0
Respiratory Care |

Quantifying Aerosol Delivery in Spontaneously Breathing Patients With Tracheostomy Using Different Humidification Systems With or Without Exhaled Humidity

Arzu Ari, PhD; James Fink, PhD
Author and Funding Information

Georgia State University, Atlanta, GA


Chest. 2014;145(3_MeetingAbstracts):539A. doi:10.1378/chest.1814962
Text Size: A A A
Published online

Abstract

SESSION TITLE: Respiratory Support Posters

SESSION TYPE: Poster Presentations

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

PURPOSE: Aerosol and humidification therapy are used in long-term airway management of critically ill patients with tracheostomy. The purpose of this study was to determine delivery efficiency of jet (JN) and mesh (MN) nebulizers combined with various humidification systems in a spontaneously breathing adult lung model with tracheostomy with or without exhaled humidity.

METHODS: An in-vitro model was constructed to simulate spontaneously breathing adults (Vt: 400 mL, RR:20 bpm, and I:E ratio 1:2) with tracheostomy using a teaching manikin attached to a test lung through a collecting filter (Respirgard II, Vital Signs). Exhaled heat and humidity was simulated using a cascade humidifier set to deliver 37 °C and >95% relative humidity. Albuterol sulfate (2.5mg/3mL) was administered through JN (Misty Max, Airlife) and MN (Aeroneb Solo, Aerogen) using heated humidifier (HH), unheated large volume humidifier (LVH) at 40 lpm output and heat-moisture exchanger (HME). Inhaled drug was collected on a filter during each experiment and analyzed via spectrophotometry (276 nm).

RESULTS: Percentage of dose (mean ± SD ) delivered distal to the trachea with JN (from 1.4 to 6.6%) and was less than MN ( 2.1 - 17.7%) under all conditions (p<0.05). Independent of nebulizer used, delivery was greatest in room air and lowest when HH with higher flows. Exhaled humidity decreased drug delivery up to 40%.

CONCLUSIONS: Use of supplemental gas flow during aerosol can reduce inhaled dose with both JN and MN. This model simulating exhaled humidity demonstrated a reduction in drug delivery compared to models with nonheated/humidified exhalation.

CLINICAL IMPLICATIONS: Selection of aerosol devices for use with various HH, LVH and HMEs can make up to 10 fold difference in inhaled medical aerosols. Models that do not simulate exhaled humidity may over estimate delivered dose up to 40%.

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

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543