Vibrating mesh nebulization increases tidal volume relative to jet nebulization during NIV in COPD exacerbation - 28/01/26
, María Garcia-Palacios , Lorena Bernabe-Vera , Mabel Coromoto Suarez-Pineda , Elisa Serrano-Carrasco , Jose Andres Sanchez-Nicolas Graphical abstract |
Highlights |
• | Vibrating mesh nebulizers increase tidal volume more than jet nebulizers in COPD. |
• | The effect is evident within the first hour of NIV treatment. |
• | VMN efficacy is independent of ventilatory pressure settings. |
• | VMN offers clinical advantages in real-world emergency department practice. |
• | Findings support VMN as preferred device during acute COPD management. |
Abstract |
Background and importance |
Noninvasive ventilation (NIV) is the first-line treatment for acute exacerbations of chronic obstructive pulmonary disease (COPD) with hypercapnic respiratory failure (HRF). Bronchodilator therapy is essential during NIV, but real-world clinical comparisons of nebulization devices in this acute setting remain limited.
Objective |
To compare the clinical efficacy of vibrating mesh nebulizers (VMN) versus jet nebulizers (JN) in COPD patients undergoing NIV, using changes in tidal volume (VT) as the primary outcome.
Design, settings and participants |
A longitudinal observational study was performed in the ventilatory unit of the emergency department of a tertiary hospital. Patients requiring NIV for HRF were allocated to two cohorts: VMN (October 2023–March 2024) and JN (January 2015–May 2017). Ventilatory parameters, including VT, were recorded at baseline, 15 minutes, 1 hour, and 3 hours. The primary outcome was the percentage change in VT (ΔVT) from baseline.
Main results |
Eighty-four patients were analyzed (VMN: n=41; JN: n=43). Baseline characteristics were comparable between groups. The VMN cohort exhibited a significantly greater increase in VT at 1 hour and 3 hours (p<0.05) compared with the JN cohort. ΔVT mirrored these findings. No significant correlation was observed between VT and pressure support levels.
Conclusion |
In this real-world ED study of COPD patients treated with continuous NIV, VMN was associated with a greater early increase in VT than JN, consistent with more effective bronchodilator delivery. Given the historical, non-randomized design across different time periods and ventilators, and the use of VT as an indirect endpoint, these findings should be interpreted as hypothesis-generating but provide a clinically relevant starting point supporting preferential VMN use in acute practice.
Le texte complet de cet article est disponible en PDF.Keywords : Noninvasive Ventilation, Acute exacerbation of COPD, Vibrating Mesh Nebulization, Jet Nebulization
Plan
| No funding was received for this study. |
|
| All authors contributed to the conception and design of the manuscript; data collection; data analysis and interpretation; and to the drafting, revision, and final approval of the submitted manuscript. |
Vol 89
Article 101248- mai 2026 Retour au numéro
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