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Neumol Pediatr 2018; 13 (4): 149 - 163

C o n t e n i d o d i s p o n i b l e e n h t t p : / / www. n e umo l o g i a - p e d i a t r i c a . cl

161

Terapia inhalatoria en pacientes que reciben ventilación mecánica

El autor no declara conflictos de interés ya que no posee

vínculos actuales con empresas o productos mencionados en

este artículo. Las Tablas son originales del autor, confeccionadas

en base a las referencias mencionadas en cada una de ellas.

AGRADECIMIENTOS

Por su colaboración, a los kinesiólogos Héctor Pafian de

la Unidad de Paciente Crítico Pediátrico (UPCP) del Hospital Puerto

Montt (Figuras 1 y 8), a Paula Modinger del Hospital Fundación Josefina

Martínez de Ferrari (Figuras 6B, 6D y 7) y a Claudio Torres, de la UPCP

del Hospital Víctor Ríos Ruiz, Los Ángeles (Figuras 3C y 3D). Y muy

especialmente al Dr. Francisco Prado, quien me alentó hace 10 años a

profundizar en esta apasionante área.

REFERENCIAS

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Gardenhire D, Burnett D, Strickland S, Myers T. A Guide to

aerosol delivery devices for respiratory therapists. 4° ed.

2017. American Association for Respiratory Care. Disponible

en:

https://www.aarc.org/wp-content/uploads/2018/03/

aersol-guides-for-rts.pdf

2.

Rubin B. Inhaled corticosteroids: devices and deposition.

Paediatr Respir Rev 2004;5 Suppl A:S103-6.

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Iñiguez F, Aguirre V. Terapia Inhalatoria. En “Enfermedades

Respiratorias del Niño”. Editores: Bertrand P, Sánchez I.

Ediciones Universidad Católica de Chile, 2° Ed. actualizada.

2016, pág. 613-21.

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Haddrell A, Lewis D, Church T, Vehring R, Murnane D, Reid

J. Pulmonary aerosol delivery and the importance of growth

dynamics. Ther Deliv 2017; 8:1051-61.

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Humidity and aerosol therapy equipment. En: White GC, ed.

Equipment Theory for Respiratory Care. Thomson Delmar

Learning, New York, 2005; 97-102.

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Mitchell J, Coppolo D, Nagel M. Electrostatics and

inhaled medications: influence on delivery via pressurized

metered-dose inhalers and add-on devices. Respir Care

2007;52:283-300.

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Kleinstreuer C, Zhang Z, Donohue J. Targeted drug-aerosol

delivery in the human respiratory system. Annu Rev Biomed

Eng 2008;10:195-220.

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Everard M, Devadason S, Le Souef P. In vitro assessment of

drug delivery trough an endotracheal tube using a dry power

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10. Holland A, Smith F, Penny K, McCrossan G, Veitch L,

Nicholson C. Metered dose inhalers versus nebulizers for

aerosol bronchodilator delivery for adults patients receiving

mechanical ventilation in critical care units. Cochrane

Database of Systematic Reviews 2013, Issue 6. Art

N°:CD008863.

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Everard M. Current options in aerosolized drug therapy

for children receiving respiratory support. Anaesthesia

2017;72:1388-97.

12. Ari A, Fink J, Dhand R. Inhalation therapy in patients

receiving mechanical ventilation: an update. J Aerosol Med

Pulm Drug Deliv 2012;25:319-32.

13. Fink J, Ari A. Aerosol delivery to intubated patients. Expert

Opin Drug Deliv 2013;10:1077-93.

14. Hochrainer D, Holz H, Kreher C, Scaffidi L, Spallek M,

Watchel H. Comparison of the aerosol velocity and spray

duration of Respimat® soft mist inhaler and pressurized

metered dose inhalers. J Aerosol Med 2005;18:273-82

15. Martin A, Finlay W. Nebulizers for drug delivery to the lungs.

Expert Opin Drug Deliv 2015;12:889-900.

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nebulizer designs: constant-output, breath-enhanced, and

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to asthma patients. ISRN Allergy, 2013, 102418. http://doi.

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Effective pulmonary delivery of an aerosolized plasmid DNA

vaccine via surface acoustic wave nebulization. Respir Rev

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vibrating mesh/aperture plate technologies for aerosol

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pdf

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Tabla 12.

Técnica para administrar un medicamento mediante un

nebulizador tipo jet en el paciente con asistencia ventilatoria no invasiva:

circuito de 1 rama, generador de flujo BiPAP (57,70).

BiPAP:

Bilevel Positive Airway Pressure.

EPAP:

Expiratory Positive Airway Pressure;

IPAP:

Inspiratory Positive Airway Pressure