key: cord-1048746-t798876y
authors: Miller, Asaf; Epstein, Danny
title: Safe bronchodilator treatment in mechanically ventilated COVID-19 patients: A single center experience
date: 2020-04-21
journal: J Crit Care
DOI: 10.1016/j.jcrc.2020.04.010
sha: 46dbd09ed76ea5869f52d0f3a4e5cb3fc18ecb69
doc_id: 1048746
cord_uid: t798876y

nan

requiring multiple health care-patient interaction, which we aim to minimize.

In order to mitigate these hazards, we successfully use continuous inhalation by Aeroneb Solo (Aerogen©, Galway, Ireland) in invasively and non-invasively ventilated COVID-19 patients with COPD and asthma ( Figure 1 ). The system is composed of a syringe mounted on a pump that continuously delivers medication to the nebulizing reservoir, isolated from the breathing circuit, where an electric powered ultrasonic mesh vibrating at ultra-high rate transforms the drug into an aerosol that enters the ventilator circuit. This closed system requires minimal staff handling and no circuit opening, thereby reducing workload and increasing safety. To our knowledge, this is the first report of administering bronchodilators safely and efficiently to COVID-19 ventilated patients.

a.

Illustration of the Aerogen Solo continuous inhalation setup.

b. The nebulizer is connected to the ventilator circuit distal to the HME filter. An antiviral filter can be placed at the exit of the inspiratory limb.

c. The nebulizer is placed on the inspiratory limb just proximal to the Y piece. The HME filter is connected to the inspiratory tubing at the ventilator exit site. HME-Heat and Moisture Exchanger.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations

Covid-19 in Critically Ill Patients in the Seattle Region -Case Series

Chronic obstructive pulmonary disease is associated with severe coronavirus disease

Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis

Consensus guidelines for managing the airway in patients with COVID-19

Inhaled bronchodilator administration during mechanical ventilation