PT  - JOURNAL ARTICLE
AU  - Michael C Quong
AU  - Bernard Thébaud
AU  - Warren H Finlay
TI  - A Method for Increasing Jet Nebulizer Delivery Efficiency for Aerosol Drug Delivery in Ventilated Newborns: An In Vitro Study
DP  - 2006 Nov 01
TA  - Respiratory Care
PG  - 1244--1250
VI  - 51
IP  - 11
4099  - http://rc.rcjournal.com/content/51/11/1244.short
4100  - http://rc.rcjournal.com/content/51/11/1244.full
AB  - BACKGROUND: A substantial percentage of the aerosol produced by a nebulizer is lost down the expiratory limb of the ventilator circuit. We describe a method for the capture, return, and reaerosolization of that undelivered aerosol. METHODS: We designed an expiratory-limb setup in which an “entraining jet” of gas accelerates unused aerosol and propels it toward an impaction surface. The deposited solution is then returned to the nebulizer reservoir via a feedback tube. As a result, more of the initial dose is delivered to the patient. The fraction of the dose delivered to a filter connected to a passive neonatal test lung was measured with and without the aerosol-recycling components activated. We used a ΔP (difference between the peak inspiratory pressure and the positive-end-expiratory pressure) of approximately 7.5 cm H2O, tidal volume of approximately 6 mL, respiratory rate of 40 breaths/min, and an inspiratory-expiratory ratio of 1:2.3. RESULTS: There was a statistically significant improvement with the feedback return to the reservoir, with up to nearly 60% more aerosol delivered. CONCLUSION: This improvement in aerosol delivery is encouraging, but more comprehensive studies are needed before such a device could be implemented clinically.