Aerosol Delivery Using Jet Nebulizer and Vibrating Mesh Nebulizer During High Frequency Oscillatory Ventilation: An In Vitro Comparison

被引：15

作者：

Fang, Tien-Pei ^{[1
,6
]}

Lin, Hui-Ling ^{[3
]}

Chiu, Shu-Hua ^{[1
]}

Wang, Szu-Hui ^{[1
]}

DiBlasi, Robert M. ^{[4
]}

Tsai, Ying-Huang ^{[2
]}

Fink, James B. ^{[5
]}

机构：

[1] Chang Gung Mem Hosp, Dept Resp Therapy, Chiayi, Taiwan

[2] Chang Gung Mem Hosp, Dept Internal Med, Chiayi, Taiwan

[3] Chang Gung Univ, Dept Resp Therapy, Taoyuan, Taiwan

[4] Seattle Childrens Hosp, Dept Resp Therapy, Seattle, WA USA

[5] Georgia State Univ, Div Resp Therapy, Atlanta, GA 30303 USA

[6] Chang Gung Univ Sci & Technol, Dept Resp Care, Chiayi Campus, Taiwan

来源：

JOURNAL OF AEROSOL MEDICINE AND PULMONARY DRUG DELIVERY | 2016年 / 29卷 / 05期

关键词：

aerosol delivery; breathing patterns; high frequency oscillatory ventilation; jet nebulizer; vibrating mesh nebulizer; RESPIRATORY-DISTRESS-SYNDROME; MECHANICAL VENTILATION; FLOW; POSITION;

D O I：

10.1089/jamp.2015.1265

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: High frequency oscillatory ventilation (HFOV) is used in critically ill patients with severe hypoxemic respiratory failure. The purpose of this in vitro study was to determine the efficiency of aerosol delivery with different lung parameters during simulated neonatal, pediatric, and adult HFOV. Methods: Sensormedics 3100A/B ventilators were used to deliver infant, pediatric, and adult HFOV. Two types of aerosol generators were chosen for testing: 1) a continuous jet nebulizer (JN) with a unit-dose of 5.0 mg/2.5 mL salbutamol sulfate diluted into 4 mL, and 2) a vibrating mesh nebulizer (VMN) with salbutamol sulfate were run to completion of aerosol generation. Both aerosol devices were placed 1) between the ventilator circuit and the endotracheal tube (ETT) (proximal position); and 2) at the inlet of the heated humidifier (distal position) (n = 5). Drug was collected on a bacterial filter placed distal to the ETT, and the drug eluted and analyzed with a UV Spectrophotometer at 276 nm. T-test and ANOVA tests were used for comparison (p < 0.05). Results: The inhaled drug delivered by JN was 0%-0.6% of the nominal dose when placed at distal position, and 0%-3% at proximal position (p < 0.01), while the VMN was 0%-0.5% at distal and 8.6%-22.7% at proximal position (p < 0.01). Aerosol delivery during HFOV was greater with adult settings than pediatric and infant settings with VMN and JN (22.7%, 8.6%, and 17.4% respectively, p < 0.01). When the aerosol delivery device was placed at the distal position, negligible drug mass was observed (<0.5%), regardless of the nebulizer device used. Conclusions: During HFOV, aerosol delivery with the nebulizer placed at proximal was greater than placement distal from the ETT, with VMN delivering more drug than JN. The inhaled drug was delivery correlated positively with ETT size, MAP, and bias flow, and inversely proportional to power settings.

引用

页码：447 / 453

页数：7

共 29 条

[1]

Alzahrani WA, 2010, COMP ALBUTEROL DELIV

[2] Aerosolized drug delivery in patient-specific lung model during invasive high frequency oscillatory ventilation [J].