Effect of Tiotropium Soft Mist Inhalers on Dynamic Changes in Lung Mechanics of Patients with Chronic Obstructive Pulmonary Disease Receiving Mechanical Ventilation: A Prospective Pilot Study
, Yu-Feng Wei 4,5, Chau-Chyun Sheu 6,7, Chen-Yu Wang 1,8, Chi-Kuei Hsu 4, Chia-Min Chen 6, Wei-Chih Chen 9,10,11 and Kuang-Yao Yang 9,10,11,12,*
Round 1
Reviewer 1 Report
Congratulations for a well written interesting manuscript
Author Response
Thank you for your kindly review and suggestion.
Reviewer 2 Report
This study presents the effects of tiotropium bromide soft mist inhalers (SMIs) in patients with COPD receiving mechanical ventilation which is not explored sufficiently in clinic.
Although the parameters of lung mechanics did not reach statistical significance, trends of parameters were well discussed.
Following suggestions are recommended to improve the manuscript;
- Font and symbol size in Figure, Table, and Foot note
- Although the manuscript has a contribution on the pilot result to tiotropium bromide soft mist inhalers with mechanical ventilator, drug delivery efficiency is most related to aerosol particle size, velocity, output rate even the aerosol sprayed in the ventilation circuit. Therefore, SMI and its characteristics should be described in the method and discussion. It is also recommended to clarify where SMI was applied in the ventilation circuit.
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 3 Report
two minor observation
in the methods section please mention if you used tiotropium only one day or if for several days
please try to briefly describe which of the lung ventilation parameters are able to describe the rest hyperinflation (air trapping) and so that their improvement also demonstrate a reduction of this hyperinflation as a result of tiotropium dosing.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
