Madney YM, et al. - In COPD patients on low-flow oxygen therapy through an high-flow nasal cannula (HFNC), researchers estimated and compared the relative pulmonary and systemic delivery of salbutamol, with 2 different nebulizers. On days 1, 3, and 5 of admission, 12 subjects (6 females), age 51.3 ± 11.2 y, were randomly given study doses of 5 mg salbutamol nebulized by either a jet nebulizer or a vibrating mesh nebulizer with a T-piece or spacer. According to the findings, it was possible to efficiently combine aerosolized medication with low-flow oxygen, via HFNC, in COPD subjects, and this could be done without the need to interrupt the gas supply. Larger doses could be delivered with vibrating mesh nebulizer vs jet nebulizer. However, using the large spacer with HFNC in low-flow delivery offered no benefit; the reason for this was the small inner diameter of the HFNC did not allow larger aerosol droplet sizes (preserved by the spacer) to reach the subject.