TY - JOUR T1 - SCINTIGRAPHIC ASSESSMENT OF RADIOAEROSOL PULMONARY DEPOSITION THROUGH ACAPELLA DEVICE WITH DIFFERENT NEBULISER CONFIGURATIONS JF - Respiratory Care DO - 10.4187/respcare.02291 SP - respcare.02291 AU - Fabrício O S Mesquita AU - Valdecir C Galindo-Filho AU - João Luis F Neto AU - André M. Galvão AU - James B Fink AU - Armèle Dornelas-de-Andrade Y1 - 2013/08/06 UR - http://rc.rcjournal.com/content/early/2013/08/06/respcare.02291.abstract N2 - Background: Acapella® 27 produces high frequency oscillations and positive expiratory pressure (HFOPEP) for use in bronchial hygiene. However, its performance in aerosol delivery has not been described. The aim of this study was to evaluate the effect of nebulizer configuration in relation to the HFOPEP device on deposition of radiotagged aerosols with healthy subjects. Methods: 10 healthy male subjects (mean age of 24.4±2.2 years) participated in a crossover study that compared pulmonary delivery of 4 mL of Tc99m— DTPA(25mCi) and 0.9% saline solution via jet nebulizer with the following configurations: A—nebulizer attached to the distal end of equipment (distal); B -nebulizer placed between the mouthpiece and the device (proximal); and C -inhalation with the nebulizer alone (control). Scintigraphy was performed to count radioaerosol particles deposited in the regions of interest (ROI) in both lungs in vertical (upper, middle, lower) and horizontal (central, intermediate, peripheral) gradients. Results: Deposition between the right and left lungs was similar, with no significant differences between device configurations. Lung deposition was less with A compared to B (p=.001, for both lungs), and C (p=.003 and p=.001, right and left lungs, respectively). No differences were found between configurations B and C. Vertical gradient demonstrated lower deposition with A in comparison to B (upper, p<.0001; middle, p=.001 and lower regions, p=.003) and configuration C (both upper and middle, p=.001; lower regions, p=.002) with up to a 3 fold difference in the middle lower regions. Horizontal gradient also showed a lower deposition in configuration A when compared to B (central,p<.0001 and peripheral,p=.0002) and C (central and peripheral, p=0.002) differences of 3-4 fold were observed in the central and peripheral regions. Conclusion: Placement of jet nebulizer distal to the HFOPEP devise is recommended by the manufacturer decreased intrapulmonary deposition compared placement of the nebulizer between device and the patient airway or the nebulizer alone. ER -