Publications by authors named "Jean-Bernard Michotte"

Article Synopsis
  • A study was done to see how well different setups deliver inhaled medicine to patients on ventilators after brain surgery.
  • The researchers used a special machine to deliver the medicine in four different ways and found that one setup helped deliver much more of the medicine to the lungs.
  • They discovered that the best method increased the amount of medicine reaching the lungs by two to three times compared to the other methods, and they think more testing is needed to make sure this method is the best one to use.
View Article and Find Full Text PDF
Article Synopsis
  • The clinical practice of aerosol delivery for critically ill adult patients using respiratory support devices is complex and controversial, prompting the need for clearer guidelines.
  • A modified Delphi method was used to gather expert opinions from a panel of 17 international researchers to establish consensus on aerosol delivery techniques and identify areas needing further study.
  • The resulting document includes 20 statements that review the safety and efficacy of aerosol therapies, largely based on low-level evidence, and emphasizes the need for future randomized clinical trials.
View Article and Find Full Text PDF

Background: During the COVID-19 breakout, a global call for low-cost portable ventilators was made following the strong demand for ventilatory support techniques. Among a few development projects, COVIDair non-invasive ventilator was developed and produced in a record time during the critical period of spring 2020.

Objectives: To evaluate COVIDair performance (i.

View Article and Find Full Text PDF

Background: Positive airway pressure (PAP) is the accepted standard treatment for obstructive sleep apnea. In the last decades, automatic PAP (APAP) adjustment modes have been increasingly used. Pressure auto adjustment offers better comfort to the patient and represents a valuable help for the clinician to provide optimal treatment.

View Article and Find Full Text PDF

Background: CPAP is the first line treatment of obstructive sleep apnea. Recently, the use of added filters has been debated following the field safety notice of Philips Respironics™ on potential health risks due to foam degradation used in their ventilators. However, the added resistance of filters has never been analyzed.

View Article and Find Full Text PDF

Introduction: With the gain in popularity of non-invasive ventilation (NIV), particularly in patients requiring drug delivery by aerosol therapy, the feasibility of the combination between NIV and aerosol therapy has regularly been questioned.

Areas Covered: This review covers the in vitro and in vivo studies which explored the effects of this combination on pulmonary drug delivery (imaging and pharmacological studies) and on physiological measurements

Expert Opinion: Even if the feasibility of the combination is evident, the type of nebulizer influences the lung deposition with a greater delivery with vibrating mesh nebulizers. The influence of the interfaces of NIV devices should be further investigated even if vented masks may seem less efficient for nebulization.

View Article and Find Full Text PDF

Background: Oxygen cylinders are widely used both in hospital and prehospital care. Excessive or inappropriate F may be critical for patients with hypercapnia or hypoxia. Moreover, over-oxygenation could be deleterious in ischemic disorders.

View Article and Find Full Text PDF

Background: A breath-synchronized nebulization option that could potentially improve drug delivery during noninvasive positive pressure ventilation (NIPPV) is currently not available on single-limb circuit bilevel ventilators. The aim of this study was to compare urinary excretion of amikacin following aerosol delivery with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes.

Materials And Methods: A crossover clinical trial involving 6 noninvasive ventilated healthy volunteers (mean age of 32.

View Article and Find Full Text PDF

Background: High-flow nasal cannula use is developing in ICUs. The aim of this study was to compare aerosol efficiency by using two nebulizers through a high-flow nasal cannula: the most commonly used jet nebulizer (JN) and a more efficient vibrating-mesh nebulizer (VN).

Methods: Aerosol delivery of diethylenetriaminepentaacetic acid labeled with technetium-99m (4 mCi/4 mL) to the lungs by using a VN (Aerogen Solo; Aerogen Ltd.

View Article and Find Full Text PDF

Purpose: To compare in vivo the total and regional pulmonary deposition of aerosol particles generated by a new system combining a vibrating-mesh nebulizer with a specific valved holding chamber and constant-output jet nebulizer connected to a corrugated tube.

Methods: Cross-over study comparing aerosol delivery to the lungs using two nebulizers in 6 healthy male subjects: a vibrating-mesh nebulizer combined with a valved holding chamber (Aerogen Ultra®, Aerogen Ltd., Galway, Ireland) and a jet nebulizer connected to a corrugated tube (Opti-Mist Plus Nebulizer®, ConvaTec, Bridgewater, NJ).

View Article and Find Full Text PDF

Background: Volume-controlled ventilation has been suggested to optimize lung deposition during nebulization although promoting spontaneous ventilation is targeted to avoid ventilator-induced diaphragmatic dysfunction. Comparing topographic aerosol lung deposition during volume-controlled ventilation and spontaneous ventilation in pressure support has never been performed. The aim of this study was to compare lung deposition of a radiolabeled aerosol generated with a vibrating-mesh nebulizer during invasive mechanical ventilation, with two modes: pressure support ventilation and volume-controlled ventilation.

View Article and Find Full Text PDF

Unlabelled: Backround: Coupling nebulization with noninvasive ventilation (NIV) has been shown to be effective in patients with respiratory diseases. However, a breath-synchronized nebulization option that could potentially improve drug delivery by limiting drug loss during exhalation is currently not available on bilevel ventilators. The aim of this in vitro study was to compare aerosol delivery of amikacin with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes.

View Article and Find Full Text PDF

Background: Aerosol delivery during invasive mechanical ventilation (IMV) depends on nebulizer type, placement of the nebulizer and ventilator settings. The purpose of this study was to determine the influence of two inspiratory flow patterns on amikacin delivery with a vibrating-mesh nebulizer placed at different positions on an adult lung model of IMV equipped with a proximal flow sensor (PFS).

Methods: IMV was simulated using a ventilator connected to a lung model through an 8-mm inner-diameter endotracheal tube.

View Article and Find Full Text PDF

Background: Few studies on performance comparison of nebulizer systems coupled with a single-limb circuit bilevel ventilator are available. Most of these data compared the aerosol drug delivery for only two different systems. Using an adult lung bench model of noninvasive ventilation, we compared inhaled and lost doses of three nebulizer systems coupled with a single-limb circuit bilevel ventilator, as well as the influence of the nebulizer position.

View Article and Find Full Text PDF

Background: Non-invasive ventilation (NIV) has become a standard of care in acute respiratory failure. However, little data is available on its usefulness in recovery ward patients after general surgery. The present study aimed to document the feasibility of implementing NIV in this setting, and its impact on lung function.

View Article and Find Full Text PDF

Objective: Inspiratory pressure (Pi) support delivered by a bilevel device has become the technique of choice for noninvasive home ventilation. Considerable progress has been made in the performance and functionality of these devices. The present bench study was designed to compare the various characteristics of 10 recently developed bilevel Pi devices under different conditions of respiratory mechanics.

View Article and Find Full Text PDF

Objective: To evaluate the feasibility of relying on a mathematical model to adjust the optimal level of expiratory trigger, materialized by the ratio of inspiratory flow at the end of inspiratory effort (V'ti) and peak inspiratory flow (V'peak), or V'ti/V'peak, during pressure support, by comparing its predicted values with those measured in intubated patients.

Design: Prospective observational study.

Setting: Medical intensive care unit, university hospital.

View Article and Find Full Text PDF