Respiratory Care |

Performance Comparisons of Jet and Mesh Nebulizers With Mouthpiece, Aerosol Mask, and Valved Mask in Simulated Spontaneously Breathing Adults FREE TO VIEW

Arzu Ari, PhD; Armele Dornelas de Andrade, PhD; James Fink, PhD
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Georgia State University, Atlanta, GA

Chest. 2014;145(3_MeetingAbstracts):548A. doi:10.1378/chest.1814806
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SESSION TITLE: Respiratory Support Posters

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: A variety of nebulizers and interfaces are used to administer medical aerosols to adults with pulmonary diseases. The purpose of this study was to determine the efficiency of a mesh nebulizer (MN) with adaptor and jet nebulizer (JN) using mouthpiece, valved-mask and open aerosol mask during simulated adult breathing parameters.

METHODS: A teaching manikin connected to a sinusoidal pump simulating spontaneous adult breathing (Vt 500 mL, RR 15 bpm and I:E ratio 1:2) via a collecting filter distal to bronchi. Albuterol sulfate (2.5 mg/3 mL) was aerosolized with JN (Mistymax 10, Airlife) and MN with a prototype adaptor (Aeroneb Solo, Aerogen Ltd, Galway, Ireland) using mouthpiece, open aerosol mask, and valved-mask (n=3). The valved-mask was a modified non-rebreathing oxygen mask with one-way valves on ports on both sides of the mask. The JN was operated at 10 L/min while the MN with adapter was used with supplemental oxygen of 2 lpm. Drug was eluted from the filter and analyzed via spectrophotometry. Descriptive statistics and ANOVA were used (p<0.05).

RESULTS: The percent of dose deposited distal to the bronchi (mean ± SD) with the JN was greater with the valved-mask (8.63 ± 0.22) and mouthpiece (7.66 ± 0.62) than open aerosol mask (6.84 ± 0.49). When supplemental oxygen of 2 lpm was used with MN, aerosol deposition with MN was similar with mouthpiece and valved-mask (15.42 ± 1.41 and 15.15 ± 1.05, respectively), but 50% lower with the open aerosol mask (7.54 ± 0.39; p=0.0001). Delivery efficiency of MN was two-fold more than JN with mouthpiece or valved-mask (p=0.01 and p=0.01, respectively). Without supplemental oxygen, MN with mouthpiece achieved up to 30% inhaled mass.

CONCLUSIONS: The MN with adapter was more efficient than JN with both mouthpiece and valved-mask, while the open aerosol mask was delivered the least drug independent of nebulizer used in this study.

CLINICAL IMPLICATIONS: Selection of nebulizer and interface for aerosol therapy has a large impact on the amount of drug inhaled.

DISCLOSURE: James Fink: Consultant fee, speaker bureau, advisory committee, etc.: Bayer, Boerhinger Ingleheim, Cubist, Dance Biopharm, Novartis, ONY, Parion, Aridis, and the WHO The following authors have nothing to disclose: Arzu Ari, Armele Dornelas de Andrade

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