Inhalation therapy in patients with tracheostomy: a guide to clinicians.

INTRODUCTION: Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation therapy because of the many factors affecting aerosol therapy to this patient population, and the lack of literature providing guidance in this area of research. Areas covered: The purpose of this paper is to describe the factors affecting aerosol drug delivery to patients with tracheostomy and to explain how to optimize inhalation therapy through device selection, interface selection and delivery technique in this patient population. Expert commentary: Many factors affect inhalation therapy in this patient population and without understanding the impact of these factors on aerosol drug delivery, clinicians will not be able to provide the treatment properly and patients may not benefit from prescribed medications. In the next 5 years, aerosol medicine will continue to experience tremendous growth with new devices and drug/device combinations. However, these advances will have minimal impact on inhalation therapy in patients with tracheostomy unless we provide guidance and training to clinicians on optimizing aerosol drug delivery to this patient population.