TY - JOUR T1 - Evaluation of aerosol drug delivery with concurrent low- and high-flow nasal oxygen JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00220-2022 VL - 8 IS - 4 SP - 00220-2022 AU - Barry Murphy AU - Marc Mac Giolla Eain AU - Mary Joyce AU - James B. Fink AU - Ronan MacLoughlin Y1 - 2022/10/01 UR - http://openres.ersjournals.com/content/8/4/00220-2022.abstract N2 - Question addressed by study Administration of aerosol to patients receiving high-flow nasal oxygen (HFNO) ranges from concurrent aerosol delivery by mouthpiece to aerosol via cannula alone. This study examines the conditions to provide optimal aerosol delivery with low- or high-flow nasal oxygen with concurrent mouthpiece or through nasal cannula alone, and the impact on fugitive aerosols.Materials and methods A vibrating mesh nebuliser delivered salbutamol via mouthpiece, aerosol holding chamber and nasal cannula to an adult head model simulating relaxed breathing. The mean±sd inhaled dose (%) was assayed from a filter distal to the trachea. Optical particle sizers were used to measure fugitive aerosol concentrations during aerosol delivery.Results Concurrent low-flow nasal oxygen (LFNO) and aerosol delivery with a mouthpiece and aerosol holding chamber increased the inhaled dose (%) available, 31.44±1.33% when supplemented with 2 L·min−1 of nasal oxygen. Concurrent HFNO above 30 L·min−1 resulted in a lower inhaled dose (%) compared to aerosol delivered through HFNO alone. The addition of concurrent LFNO or HFNO resulted in no increase in aerosol levels in the test room.Answer to question posed Concurrent LFNO with a mouthpiece and aerosol holding chamber is an effective and safe means of aerosol delivery.Concurrent low- and high-flow nasal oxygen cannula used with a mouthpiece and aerosol holding chamber is a safe and effective means of aerosol drug delivery in a spontaneously breathing simulated adult patient model https://bit.ly/3zmV2W1 ER -