g NaCl\/min. For infusion pump flows of 5 to 12 mL\/h, the rate of drug delivery was independent of nebulizer type (\n P<\/jats:italic>\n = .19) and dependent on infusion pump flow (\n P<\/jats:italic>\n < .001) and gas flow (\n P<\/jats:italic>\n < .001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Increasing gas flow increased breath-enhanced jet nebulizer output, which demonstrated the effects of breath enhancement. At 60 L\/min, breath enhanced jet nebulizer delivered up to 5 times more aerosol compared with conventional vibrating mesh nebulizer technology. Breath-enhanced jet nebulizer delivered a wide range of dose rates at all high flows. In patients who are critically ill, breath-enhanced jet nebulizer technology may allow titration of bedside dosing based on clinical response by simple adjustment of the infusion rate.<\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.10644","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T14:05:59Z","timestamp":1685455559000},"page":"1221-1228","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Enhanced Aerosol Delivery During High-Flow Nasal Cannula Therapy"],"prefix":"10.1177","volume":"68","author":[{"given":"Jane","family":"Moon","sequence":"first","affiliation":[{"name":"Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine, Stony Brook University Medical Center, Stony Brook, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McPeck","sequence":"additional","affiliation":[{"name":"Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine, Stony Brook University Medical Center, Stony Brook, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeyanthan","family":"Jayakumaran","sequence":"additional","affiliation":[{"name":"Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine, Stony Brook University Medical Center, Stony Brook, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald C","family":"Smaldone","sequence":"additional","affiliation":[{"name":"Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine, Stony Brook University Medical Center, Stony Brook, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-2871"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2022.153989"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201707-548FR"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2015.1219"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41030-018-0054-x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0473-8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11095-016-2061-7"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2019.1524"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10643"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41030-019-0086-x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/jamp.2008.0738"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/17425247.2022.2061460"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-021-01827-4"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.05344"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.4187\/respcare.10644","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.10644","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.4187\/respcare.10644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:13:48Z","timestamp":1775466828000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.4187\/respcare.10644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,30]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.4187\/respcare.10644"],"URL":"https:\/\/doi.org\/10.4187\/respcare.10644","relation":{},"ISSN":["0020-1324"],"issn-type":[{"value":"0020-1324","type":"print"}],"subject":[],"published":{"date-parts":[[2023,5,30]]}}}