Respiratory Care |

Aerosol Delivery With Jet and Mesh Nebulizers Using Different Masks in Spontaneously Breathing Infants: An In Vitro Study 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):540A. doi:10.1378/chest.1814878
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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: Inhaled drug delivery to infants varies with type of nebulizer and interface used during aerosol therapy. The purpose of this study was to quantify aerosol delivery with a jet nebulizer (JN) and mesh nebulizer (MN) with a prototype adaptor using a variety of masks in a simulated spontaneously breathing infant.

METHODS: A teaching manikin was connected to a sinusoidal pump simulating a spontaneously breathing infant/toddler (Vt 150 mL, RR 25 bpm and I:E ratio 1:2) via a collecting filter at the level of the trachea. Albuterol sulfate (2.5 mg/3 mL) was aerosolized with JN (Mistymax 10, Airlife) or MN with a prototype adaptor (Aeroneb Solo, Aerogen Ltd, Galway, Ireland) using the dragon mask, open aerosol mask, and valved-mask. The JN was operated at 10 L/min while the MN with adapter was used with supplemental oxygen of 2 lpm. A valved-mask was prepared by modifying a non-rebreathing oxygen mask with one-way valves on ports on both sides of the mask. Drug was eluted from the filter and analyzed via spectrophotometry. Descriptive statistics, dependent t-test and one-way analysis of variance were used for data analysis at the significant level of 0.05.

RESULTS: The percent of dose deposited (mean ± SD) distal to the trachea was greatest with MN via valved-mask (11.1 ± 0.7%) than the dragon mask (6.4 ± 0.3%; p= 0.002) and open aerosol mask (4.6 ± 0.4; p=0.002), while the dragon mask was more efficient than the open aerosol mask (p=0.009). JN was less efficient than MN with the valved-mask (5.3 ± 0.8; p=0.002) and trended lower with the dragon mask (4.7 ± 0.9) and open aerosol mask (4.1 ± 0.3%).

CONCLUSIONS: Delivery efficiency of JN was less than MN with adapter regardless of the type of mask tested in this study. MN with adapter with the valved-mask delivered > 2 fold more drug than JN with any interface used in this study.

CLINICAL IMPLICATIONS: Selection of both aerosol generator and interface can make a large difference in aerosol drug delivery to children.

DISCLOSURE: James Fink: Consultant fee, speaker bureau, advisory committee, etc.: Aerogen, 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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