Aerosol delivery in intubated, mechanically ventilated patients

Crit Care Med. 1985 Feb;13(2):81-4. doi: 10.1097/00003246-198502000-00005.


To study the effects of respiratory failure and mechanical ventilation on aerosol delivery to the lungs, we performed nuclear scans after aerosolization of 5 to 9 mCi of Tc-99m diethylenetriamine pentaacetic acid in seven stable, intubated, and mechanically ventilated patients. The radioactivity reaching the lungs was 2.9 +/- .7% (mean +/- SD) of the administered dose, an amount significantly less than that in three healthy nonintubated subjects and also less than what would be expected in nonintubated subjects from other published reports. We then performed a subsequent study in 15 additional mechanically ventilated patients who were receiving aerosolized bronchodilators through their endotracheal tube. In these patients, heart rate and lung mechanical function values before and after treatment were not significantly different. We conclude from these studies that aerosol delivery in mechanically ventilated patients is significantly reduced and that this is probably due to a combination of suboptimal breathing pattern, intrinsic airway disease, and the endotracheal tube functioning as both a site for aerosol deposition through impaction as well as a barrier to gastrointestinal absorption.

MeSH terms

  • Aerosols
  • Aged
  • Airway Resistance
  • Bronchodilator Agents / administration & dosage*
  • Bronchodilator Agents / therapeutic use
  • Female
  • Heart Rate
  • Humans
  • Intubation, Intratracheal*
  • Male
  • Metaproterenol / administration & dosage
  • Middle Aged
  • Pentetic Acid
  • Respiration
  • Respiration, Artificial*
  • Respiratory Insufficiency / drug therapy
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy
  • Technetium
  • Vital Capacity


  • Aerosols
  • Bronchodilator Agents
  • Metaproterenol
  • Technetium
  • Pentetic Acid