RT Journal Article
SR Electronic
T1 Aerosol Delivery to Simulated Spontaneously Breathing Tracheostomized Adult Model With and Without Humidification
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.11495
DO 10.4187/respcare.11495
A1 AlBuainain, Fai
A1 Li, Jie
YR 2024
UL http://rc.rcjournal.com/content/early/2024/03/14/respcare.11495.abstract
AB Background: The optimal aerosol delivery methods for tracheostomized spontaneously breathing patients remain unclear. Thus, we aimed to assess the impact of nebulizer placement, flow settings, and interfaces on aerosol delivery using a vibrating mesh nebulizer (VMN) and jet nebulizer (JN) in-line with unheated humidification.Methods: An 8.0 mm tracheostomy tube (TT) was connected to the lung model simulating adult breathing parameters via a collecting filter. Albuterol sulfate (2.5mg/3mL) was administered via VMN and JN, which was placed in-line with unheated humidification provided by a large volume nebulizer (LVN) with FIO2 set at 0.28, with gas flows of 2 vs. 6 L/min. Nebulizers were placed in-line distal and proximal to the lung model, using trach collar (TC) and T-piece (TP). A conventional nebulization was tested using VMN and JN directly connected to TT without unheated humidification. Drug was eluted from the collecting filter, assayed with ultraviolet spectrophotometry (276 nm).Results: During in-line nebulizer placement with unheated humidification, inhaled dose was 2–4 times higher with gas flow of 2 vs. 6 L/min, regardless of nebulizer type, placement and interfaces (all P < .01). At 6 L/min, inhaled dose was higher with proximal than distal placement using both interfaces, but at 2 L/min the inhaled dose tended to be lower with proximal placement. With JN, the TC generated a higher inhaled dose at proximal placement compared to the TP, whereas TP gave a higher inhaled dose than TC with distal placement, regardless of the flow settings. Compared to conventional nebulization using VMN, in-line VMN with LVN at 2 L/min had an inhaled dose similar, regardless of nebulizer placement and interfaces. In contrast, in-line JN was influenced by both placement and interface.Conclusion: Aerosol delivery in-line VMN and JN with unheated humidification was affected by nebulizer placement, interface, and gas flow settings.