Abstract
What is the delivered dose with jet (JN) and mesh nebulizers (MN) during spontaneous breathing (SB), noninvasive ventilation (NIV), and mechanical ventilation (MV) using an adult lung model with exhaled humidity (EH)? Albuterol sulfate (2.5 mg·3 mL−1) delivery with JN (Mistymax10) and MN (AerogenSolo) was compared during SB, NIV, and MV using breathing parameters (Vt=450 mL, RR=20 bpm, I:E=1:3) with three lung models simulating EH. A manikin was attached to a sinusoidal pump via a filter at the bronchi to simulate an adult with SB. A ventilator (V60) was attached via a facemask to a manikin with a filter at the bronchi connected to a test lung to simulate an adult receiving NIV. A ventilator-dependent adult was simulated through a ventilator (Servo i) operated with a heated humidifier (Fisher&Paykel) attached to an ETT with a heated-wire circuit. The ETT was inserted into a filter (RespirgardII). A heated humidifier was placed between the filter and test lung to simulate EH (35±2° C, 100% RH). Nebulizers were placed at the Y-piece of the inspiratory limb during MV and positioned between the facemask and the leak-port during NIV. A mouthpiece was used during SB. The delivered dose was collected in an absolute filter that was attached to the bronchi of the mannequin during each aerosol treatment and measured with spectrohoptometry. Drug delivery during MV was significantly greater than NIV and SB with MN (p=0.0001) but not with JN (p=0.384). Delivery efficiency of MN was greater than JN during MV (p=0.0001), NIV (p=0.0001), and SB (p=0.0001). Drug delivery with MN was greater and differed between MV, NIV, and SB, while deposition was low with JN and similar between the modes of ventilation tested.
Footnotes
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Conflict of interest: Dr. ARI reports personal fees from Aerogen Ltd, personal fees from Phillips Healthcare, during the conduct of the study.
Conflict of interest: Dr. Fink is CSO of Aerogen Pharma Company.
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- Received January 13, 2021.
- Accepted April 20, 2021.
- Copyright ©The authors 2021
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