Does NIV improve distribution of aerosolized medicine to lungs?

Your question:  There was a physician I work with who said that when patient s receive inhaled bronchodilators through the BiPAP circuit that more of the medicine gets to the lungs as compared to when the patient is off the machine.  Is this true?

My answer:  Actually, this question must be a common one, because in the April, 2014, edition of "Respiratory Care" a study by Maccari et al studied this exact thing. They gave breathing treatments to patients on and off noninvasive ventilation devices (Bi-Level and CPAP), and to patients not receiving NIV.  The concluded that there was no difference in lung distribution.

Reference:  

1. Maccari, et al, "Nebulization During Spontaneous Breathing, CPAP, and Bi-Level Positive-Pressure-ventilation: A Rondomized Analysis of Pulmonary Radioaerosol Deposition," Respiratory Care, April, 2014, volume 59, number 4, pages 479-484

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